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吸烟和/或曾吸烟的炎症性肠病患者使用肿瘤坏死因子拮抗剂治疗后银屑病的发病率:系统评价和荟萃分析。

The incidence of psoriasis among smokers and/or former smokers inflammatory bowel diseases patients treated with tumor necrosis factor antagonist: A systematic review and meta-analysis.

机构信息

The First Affiliated Hospital of China Medical University, No. 155, Beier Road, Nanjing Street, Shenyang City, Liaoning Province, China.

出版信息

Medicine (Baltimore). 2021 Oct 22;100(42):e27510. doi: 10.1097/MD.0000000000027510.

Abstract

BACKGROUND

Infliximab (IFX) and adalimumab (ADA) refer to the classic drugs to treat moderate-severe inflammatory bowel disease (IBD), which have been proven to be effective to control IBD. However, the side effects exerted by IFX and ADA should be monitored in therapies, especially the paradoxical reaction of the skin system (e.g., psoriasis). Psoriasis is recognized as the most common skin lesion, capable of significantly affecting the quality of patients' life.

METHODS

This study searched literatures published in English language with the qualifications on PubMed, Embase, Web of Science, Google, and Geenmedical databases. Over 2 co-authors assessed the quality of the articles and extracted the data independently. The data acquired were statistically analyzed with the statistical software of Revman and Stata.

RESULTS

The ADA Group achieved a higher incidence of psoriasis (odds ratio [OR] = 0.658, 95% confidence interval [CI] [0.471-0.919]); Females achieved a higher incidence of psoriasis than males (OR = 1.941, 95%CI [1.326-2.843], P < .05); Smoking up-regulated the incidence of psoriasis (OR = 1.679, 95%CI [1.237-2.279], P < .05); The interval of medication was over 1 year, and the interval of medication applying IFX was longer than that of the ADA Group; most cases could be relieved by using local hormone, phototherapy, or systemic hormone therapy under the strategy of biological agents.

CONCLUSIONS

The frequency of reported in IBD exceeds those of other autoimmune diseases, and the ADA treatment for IBD is safer than IFX. Psoriasis is more common in females than in males. Smoking refers to one of risk factors of psoriasis.

摘要

背景

英夫利昔单抗(IFX)和阿达木单抗(ADA)是治疗中重度炎症性肠病(IBD)的经典药物,已被证明可有效控制 IBD。然而,在治疗中应监测 IFX 和 ADA 的副作用,特别是皮肤系统的矛盾反应(例如,银屑病)。银屑病是最常见的皮肤病变,可显著影响患者的生活质量。

方法

本研究在 PubMed、Embase、Web of Science、Google 和 Geenmedical 数据库中搜索了以英文发表的文献。2 位以上作者评估了文章的质量,并独立提取了数据。使用 Revman 和 Stata 统计软件对获取的数据进行了统计分析。

结果

ADA 组银屑病的发病率较高(优势比 [OR] = 0.658,95%置信区间 [CI] [0.471-0.919]);女性银屑病的发病率高于男性(OR = 1.941,95%CI [1.326-2.843],P<.05);吸烟上调了银屑病的发病率(OR = 1.679,95%CI [1.237-2.279],P<.05);用药间隔超过 1 年,IFX 组用药间隔长于 ADA 组;大多数病例可通过生物制剂策略使用局部激素、光疗或全身激素治疗缓解。

结论

IBD 中报告的频率高于其他自身免疫性疾病,ADA 治疗 IBD 比 IFX 更安全。银屑病在女性中比男性更常见。吸烟是银屑病的危险因素之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9256/8542134/c85cb58291d0/medi-100-e27510-g001.jpg

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