依那西普对儿童和青少年斑块型银屑病的短期疗效与安全性系统评价

Systematic evaluation of the short-term efficacy and safety of etanercept in children and adolescents with plaque psoriasis

【目的】系统评价依那西普治疗儿童和青少年斑块型银屑病的短期疗效及安全性。【方法】通过计算机检索中文期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库、PubMed、Medline及Embase,检索时限均从2000年1月至2019年10月,语言限中英文。纳入研究的治疗组使用依那西普治疗儿童和青少年斑块型银屑病,对照组使用安慰剂。根据Cochrane系统评价方法对纳入的研究进行质量评价后,用RevMan5.3软件进行Meta分析。【结果】共纳入3篇研究,541例患者,共治疗12周。治疗组在治疗12周后银屑病皮损改善面积和严重程度指数PASI50积分[SMD=6.67,95%CI(3.35,13.31),P<0.01]、PASI75[SMD=6.67,95%CI(3.35,13.31),P<0.01]、PASI90[SMD=4.99,95%CI(3.31,7.51),P<0.01]、sPGA[SMD=4.99,95%CI(3.31,7.51),P<0.01]的改善程度及不良反应发生率[OR=2.90,95%CI(2.01,4.19),P<0.01]与对照组相比,差异均具有统计学意义。依那西普的不良反应与对照组无统计学差异[OR=1.44,95%CI(0.79,2.61),P=0.23]。【结论】依那西普对儿童和青少年斑块型银屑病的短期治疗安全有效。

【Objective】To systematically evaluate the efficacy and safety of etanercept in the treatment of plaque psoriasis in children and adolescents.【Methods】Articles were retrieved via Chinese journal full-text databases(CNKI),Wanfang database,Chinese biomedical literature database,PubMed,Medline and Embase.The search period was limited from January 2000 to October 2019,and the language was limited in Chinese and English.The patients in the treatment group in the study was treated with etanercept.Those in the control group were treated with placebo.After evaluating the quality of the included study according to the Cochrane system evaluation methods,meta-analysis was performed via RevMan5.3 software.【Results】A total of 3 studies and 541 patients were included.The patients were treated for 12 weeks.The improvement area and severity index of psoriatic lesions in the treatment group were PASI50 score[SMD=6.67,95%CI(3.35,13.31),P<0.01],PASI75[SMD=6.67,95%CI(3.35,13.31)],P<0.01],PASI90[SMD=4.99,95%CI(3.31,7.51),P<0.01],sPGA[SMD=4.99,95%CI(3.31,7.51),P<0.01])and the incidence of side effects[OR=2.90,95%CI(2.01,4.19),P<0.01].There was no statistical difference in adverse reaction rate between the treatment group and control group[OR=1.44,95%CI(0.79,2.61),P=0.23].【Conclusion】Etanercept is safe and effective in the short-term treatment of plaque psoriasis in children and adolescents.