Szebényi Júlia, Gede Noémi, Hegyi Péter, Szakács Zsolt, Solymár Margit, Erőss Bálint, Garami András, Farkas Kornélia, Csupor Dezső, Gyulai Rolland
Department of Dermatology, Venereology and Oncodermatology, Medical School, University of Pécs, 7622 Pécs, Hungary.
Acta Derm Venereol. 2020 Nov 12;100(18):adv00318. doi: 10.2340/00015555-3640.
The comparative efficacy of registered anti-psoriatic biologics and small molecules in treating nail symptoms has not been systematically evaluated. The aim of this study was to perform a network meta-analysis to determine the efficacy of biologics and small mole-cules in nail psoriasis. A Bayesian network meta- analysis of 17 randomized clinical trials (a total of 6,053 nail psoriatic patients) was performed, comparing the short-term (week 10-16) efficacy of biologics and small molecules in the treatment of nail psoriasis. All active treatments were found to be superior to place-bo. Ixekizumab 80 mg every 4 weeks (Nail Psoriasis Severity Index (NAPSI) % improvement, Surface Under the Cumulative Ranking (SUCRA)=0.92) and etanercept 50 mg twice weekly (probability of achiev-ing NAPSI 50, SUCRA=0.82) proved the best short-term treatment options. However, efficacy end-points in psoriasis trials were not optimized for nail assessment, and outcome parameters were highly heterogeneous, limiting comparability. In conclusion, outcome parameters and efficacy endpoints of nail psoriasis trials should be standardized.
已注册的抗银屑病生物制剂和小分子药物在治疗指甲症状方面的相对疗效尚未得到系统评估。本研究的目的是进行一项网络荟萃分析，以确定生物制剂和小分子药物治疗指甲银屑病的疗效。对17项随机临床试验（共6053例指甲银屑病患者）进行了贝叶斯网络荟萃分析，比较了生物制剂和小分子药物治疗指甲银屑病的短期（第10 - 16周）疗效。发现所有活性治疗均优于安慰剂。每4周注射80mg的司库奇尤单抗（指甲银屑病严重程度指数（NAPSI）改善百分比，累积排序曲线下面积（SUCRA）=0.92）和每周两次注射50mg的依那西普（实现NAPSI改善50%的概率，SUCRA=0.82）被证明是最佳的短期治疗选择。然而，银屑病试验中的疗效终点并非针对指甲评估进行优化，且结局参数高度异质性，限制了可比性。总之，指甲银屑病试验的结局参数和疗效终点应标准化。
