Division of Rheumatology and Nephrology, Children's Medical Center, The Second Xiangya Hospital, Central South University,Changsha, China.
Clin Exp Rheumatol. 2023 Sep;41(9):1882-1900. doi: 10.55563/clinexprheumatol/2xjg0d. Epub 2023 Mar 7.
Abatacept (Orencia) is a drug used to treat patients with rheumatoid arthritis. The agent improves patients' pain and joint inflammation through modulation of a co-stimulatory signal necessary for T cell activation. We aimed to analyse the efficacy and safety of abatacept in the management of rheumatoid arthritis using the Cochrane systematic review.
We conducted a systematic search among PubMed, Cochrane central register of controlled trials, Web of Science, and Embase databases from the establishment of these databases to April 2022. The effectiveness and safety of abatacept in treating rheumatoid arthritis were assessed in terms of American College of Rheumatology (ACR) 20/50/70/90 responses, Disease Activity Score-28 for Rheumatoid Arthritis with C-reactive protein (DAS-28-CRP), and adverse events. The Relative Risks (RRs) of relative safety and efficacy and their corresponding 95 confidence intervals (CIs) were used to compute the pooled assessments of the outcomes. We used the review manager software version 5.4 to analyse our data, and the PRISMA checklist 2020 was used to ensure that our work conforms with the specification of meta-analysis.
Our study included 13 randomised control trials with a total of 5978 adult patients from different geographic regions and races. Following the combined analysis of these enrolled studies, the RRs for ACR 20/50/70/90 responses were 1.57 [95%CI 1.27, 1.93], 1.84 [95%CI 1.38, 2.44], 2.36 [95%CI 1.60, 3.47], and 2.95 [95%CI 1.88, 4.63], respectively. Such findings suggest that abatacept-treated patients were 1.57, 1.84, 2.36, and 2.95 times more likely to achieve ACR 20/50/70/90 responses, respectively, than those treated with placebo, conventional synthetic disease-modifying antirheumatic drugs, and or other biologic disease-modifying anti-rheumatic drugs. An exclusive comparison of abatacept and other biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) indicated that participants who were treated with abatacept could achieve better ACR responses than those treated with other b/tsDMARDs. Adverse events were less seen in abatacept-treated patients than in those who were given other b/tsDMARDs.
This meta-analysis concludes that in adult with rheumatoid arthritis, abatacept can achieve better health outcomes than other biologic drugs.
阿巴西普（Orencia）是一种用于治疗类风湿关节炎患者的药物。该药物通过调节 T 细胞激活所需的共刺激信号来改善患者的疼痛和关节炎症。我们旨在使用 Cochrane 系统评价分析阿巴西普治疗类风湿关节炎的疗效和安全性。
我们从各数据库建立起至 2022 年 4 月，在 PubMed、Cochrane 对照试验中心注册库、Web of Science 和 Embase 数据库中进行了系统搜索。根据美国风湿病学会（ACR）20/50/70/90 反应、类风湿关节炎的 C 反应蛋白（DAS-28-CRP）疾病活动评分-28（DAS-28-CRP）和不良事件评估阿巴西普治疗类风湿关节炎的有效性和安全性。使用相对风险（RR）和相应的 95%置信区间（CI）计算汇总评估结果。我们使用 Review Manager 软件版本 5.4 分析数据，并使用 PRISMA 检查表 2020 确保我们的工作符合荟萃分析的规范。
我们的研究纳入了来自不同地理区域和种族的 13 项随机对照试验，共 5978 名成年患者。对纳入的研究进行综合分析后，ACR 20/50/70/90 反应的 RR 分别为 1.57[95%CI 1.27,1.93]、1.84[95%CI 1.38,2.44]、2.36[95%CI 1.60,3.47]和 2.95[95%CI 1.88,4.63]。这些结果表明，与安慰剂、传统合成疾病修饰抗风湿药物和/或其他生物疾病修饰抗风湿药物相比，接受阿巴西普治疗的患者分别有 1.57、1.84、2.36 和 2.95 倍的可能性达到 ACR 20/50/70/90 反应。对阿巴西普与其他生物/靶向合成疾病修饰抗风湿药物（b/tsDMARDs）的单独比较表明，接受阿巴西普治疗的患者比接受其他 b/tsDMARDs 治疗的患者能获得更好的 ACR 反应。与接受其他 b/tsDMARDs 治疗的患者相比，接受阿巴西普治疗的患者不良反应更少。
本荟萃分析得出结论，在成年类风湿关节炎患者中，阿巴西普比其他生物药物能获得更好的健康结果。
