羟氯喹治疗 IgA 肾病的疗效和安全性的 Meta 分析。
Efficacy and Safety of Hydroxychloroquine in Patients with IgA Nephropathy: A Meta-Analysis.
机构信息
Nephrology Department, The First People's Hospital of Foshan, 528000 Foshan, Guangdong, China.
出版信息
Arch Esp Urol. 2024 Jan;77(1):16-24. doi: 10.56434/j.arch.esp.urol.20247701.2.
AIM
The purpose of this study was to determine efficacy and safety of hydroxychloroquine (HCQ) for patients with IgA nephropathy (IgAN).
METHODS
PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Wanfang database, Chinese National Knowledge Infrastructure and VIP database up to February 2023 were searched for associated studies comparing HCQ with any other nonHCQ for treating IgAN. The effects of proteinuria, a 50% decrease in proteinuria, estimated glomerular filtration rate (eGFR) and adverse events in patients with IgAN were examined in a meta-analysis. Data were extracted and pooled using RevMan 5.3.
RESULTS
Three randomized controlled trials (RCTs), two retrospective and two prospective studies (675 patients) that matched our inclusion criteria were identified. Compared with a control group, HCQ significantly reduced proteinuria (mean difference (MD): -0.26, 95% confidence interval (CI): -0.44 to -0.08, < 0.01). Patients receiving HCQ plus renin-angiotensin system inhibitors (RASSi) had a better efficacy in proteinuria alleviation and a 50% decrease in proteinuria compared with control groups (MD: -0.38, 95% CI: -0.50 to -0.25, < 0.001 and relative risk (RR) = 3.31, 95% CI: 1.73 to 6.36, < 0.001). No appreciable variations were observed in eGFR between HCQ groups and control groups in treating patients with IgAN (MD: -2.00, 95% CI: -4.36 to 0.36, = 0.10). Moreover, no serious adverse events were observed during HCQ treatment.
CONCLUSIONS
Our results indicate HCQ is an efficient, secure treatment for IgAN.
目的
本研究旨在确定羟氯喹（HCQ）治疗 IgA 肾病（IgAN）患者的疗效和安全性。
方法
检索 PubMed、Embase、Web of Science、Cochrane 中央对照试验注册库、万方数据库、中国知网和 VIP 数据库，检索时间截至 2023 年 2 月，以比较 HCQ 与任何其他非 HCQ 治疗 IgAN 的相关研究。采用荟萃分析评估 IgAN 患者蛋白尿、蛋白尿减少 50%、估算肾小球滤过率（eGFR）和不良事件的影响。使用 RevMan 5.3 提取和汇总数据。
结果
符合纳入标准的研究共有 3 项随机对照试验（RCT）、2 项回顾性研究和 2 项前瞻性研究（共 675 例患者）。与对照组相比，HCQ 能显著降低蛋白尿（均数差（MD）：-0.26，95%置信区间（CI）：-0.44 至 -0.08， < 0.01）。与对照组相比，HCQ 联合肾素-血管紧张素系统抑制剂（RASSi）治疗的患者在蛋白尿缓解和蛋白尿减少 50%方面疗效更好（MD：-0.38，95% CI：-0.50 至 -0.25， < 0.001 和相对风险（RR）=3.31，95% CI：1.73 至 6.36， < 0.001）。在治疗 IgAN 患者时，HCQ 组与对照组之间的 eGFR 无明显变化（MD：-2.00，95% CI：-4.36 至 0.36， = 0.10）。此外，在 HCQ 治疗期间未观察到严重不良事件。
结论
我们的研究结果表明，HCQ 是一种有效、安全的 IgAN 治疗方法。
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