Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China.
Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Clin Rheumatol. 2021 Aug;40(8):3053-3065. doi: 10.1007/s10067-020-05545-y. Epub 2021 Jan 12.
To assess the efficacy and safety of interleukin (IL)-17A inhibitors in patients with ankylosing spondylitis (AS). PubMed, EMBASE, and Web of Science were searched up to 5 February 2020 for randomized controlled trials (RCTs) that assessed the efficacy and safety of IL-17A inhibitors in patients with AS. We used a meta-analytic approach to perform a random effects analysis or fixed effects analysis according to heterogeneity. Subgroup analyses between studies included medication, time to primary endpoint, and data source. Odds ratios (ORs) or mean differences (MDs) were used to assess the efficacy and safety of IL-17A inhibitors in AS. A total of ten RCTs with 2613 patients were eligible for inclusion in the analysis (six for secukinumab, two for ixekizumab, one for netakimab, and one for bimekizumab). Compared to placebo, IL-17A inhibitors improved ASAS20 response rate (OR = 2.58; p < 0.01) and ASAS40 response rate (OR = 2.80; p < 0.01), and significantly increased the risk of AEs (OR = 1.23; p = 0.03) and nasopharyngitis (OR = 1.72; p < 0.01), but not SAEs (OR = 0.87; p = 0.60). IL-17A inhibitors demonstrated better efficacy in patients with AS in several evaluation indicators. However, the safety of IL-17A inhibitors remains to be further studied in studies with larger sample size and longer follow-up times.
评估白细胞介素(IL)-17A 抑制剂在强直性脊柱炎(AS)患者中的疗效和安全性。PubMed、EMBASE 和 Web of Science 数据库检索截至 2020 年 2 月 5 日的随机对照试验(RCT),评估 IL-17A 抑制剂在 AS 患者中的疗效和安全性。我们使用荟萃分析方法,根据异质性进行随机效应分析或固定效应分析。研究间的亚组分析包括药物、主要终点时间和数据来源。使用比值比(OR)或均数差(MD)评估 IL-17A 抑制剂在 AS 中的疗效和安全性。共有 10 项 RCT(6 项 secukinumab、2 项 ixekizumab、1 项 netakimab、1 项 bimekizumab)纳入分析,共 2613 例患者。与安慰剂相比,IL-17A 抑制剂改善了 ASAS20 反应率(OR=2.58;p<0.01)和 ASAS40 反应率(OR=2.80;p<0.01),显著增加了不良事件(AE)(OR=1.23;p=0.03)和鼻咽炎(OR=1.72;p<0.01)的风险,但不增加严重不良事件(SAE)(OR=0.87;p=0.60)的风险。IL-17A 抑制剂在多个评估指标中显示出更好的疗效。然而,IL-17A 抑制剂的安全性仍需在更大样本量和更长随访时间的研究中进一步研究。