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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.

DOI:10.1080/09273948.2023.2256850
PMID:37796609
Abstract

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.

摘要

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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引用本文的文献

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Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring?葡萄膜炎患者中的阿达木单抗自身抗体:我们需要常规药物监测吗?
Biomedicines. 2024 Dec 6;12(12):2782. doi: 10.3390/biomedicines12122782.