抗生素或氨苯砜根除慢性自发性荨麻疹的效果：一项系统评价和荟萃分析。

The Effects of Antibiotics for Eradication or Dapsone on Chronic Spontaneous Urticaria: A Systematic Review and Meta-Analysis.

作者信息

Watanabe Jun, Shimamoto Junya, Kotani Kazuhiko

机构信息

Division of Community and Family Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City, Tochigi 329-0498, Japan.

出版信息

Antibiotics (Basel). 2021 Feb 4;10(2):156. doi: 10.3390/antibiotics10020156.

BACKGROUND

Chronic spontaneous urticaria (CSU) is a disease with wheals and/or angioedema. Some drugs, especially antibiotics for () eradication and the sulfone antibiotic dapsone, may be candidates for treating CSU. The present study assessed the efficacy of these antibiotic therapies for CSU.

METHODS

Databases (MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched until October 2020. Study selection, data abstraction and quality assessments were independently performed using the Grading of Recommendations Assessment, Development and Evaluation approach. The outcomes were the remission of CSU-related symptoms, activities and adverse events due to antibiotics for eradication or dapsone.

RESULTS

Nine randomized controlled trials (RCTs; 361 patients) were included. The antibiotics for eradication increased the remission rate (risk ratio (RR) = 3.99, 95% confidence interval (CI) = 1.31 to 12.14; I = 0%), but dapsone did not (RR = 1.15, 95% CI = 0.74 to 1.78). Antibiotics for eradication (standard mean difference (SMD) = 1.49, 95% CI = 0.80 to 2.18; I = 69%) and dapsone (SMD = 7.00, 95% CI = 6.92 to 7.08; I = 0%) improved symptoms. The evidence of certainty was moderate. Dapsone was associated with mild adverse events, whereas eradication was not.

CONCLUSION

Antibiotics, especially those for eradication, improved the remission rate and symptoms of CSU with few adverse events. Further studies are needed.

背景

慢性自发性荨麻疹（CSU）是一种出现风团和/或血管性水肿的疾病。一些药物，尤其是用于根除（此处原文括号内容缺失，无法准确翻译）的抗生素以及砜类抗生素氨苯砜，可能是治疗CSU的候选药物。本研究评估了这些抗生素疗法对CSU的疗效。

方法

检索数据库（MEDLINE、Cochrane对照试验中心注册库、EMBASE、世界卫生组织国际临床试验平台搜索门户和ClinicalTrials.gov）直至2020年10月。使用推荐分级评估、制定和评价方法独立进行研究选择、数据提取和质量评估。结局指标为根除（此处原文括号内容缺失，无法准确翻译）或氨苯砜治疗导致的CSU相关症状缓解、活动情况及不良事件。

结果

纳入了9项随机对照试验（RCTs；361例患者）。用于根除（此处原文括号内容缺失，无法准确翻译）的抗生素提高了缓解率（风险比（RR）=3.99，95%置信区间（CI）=1.31至12.14；I²=0%），但氨苯砜未提高（RR=1.15，95%CI=0.74至1.78）。用于根除（此处原文括号内容缺失，无法准确翻译）的抗生素（标准化均数差（SMD）=1.49，95%CI=0.80至2.18；I²=69%）和氨苯砜（SMD=7.00，95%CI=6.92至7.08；I²=0%）改善了症状。确定性证据为中等质量。氨苯砜与轻度不良事件相关，而根除（此处原文括号内容缺失，无法准确翻译）则不然。