阿达木单抗治疗非感染性葡萄膜炎患者的免疫原性：系统评价和荟萃分析。
Immunogenicity of Adalimumab in Patients with Non-Infectious Uveitis: Systematic Review and Meta-Analysis.
机构信息
Doctorado en Investigación Clínica, Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia.
Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational, Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia.
出版信息
Ocul Immunol Inflamm. 2024 Oct;32(8):1539-1548. doi: 10.1080/09273948.2023.2256850. Epub 2023 Oct 5.
OBJECTIVE
To review the prevalence, incidence, and risk factors for developing anti-drug antibodies (AAA) in patients with non-infectious uveitis (NIU) treated with Adalimumab (ADA).
METHODS
A systematic literature search was performed on PubMed, EMBASE, Virtual Health Library, Cochrane, and medRxiv. Meta-analysis was performed using random effects.
RESULTS
Nine out of 2,373 studies were included. The prevalence of AAA in NIU patients treated with ADA was 9% (95% CI: 2% to 37%, I = 95% with a P<0.01), it was significantly higher in real-life scenarios (observational studies) than in clinical trials. The pooled incidence at 12 months was 27% (CI 95% 16%-42% I = 0%). Several factors have been associated with AAA generation in NIU patients, including the non-use of concomitant immunosuppressants, presence of autoimmune systemic disease, female gender, etc.
CONCLUSION
This study showed that AAA prevalence is higher in real-life scenarios compared to clinical trials. Further research is needed to elucidate the factors that trigger AAA generation in NIU patients.
目的
综述阿达木单抗（ADA）治疗非感染性葡萄膜炎（NIU）患者发生抗药物抗体（AAA）的流行率、发病率和危险因素。
方法
对 PubMed、EMBASE、Virtual Health Library、Cochrane 和 medRxiv 进行系统文献检索。采用随机效应进行荟萃分析。
结果
纳入了 2373 项研究中的 9 项。接受 ADA 治疗的 NIU 患者 AAA 的流行率为 9%（95%CI：2%至 37%，I=95%，P<0.01），在真实场景（观察性研究）中明显高于临床试验。12 个月时的累积发病率为 27%（95%CI：16%至 42%，I=0%）。一些因素与 NIU 患者 AAA 的发生有关，包括不使用伴随免疫抑制剂、自身免疫性系统性疾病的存在、女性性别等。
结论
本研究表明，与临床试验相比，AAA 的流行率在真实场景中更高。需要进一步研究阐明触发 NIU 患者 AAA 发生的因素。
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