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度普利尤单抗治疗慢性阻塞性肺疾病:系统评价与荟萃分析方案

Dupilumab for the treatment of COPD: protocol for a systematic review and meta-analysis.

作者信息

Xue Bingyu, Xiao Qionghua, Huang Yuanming, Wang Minghang

机构信息

National Regional Medical Center of Traditional Chinese Medicine (TCM) (Pulmonary Disease), The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China.

The First Clinical Medical School, Henan University of Chinese Medicine, Zhengzhou, Henan, China.

出版信息

Front Med (Lausanne). 2025 Jul 21;12:1636238. doi: 10.3389/fmed.2025.1636238. eCollection 2025.

Abstract

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is a significant global public health issue, with a high incidence and mortality burdening patients heavily. Although existing treatment methods have made certain progress, their effectiveness in intervention during acute exacerbations and long-term management remains suboptimal for some patients. In recent years, biologic agents have provided new directions for COPD treatment. Dupilumab, a humanized monoclonal antibody targeting IL-4Rα, has shown good efficacy in type 2 inflammation-related diseases; however, its efficacy and safety in COPD treatment remain to be verified.

METHODS AND ANALYSIS

This study will assess the efficacy and safety of dupilumab in the treatment of COPD through a systematic review and meta-analysis. Randomized controlled trials (RCTs) meeting the inclusion criteria will be included, and the Population-Intervention-Comparator-Outcome-Study (PICOS) research design standard will be adopted to compare the efficacy of dupilumab against placebo or conventional treatment. The primary outcome will be the annual exacerbation rate (AER) of COPD, and the secondary outcomes will include changes in FEV1 before baseline bronchodilators, St. George's Respiratory Questionnaire (SGRQ) scores, Evaluating Respiratory Symptoms in COPD (E-RS COPD) and blood eosinophil counts. Safety will also be assessed, and the incidence of adverse reactions will be statistically analyzed. A literature search will be conducted across multiple databases, including PubMed, Embase, WOS, Cochrane Library, and Scopus. Ultimately, this study will assess the impact of dupilumab on COPD patients through meta-analysis, aiming to provide new evidence-based insights for the treatment of COPD.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review. Upon completion, the results of this review will be submitted to peer-reviewed journals for publication and/or presented at academic conferences.

TRIAL REGISTRATION NUMBER

https://www.crd.york.ac.uk/prospero/, identifier CRD42024605417.

摘要

引言

慢性阻塞性肺疾病(COPD)是一个重大的全球公共卫生问题,其高发病率和死亡率给患者带来沉重负担。尽管现有治疗方法已取得一定进展,但对于一些患者而言,它们在急性加重期干预和长期管理中的有效性仍不尽人意。近年来,生物制剂为COPD治疗提供了新方向。度普利尤单抗是一种靶向白细胞介素-4受体α(IL-4Rα)的人源化单克隆抗体,在2型炎症相关疾病中显示出良好疗效;然而,其在COPD治疗中的疗效和安全性仍有待验证。

方法与分析

本研究将通过系统评价和荟萃分析评估度普利尤单抗治疗COPD的疗效和安全性。将纳入符合纳入标准的随机对照试验(RCT),并采用人群-干预-对照-结局-研究(PICOS)研究设计标准,比较度普利尤单抗与安慰剂或传统治疗的疗效。主要结局将是COPD的年加重率(AER),次要结局将包括基线支气管扩张剂使用前第一秒用力呼气容积(FEV1)的变化、圣乔治呼吸问卷(SGRQ)评分、慢性阻塞性肺疾病呼吸症状评估(E-RS COPD)和血液嗜酸性粒细胞计数。还将评估安全性,并对不良反应的发生率进行统计分析。将在多个数据库中进行文献检索,包括PubMed、Embase、Web of Science(WOS)、Cochrane图书馆和Scopus。最终,本研究将通过荟萃分析评估度普利尤单抗对COPD患者的影响,旨在为COPD治疗提供新的循证见解。

伦理与传播

本评价无需伦理批准。完成后,本评价的结果将提交给同行评审期刊发表和/或在学术会议上展示。

试验注册号

https://www.crd.york.ac.uk/prospero/,标识符CRD42024605417。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94d5/12318725/603a23c24f7c/fmed-12-1636238-g001.jpg

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