TNF-α 抑制剂治疗非放射性 axSpA 的疗效：基于随机对照试验的系统评价和荟萃分析。
Efficacy of TNF-α Inhibitors in the Treatment of nr-axSpA: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.
机构信息
The Medical Imaging College, Hangzhou Medical College, Hangzhou, China.
Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, China.
出版信息
Int Arch Allergy Immunol. 2024;185(6):590-599. doi: 10.1159/000536601. Epub 2024 Mar 1.
INTRODUCTION
A growing number of randomized controlled trials (RCTs) have demonstrated the effectiveness of tumor necrosis factor-α (TNF-α) inhibitors in treating non-radiographic axial spondyloarthritis (nr-axSpA). This study aimed to evaluate the efficacy of TNF-α inhibitors in the treatment of nr-axSpA.
METHODS
PubMed, EMBASE, Web of Science, and the Cochrane Library databases were systematically searched for relevant RCTs using specific keywords up to June 2023. The primary outcome was the proportion of patients who achieved Assessment in SpondyloArthritis international Society 40% (ASAS40). Secondary outcomes included ASAS20, Bath Ankylosing Spondylitis Disease Activity Index 50% (BASDAI50), ASAS partial remission, and ASAS5/6.
RESULTS
A total of eight RCTs involving 1,376 patients were included. Patients receiving anti-TNF therapy exhibited a higher rate of ASAS40 (pooled RR = 2.36; 95% CI: 1.63-3.42; p < 0.001). In addition, the TNF-α inhibitor group showed higher BASDAI50 rates (pooled RR = 2.06; 95% CI: 1.48-2.89), ASAS20 rates (pooled RR = 1.48; 95% CI: 1.31-1.67), ASAS partial remission rates (pooled RR = 2.33; 95% CI: 1.58-3.43), and ASAS5/6 rates (RR = 3.46; 95% CI: 2.05-5.83) than the placebo group.
CONCLUSION
The TNF-α inhibitors were effective in treating nr-axSpA.
简介
越来越多的随机对照试验（RCTs）已经证明肿瘤坏死因子-α（TNF-α）抑制剂在治疗非放射性轴性脊柱关节炎（nr-axSpA）方面的有效性。本研究旨在评估 TNF-α抑制剂在 nr-axSpA 治疗中的疗效。
方法
系统检索了 PubMed、EMBASE、Web of Science 和 Cochrane 图书馆数据库，使用特定关键词搜索了截至 2023 年 6 月的相关 RCTs。主要结局指标是达到国际脊柱关节炎评估协会 40%（ASAS40）的患者比例。次要结局指标包括 ASAS20、Bath 强直性脊柱炎疾病活动指数 50%（BASDAI50）、ASAS 部分缓解和 ASAS5/6。
结果
共纳入 8 项 RCTs，涉及 1376 名患者。接受抗 TNF 治疗的患者 ASAS40 发生率更高（合并 RR = 2.36；95%CI：1.63-3.42；p < 0.001）。此外，TNF-α 抑制剂组 BASDAI50 率（合并 RR = 2.06；95%CI：1.48-2.89）、ASAS20 率（合并 RR = 1.48；95%CI：1.31-1.67）、ASAS 部分缓解率（合并 RR = 2.33；95%CI：1.58-3.43）和 ASAS5/6 率（RR = 3.46；95%CI：2.05-5.83）均高于安慰剂组。
结论
TNF-α 抑制剂在治疗 nr-axSpA 方面是有效的。
Zotero 插件