He Chongru, Xue Chenchen, Zhu Ge, Kang Pengde
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China.
Department of Orthopedics, Changhai Hospital Affliated to The Second Military Medical University, Shanghai, China.
J Clin Pharm Ther. 2021 Aug;46(4):895-906. doi: 10.1111/jcpt.13416. Epub 2021 Mar 25.
To assess the efficacy and safety of interleukin-17 inhibitors (ixekizumab, secukinumab, bimekizumab, netakimab and brodalumab) in chronic inflammatory rheumatic diseases, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
A comprehensive search for randomized controlled trials (RCTs) evaluating efficacy and safety of interleukin-17 inhibitors was performed through PubMed, Embase and Cochrane Library databases. Quality assessment was performed using the Cochrane Collaboration risk of bias tool. Data were pooled using the fixed or random-effects models.
Twenty RCTs were identified: of these 9 studies on patients with AS and 11 studies on patients with PsA. Concerning clinical efficacy, a pooled analysis showed interleukin-17 inhibitors had a higher response rate for the primary endpoint (p < 0.05) and secondary endpoint (p < 0.05) at the treatment endpoint for AS/PsA patients. Moreover, an increased risk of treatment-emergent adverse events and infection was found in AS patients (p < 0.05). In contrast, no increased risk of any adverse events was reported in PsA patients.
In this meta-analysis, our findings found interleukin-17 inhibitors had a significant clinical benefit in the management of AS/PsA patients.
评估白细胞介素-17抑制剂（司库奇尤单抗、苏金单抗、比美吉珠单抗、奈他珠单抗和布罗达单抗）在慢性炎症性风湿性疾病中的疗效和安全性，包括强直性脊柱炎（AS）和银屑病关节炎（PsA）。
通过PubMed、Embase和Cochrane图书馆数据库全面检索评估白细胞介素-17抑制剂疗效和安全性的随机对照试验（RCT）。使用Cochrane协作偏倚风险工具进行质量评估。采用固定效应或随机效应模型汇总数据。
共纳入20项RCT：其中9项针对AS患者，11项针对PsA患者。关于临床疗效，汇总分析显示白细胞介素-17抑制剂在AS/PsA患者治疗终点时，主要终点（p<0.05）和次要终点（p<0.05）的缓解率更高。此外，AS患者出现治疗中出现的不良事件和感染的风险增加（p<0.05）。相比之下，PsA患者未报告任何不良事件风险增加。
在这项荟萃分析中，我们的研究结果表明白细胞介素-17抑制剂在AS/PsA患者的治疗中具有显著的临床益处。
