Department of Dermatology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China.
Key Laboratory of Ethnomedicine Ministry of Education, School of Pharmacy, Minzu University of China, Beijing, China.
J Pharmacol Sci. 2019 Apr;139(4):289-303. doi: 10.1016/j.jphs.2018.12.006. Epub 2018 Dec 27.
This network meta-analysis was aimed to enhance the corresponding evidence with respect to the efficacy and safety of biologic treatments.
PubMed and EMBASE database searches were conducted. Odds ratios were used to evaluate multi-aspect comparisons. SUCRA was used to analyze the ranking of treatments in each endpoint. Psoriasis Area and Severity Index 50%, 75%, 90%, 100%, PGA, dermatology quality of life index were considered as outcomes while adverse events and discontinuation were adopted to evaluate safety.
For safety issues, briakinumab was associated with least headache and itolizumab had the lowest risk of infection. Ustekinumab performed best in discontinuation. SUCRA ranked briakinumab, brodalumab, Infliximab and ixekizumab as the favorable efficacy therapies, while briakinumab and brodalumab seemed to have mild side effects. No heterogeneity was observed between these comparisons.
Briakinumab performed relatively stable under efficacy and safety outcome. Infliximab can be a good choice for its lower risk of infection. Brodalumab present very good potential in efficacy outcome like PASI and PGA. More clinical trials are required to supply more data about discontinuation of infliximab and infection of brodalumab and larger RCT for assessment of briakinumab.
本网络荟萃分析旨在增强生物治疗疗效和安全性的相关证据。
对 PubMed 和 EMBASE 数据库进行检索。采用优势比评估多方面比较。采用 SUCRA 分析每个终点治疗的排名。采用银屑病面积和严重程度指数 50%、75%、90%、100%、PGA、皮肤病生活质量指数作为疗效指标，采用不良反应和停药来评估安全性。
在安全性方面，布罗利尤单抗引起头痛的风险最小，依奇珠单抗感染风险最低。乌司奴单抗停药率最低。布罗利尤单抗、司库奇尤单抗、英夫利昔单抗和依奇珠单抗在疗效方面排名较高，而布罗利尤单抗和司库奇尤单抗的副作用较轻。这些比较之间没有观察到异质性。
布罗利尤单抗在疗效和安全性方面表现相对稳定。英夫利昔单抗感染风险较低，是一个不错的选择。司库奇尤单抗在 PASI 和 PGA 等疗效指标方面表现出非常好的潜力。需要更多的临床试验来提供关于英夫利昔单抗停药和布罗利尤单抗感染的更多数据，以及更大规模的 RCT 来评估布罗利尤单抗。
