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评价阿尼鲁单抗治疗系统性红斑狼疮的安全性:一项荟萃分析和系统评价。

Evaluation of anifrolumab safety in systemic lupus erythematosus: A meta-analysis and systematic review.

机构信息

Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.

Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Immunol. 2022 Sep 23;13:996662. doi: 10.3389/fimmu.2022.996662. eCollection 2022.

Abstract

OBJECTIVES

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, and type I interferon plays an important role in its pathogenesis. Anifrolumab is a new strategy for the treatment of systemic lupus erythematosus. It could antagonize the activity of all type 1 interferons by binding with type I interferon receptor subunit 1. The aim of our study was to evaluate the safety of anifrolumab in patients with moderate to severe SLE (excluding patients with active severe lupus nephritis or central nervous system lupus).

METHODS

Four databases (Embase, Cochrane, PubMed, Web of Science) were systematically searched from inception until December 2021 for randomized controlled trials (RCTs) evaluating the safety of anifrolumab versus placebo in SLE patients. Then, the incidence of adverse events in each study was aggregated using meta-analysis.

RESULTS

A total of 1160 SLE patients from four RCTs were included in the analysis. Serious adverse events were less common in the anifrolumab group than in the placebo group (RR: 0.76, 95% CI: 0.59-0.98, p<0.03). The most common adverse events included upper respiratory tract infection (RR: 1.48, 95% CI: 1.13-1.94, P=0.004), nasopharyngitis (RR: 1.66, 95% CI: 1.25-2.20, P=0.0004), bronchitis (RR: 1.96, 95% CI: 1.32-2.92, P=0.0009), and herpes zoster (RR: 3.40, 95% CI: 1.90-6.07, P<0.0001).

CONCLUSION

Anifrolumab is considered a well-tolerated option for the treatment of SLE patients with good safety.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com, identifier 202230054.

摘要

目的

系统性红斑狼疮(SLE)是一种慢性自身免疫性疾病,Ⅰ型干扰素在其发病机制中发挥重要作用。阿尼鲁单抗是一种治疗系统性红斑狼疮的新策略。它可以通过与Ⅰ型干扰素受体亚单位 1 结合来拮抗所有Ⅰ型干扰素的活性。我们的研究目的是评估阿尼鲁单抗在中重度 SLE 患者(不包括有活动性严重狼疮肾炎或中枢神经系统狼疮的患者)中的安全性。

方法

从建库至 2021 年 12 月,我们系统性地检索了 Embase、Cochrane、PubMed 和 Web of Science 这四个数据库,以评估阿尼鲁单抗与安慰剂在 SLE 患者中的安全性的随机对照试验(RCT)。然后,使用荟萃分析汇总每个研究中的不良事件发生率。

结果

共有来自四项 RCT 的 1160 例 SLE 患者纳入分析。阿尼鲁单抗组的严重不良事件发生率低于安慰剂组(RR:0.76,95%CI:0.59-0.98,p<0.03)。最常见的不良事件包括上呼吸道感染(RR:1.48,95%CI:1.13-1.94,P=0.004)、鼻咽炎(RR:1.66,95%CI:1.25-2.20,P=0.0004)、支气管炎(RR:1.96,95%CI:1.32-2.92,P=0.0009)和带状疱疹(RR:3.40,95%CI:1.90-6.07,P<0.0001)。

结论

阿尼鲁单抗被认为是一种治疗 SLE 患者的耐受性良好的选择,具有良好的安全性。

系统评价注册

https://inplasy.com,标识符 202230054。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a79a/9537685/d049270305b0/fimmu-13-996662-g001.jpg

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