Chen Pengfei, Chen Xiubing, Lei Lei, Zhang Yang, Xiang Jianjun, Zhou Jinxia, Lv Jun
Department of Gastroenterology, The Central Hospital of Enshi Autonomous Prefecture, Enshi.
Department of Gastroenterology, The First People's Hospital of Qinzhou, Qinzhou.
Medicine (Baltimore). 2020 Aug 7;99(32):e21549. doi: 10.1097/MD.0000000000021549.
Pioglitazone may have potential benefits in the treatment of cutaneous and metabolic derangements of psoriasis, but its role in the treatment of psoriasis remains in debate. We therefore conducted a meta-analysis to evaluate the clinical efficacy and safety of pioglitazone in psoriasis vulgaris (PsV).We performed a comprehensive search in database of PubMed, Web of Science, Cochrane library, Embase and China National Knowledge Infrastructure (CNKI), and Wan fang database through March 2019 to identify eligible studies. Randomized controlled trials that have evaluated the effect and safety of pioglitazone in PsV were included. Treatment success was defined as ≥75% reduction in psoriasis area and severity index (PASI) score after treatment. Weighted mean differences (WMD), relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were pooled to compare the clinical efficacy and safety between different groups.Six randomized controlled trials (n = 270) were included. Meta-analysis showed that pioglitazone was associated with a remarkable reduction in PASI score in patients with PsV (weight mean difference: 2.68, 95% CI 1.41-3.94, P < .001). The treatment success rate in the pioglitazone group was higher than in the control group (RR 3.60, 95 CI 1.61-8.01, P < .001). Compared with control group, pioglitazone was not related to a pronounced increase in total adverse events (RR 1.180, 95 CI 0.85-1.63, P = .33). Moreover, the risk of common adverse events in the 2 groups were similar, such as elevated liver enzyme, fatigue, nausea, weight gain.This meta-analysis suggested pioglitazone is an effective and safe drug in the treatment of patients with PsV.
吡格列酮在治疗银屑病的皮肤和代谢紊乱方面可能具有潜在益处，但其在银屑病治疗中的作用仍存在争议。因此，我们进行了一项荟萃分析，以评估吡格列酮治疗寻常型银屑病（PsV）的临床疗效和安全性。我们在PubMed、Web of Science、Cochrane图书馆、Embase和中国知网（CNKI）以及万方数据库中进行了全面检索，截至2019年3月，以确定符合条件的研究。纳入评估吡格列酮在PsV中的疗效和安全性的随机对照试验。治疗成功定义为治疗后银屑病面积和严重程度指数（PASI）评分降低≥75%。汇总加权平均差（WMD）、相对风险（RRs）及相应的95%置信区间（CIs），以比较不同组之间的临床疗效和安全性。纳入了6项随机对照试验（n = 270）。荟萃分析表明，吡格列酮与PsV患者的PASI评分显著降低相关（加权平均差：2.68，95%CI 1.41 - 3.94，P <.001）。吡格列酮组的治疗成功率高于对照组（RR 3.60，95 CI 1.61 - 8.01，P <.001）。与对照组相比，吡格列酮与总不良事件的显著增加无关（RR 1.180，95 CI 0.85 - 1.63，P =.33）。此外，两组常见不良事件的风险相似，如肝酶升高、疲劳、恶心、体重增加。这项荟萃分析表明，吡格列酮是治疗PsV患者的一种有效且安全的药物。
