阿达木单抗与甲氨蝶呤治疗银屑病的比较：一项随机对照研究的荟萃分析。
Comparison of adalimumab with methotrexate for psoriasis: A meta-analysis of randomized controlled studies.
机构信息
Department of Skin Burn Wound Repair, Chongqing Kaizhou District People's Hospital, Chongqing, China.
Department of Otolaryngology Head and Neck Surgery, Chongqing Kaizhou District People's Hospital, Chongqing, China.
出版信息
Medicine (Baltimore). 2024 Aug 9;103(32):e37216. doi: 10.1097/MD.0000000000037216.
INTRODUCTION
The efficacy of adalimumab versus methotrexate for psoriasis remained controversial. We conducted this systematic review and meta-analysis to explore the influence of adalimumab versus methotrexate on treatment efficacy for psoriasis patients.
METHODS
We have searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through August 2023 for randomized controlled trials (RCTs) assessing the efficacy of adalimumab versus methotrexate for psoriasis. This meta-analysis was performed using the random-effect or fixed-effect model based on the heterogeneity.
RESULTS
Four RCTs and 733 patients with psoriasis were included in this meta-analysis. Overall, compared with methotrexate treatment, adalimumab treatment was associated with improved Psoriasis Area and Severity Index 75 (PASI 75, odd ratio [OR] = 4.50; 95% confidence interval [CI] = 2.81-7.22; P < .00001), physician global assessment (PGA) 0/1 response (OR = 4.86; 95% CI = 3.02-7.82; P < .00001), PASI 100 (OR = 3.01; 95% CI = 1.33-6.80; P = .008) and decreased Dermatology Life Quality Index (DLQI, standard mean difference [SMD] = -0.60; 95% CI = -0.84 to -0.36; P < .00001), but exhibited no impact on PASI 90 (OR = 3.30; 95% CI = 0.77-14.20; P = .11), adverse events (OR = 1.23; 95% CI = 0.26-5.87; P = .79) or serious adverse events (OR = 2.59; 95% CI = 0.49-13.79; P = .26).
CONCLUSIONS
Adalimumab was superior to methotrexate for the treatment of psoriasis.
介绍
阿达木单抗与甲氨蝶呤治疗银屑病的疗效仍存在争议。我们进行了这项系统评价和荟萃分析，以探讨阿达木单抗与甲氨蝶呤对银屑病患者治疗效果的影响。
方法
我们通过检索 PubMed、EMbase、Web of Science、EBSCO 和 Cochrane Library 数据库，截至 2023 年 8 月，收集了评估阿达木单抗与甲氨蝶呤治疗银屑病疗效的随机对照试验（RCT）。本荟萃分析基于异质性，采用随机效应或固定效应模型进行分析。
结果
共有 4 项 RCT 和 733 例银屑病患者纳入本荟萃分析。总体而言，与甲氨蝶呤治疗相比，阿达木单抗治疗可显著改善银屑病面积和严重程度指数 75（PASI 75，优势比[OR] = 4.50；95%置信区间[CI] = 2.81-7.22；P <.00001）、医生整体评估（PGA）0/1 反应（OR = 4.86；95%CI = 3.02-7.82；P <.00001）、PASI 100（OR = 3.01；95%CI = 1.33-6.80；P =.008）和降低皮肤病生活质量指数（DLQI，标准均数差[SMD] = -0.60；95%CI = -0.84 至-0.36；P <.00001），但对 PASI 90（OR = 3.30；95%CI = 0.77-14.20；P =.11）、不良事件（OR = 1.23；95%CI = 0.26-5.87；P =.79）或严重不良事件（OR = 2.59；95%CI = 0.49-13.79；P =.26）无影响。
结论
阿达木单抗治疗银屑病优于甲氨蝶呤。
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