基于网络荟萃分析,哪些药物在预防家族性腺瘤性息肉病进展方面更有效?
Which Drugs are More Effective in Preventing Familial Adenomatous Polyposis Progression based on Network Meta-analysis?
作者信息
Luo Pei, Shi Wenjun, Cheng Xianshuo, Yang Jun, Pei Gen, Dong Jian
机构信息
Colorectal Surgery Department, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming 650106, Yunnan, China.
Colorectal Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming 650106, Yunnan, China.
出版信息
Curr Pharm Des. 2024;30(20):1548-1563. doi: 10.2174/0113816128289465240422074745.
BACKGROUND
Familial adenomatous polyposis (FAP) is an inherited disorder. At present, an increasing number of medications are being employed to treat FAP; however, only a few have been assessed for their efficacy and safety. Therefore, this study aimed to conduct a network meta-analysis to compare the therapeutic outcomes and adverse drug reactions of all FAP-associated medications.
METHODS
Six relevant databases were searched to identify pertinent randomized controlled trials (RCTs), and information on the dosage and frequency of various drugs was extracted. Additionally, data on changes in polyp counts and dimensions, as well as treatment-related adverse reactions for different medications were collected. The Bayesian method was employed to directly or indirectly compare the impact of different treatment regimens on changes in polyp numbers and diameters, and the safety of the drugs was investigated.
RESULTS
CXB at 16 mg/kg/day significantly reduced polyp numbers. Celecoxib at 8 mg/kg/day and sulindac (150 mg twice daily) plus erlotinib (75 mg/day) were effective for tolerant FAP patients. Additionally, EPAFFA 2 g daily and sulindac (150 mg twice daily) plus erlotinib (75 mg/day) emerged as the most effective for reducing polyp size.
CONCLUSION
The most effective treatment for reducing the number of colorectal polyps is celecoxib 16 mg/kg/day. On the other hand, a daily dosage of 2 g EPA-FFA demonstrates the best results in terms of decreasing colorectal polyp diameter.
背景
家族性腺瘤性息肉病(FAP)是一种遗传性疾病。目前,越来越多的药物被用于治疗FAP;然而,只有少数药物的疗效和安全性得到了评估。因此,本研究旨在进行一项网状荟萃分析,以比较所有与FAP相关药物的治疗效果和药物不良反应。
方法
检索六个相关数据库以识别相关的随机对照试验(RCT),并提取各种药物的剂量和用药频率信息。此外,收集不同药物的息肉数量和大小变化数据,以及与治疗相关的不良反应数据。采用贝叶斯方法直接或间接比较不同治疗方案对息肉数量和直径变化的影响,并研究药物的安全性。
结果
每天16mg/kg的塞昔布显著减少息肉数量。每天8mg/kg的塞来昔布以及舒林酸(每日两次,每次150mg)加厄洛替尼(每日75mg)对耐受性FAP患者有效。此外,每天2g的二十碳五烯酸/二十二碳六烯酸以及舒林酸(每日两次,每次150mg)加厄洛替尼(每日75mg)在减少息肉大小方面最为有效。
结论
减少结直肠息肉数量最有效的治疗方法是每天16mg/kg的塞来昔布。另一方面,每天2g的二十碳五烯酸/二十二碳六烯酸在减小结直肠息肉直径方面效果最佳。