Jin Xin-Xing, Wang Xue, Shan Ying, Li Si-Zhe, Xu Qun, Jin Hong-Zhong, Zuo Ya-Gang
Department of Dermatology, National Clinical Research Center for Dermatologic and Immunologic Diseases, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 1, shuaifuyuan hutong, Dongcheng district, Beijing, 100730, China.
Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Arch Dermatol Res. 2022 Mar;314(2):191-201. doi: 10.1007/s00403-021-02216-z. Epub 2021 Mar 28.
The aim of this review was to evaluate the efficacy and safety of tetracyclines for treatment of pemphigoid. We searched PubMed, EMBASE, Ovid, Web of Science, and the Cochrane Library for studies involving pemphigoid patients treated with tetracyclines published in English before 29 February 2020. References of included studies were also screened to widen the scope of the literature search. Data regarding predefined clinical outcomes of 341 patients from 77 studies were extracted and analyzed. A meta-analysis was conducted on the basis of 4 studies including 2 randomized controlled trials and 2 comparative studies. The patients had a mean age of 74.60 ± 13.18 years, 45.4% were males, and 54.6% were females. There were 185 patients with mild-to-moderate and 143 patients with severe disease. The average initial doses were 1.62 ± 0.39 g/day for tetracycline, 0.20 ± 0.01 g/day for doxycycline, and 0.11 ± 0.05 g/day for minocycline. The average time on tetracyclines was 3.74 ± 5.99 months, and 261 (81.3%) patients reported partial or complete remission. Relapses occurred in 72 (28.3%) cases. Adverse effects were experienced by 130 (41.9%) patients. The pooled ORs for short-term effectiveness, relapse, adverse effects, and 1-year survival in patients treated with oral tetracyclines vs. systemic corticosteroids were 0.40 (95% CI, 0.22-0.76), 0.69 (95% CI, 0.44-1.10), 0.47 (95% CI, 0.27-0.82) and 2.02 (95% CI, 1.16-3.50), respectively. Compared to doxycycline and minocycline, tetracycline was significantly associated with better treatment outcomes and fewer adverse effects (p < 0.05). This review revealed tetracyclines' efficacy and safety in pemphigoid treatment and may offer support for clinical use of tetracyclines in pemphigoid.
本综述的目的是评估四环素类药物治疗类天疱疮的疗效和安全性。我们检索了PubMed、EMBASE、Ovid、Web of Science和Cochrane图书馆，查找2020年2月29日前发表的涉及用四环素类药物治疗类天疱疮患者的英文研究。还对纳入研究的参考文献进行了筛选，以扩大文献检索范围。提取并分析了来自77项研究的341例患者的预定义临床结局数据。基于4项研究进行了荟萃分析，其中包括2项随机对照试验和2项比较研究。患者的平均年龄为74.60±13.18岁，男性占45.4%，女性占54.6%。有185例轻度至中度患者和143例重度患者。四环素的平均初始剂量为1.62±0.39克/天，强力霉素为0.20±0.01克/天，米诺环素为0.11±0.05克/天。使用四环素类药物的平均时间为3.74±5.99个月，261例（81.3%）患者报告部分或完全缓解。72例（28.3%）出现复发。130例（41.9%）患者出现不良反应。口服四环素类药物与全身用皮质类固醇治疗患者的短期疗效、复发、不良反应和1年生存率的汇总比值比分别为0.40（95%CI，0.22-0.76）、0.69（95%CI，0.44-1.10）、0.47（95%CI，0.27-0.82）和2.02（95%CI，1.16-3.50）。与强力霉素和米诺环素相比，四环素与更好的治疗效果和更少的不良反应显著相关（p<0.05）。本综述揭示了四环素类药物在治疗类天疱疮方面的疗效和安全性，可能为四环素类药物在类天疱疮临床应用中提供支持。
