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抗白细胞介素-17A 单克隆抗体司库奇尤单抗治疗强直性脊柱炎的疗效和安全性:一项荟萃分析。

Efficacy and Safety of Anti-Interleukin-17A Monoclonal Antibody Secukinumab in Treatment of Ankylosing Spondylitis: A Meta-Analysis.

机构信息

Department of Neurosurgery, One Medical Center, Morgantown, West Virginia, USA.

Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain.

出版信息

Monoclon Antib Immunodiagn Immunother. 2020 Oct;39(5):160-166. doi: 10.1089/mab.2020.0022. Epub 2020 Oct 1.

Abstract

Different signaling pathways have been studied in ankylosing spondylitis. New treatment options such as secukinumab could have an important role inhibiting the release of proinflammatory cytokine IL-17. The aim of this study was to compare the efficacy and safety of secukinumab in ankylosing spondylitis. A systematic review was conducted using MEDLINE and EMBASE databases to identify randomized clinical trials (RCTs) that assess the role of secukinumab in ankylosing spondylitis. The variables were safety (total adverse events, serious adverse events, headache, nasopharyngitis, cough, deaths, discontinuation due to adverse events, candida, neutropenia, and diarrhea) and efficacy based on quality-of-life scores (ASAS 20, ASAS 40, ASAS 5/6, ASASPR). Three RCTs (770 patients) that compare secukinumab with placebo were included in the study. There were significant differences in the quality-of-life scores in favor of the secukinumab group ( < 0.05). Regarding the adverse events, there were higher rates of any adverse events in the secukinumab group ( < 0.05). Also, the secukinumab group showed a higher rate of nasopharyngitis and diarrhea ( < 0.05). The use of secukinumab in ankylosing spondylitis increased the quality of life and had more adverse events rate compared with placebo.

摘要

已有研究探讨了不同的信号通路在强直性脊柱炎中的作用。新型治疗选择如司库奇尤单抗可能在抑制促炎细胞因子 IL-17 的释放方面发挥重要作用。本研究旨在比较司库奇尤单抗在强直性脊柱炎中的疗效和安全性。通过 MEDLINE 和 EMBASE 数据库进行系统评价,以确定评估司库奇尤单抗在强直性脊柱炎中作用的随机临床试验(RCT)。变量包括安全性(总不良事件、严重不良事件、头痛、鼻咽炎、咳嗽、死亡、因不良事件停药、念珠菌病、中性粒细胞减少症和腹泻)和基于生活质量评分的疗效(ASAS 20、ASAS 40、ASAS 5/6、ASASPR)。本研究纳入了 3 项比较司库奇尤单抗与安慰剂的 RCT(770 例患者)。司库奇尤单抗组在生活质量评分方面具有显著优势( < 0.05)。关于不良事件,司库奇尤单抗组的任何不良事件发生率更高( < 0.05)。此外,司库奇尤单抗组还显示出更高的鼻咽炎和腹泻发生率( < 0.05)。与安慰剂相比,司库奇尤单抗在强直性脊柱炎中的应用提高了生活质量,且不良事件发生率更高。

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