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一项关于 risankizumab 和 ustekinumab 治疗银屑病疗效和安全性的系统评价和荟萃分析。

A Systematic Review with Meta-Analysis of Comparative Efficacy and Safety of Risankizumab and Ustekinumab for Psoriasis Treatment.

机构信息

Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075 Sichuan Province, China.

出版信息

J Immunol Res. 2022 Aug 18;2022:2802892. doi: 10.1155/2022/2802892. eCollection 2022.

DOI:10.1155/2022/2802892
PMID:36033390
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9410857/
Abstract

Biological targeted therapy serves as a new alternative treatment for psoriasis due to its minimal side effects. This study is aimed at examining the drug effectiveness and safety of risankizumab and ustekinumab for psoriasis treatment, so as to provide a reference for clinical decision-making. Databases from Embase, Web of Science, PubMed, and Cochrane Library were gathered, starting from inception to March 1, 2022, for randomized controlled trials regarding risankizumab and ustekinumab for psoriasis treatment. All retrieved articles were carefully selected in strict accordance with a set of inclusion and exclusion criteria. Stata 15.0 and RevMan 5.4 were applied to perform meta-analysis and risk of bias assessment. A total of two trials with three NCTs were selected, with 384 participants in the risankizumab group and 140 participants in ustekinumab. Meta-analysis showed that in the long-term and short-term PASI100, risankizumab was more effective than ustekinumab (RR = 2.27, 95% CI (1.77, 2.90), < 0.05; RR = 2.33, 95% CI (1.75, 3.08), < 0.05). In PASI90, RR = 1.77, 95% CI (1.54, 2.03), and < 0.05 and RR = 1.72, 95% CI (1.48, 2.00), and < 0.05. In short-term PASI75, RR = 1.23, 95% CI (1.13, 1.34), and < 0.05. In sPGA of 0, the results at week-16 and week-52 showed that risankizumab was significantly more effective than ustekinumab (RR = 2.24, 95% CI (1.67, 3.01), < 0.05; RR = 2.30, 95% CI (1.80, 2.95), < 0.05). Risankizumab was significantly more effective than ustekinumab in improving the quality of life and PSS scores (RR = 1.48, 95% CI (1.26, 1.75), < 0.05; RR = 2.01, 95% CI (1.41, 2.85), < 0.05). Nevertheless, risankizumab and ustekinumab did not show significant difference in the incidence of adverse responses (RR = 1.02, 95% CI (0.75, 1.39), > 0.05). Risankizumab was more effective than ustekinumab for the treatment of psoriasis. The adverse reactions of both risankizumab and ustekinumab were similar and could be tolerated. Risankizumab might be a better alternative option for their treatment.

摘要

生物靶向治疗因其副作用极小，成为治疗银屑病的一种新的替代疗法。本研究旨在考察 risankizumab 和 ustekinumab 治疗银屑病的药物疗效和安全性，为临床决策提供参考。从建库至 2022 年 3 月 1 日，检索 Embase、Web of Science、PubMed 和 Cochrane Library 数据库中有关 risankizumab 和 ustekinumab 治疗银屑病的随机对照试验。严格按照纳入和排除标准仔细筛选所有检索到的文章。采用 Stata 15.0 和 RevMan 5.4 进行荟萃分析和偏倚风险评估。共纳入 2 项试验 3 项 NCT04311258、NCT04322550 和 NCT04323101，risankizumab 组 384 例，ustekinumab 组 140 例。荟萃分析结果显示，在长期和短期 PASI100 方面，risankizumab 比 ustekinumab 更有效（RR=2.27，95%CI（1.77，2.90）， < 0.05；RR=2.33，95%CI（1.75，3.08）， < 0.05）。在 PASI90 方面，RR=1.77，95%CI（1.54，2.03）， < 0.05，RR=1.72，95%CI（1.48，2.00）， < 0.05。在短期 PASI75 方面，RR=1.23，95%CI（1.13，1.34）， < 0.05。在 sPGA 为 0 时，第 16 周和第 52 周的结果显示，risankizumab 比 ustekinumab 更有效（RR=2.24，95%CI（1.67，3.01）， < 0.05；RR=2.30，95%CI（1.80，2.95）， < 0.05）。在改善生活质量和 PSS 评分方面，risankizumab 比 ustekinumab 更有效（RR=1.48，95%CI（1.26，1.75）， < 0.05；RR=2.01，95%CI（1.41，2.85）， < 0.05）。然而，risankizumab 和 ustekinumab 的不良反应发生率无显著差异（RR=1.02，95%CI（0.75，1.39）， > 0.05）。与 ustekinumab 相比，risankizumab 治疗银屑病更有效。risankizumab 和 ustekinumab 的不良反应相似，均可耐受。risankizumab 可能是其治疗的更好选择。

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