益赛普与柳氮磺胺吡啶治疗强直性脊柱炎的Mete分析

Etanercept Versus Sulfasalazine for Patients with Ankylosing Spondylitis: A Systematic Review

目的评价益赛普与柳氮磺胺吡啶治疗强直性脊柱炎的疗效和副作用。方法计算机检索Cochrane Library（2013年第3期）,MEDLINE（1966~2013.10）,EMbase（1974~2013.10）,中国生物医学文献数据库（1978~2013.10）,中国期刊全文数据库（1994~2013.10）,中文科技期刊全文数据库（1989~2013.10）,万方数据库（1980~2013.10）中所有益赛普与柳氮磺胺吡啶治疗强直性脊柱炎的随机对照试验和半随机对照试验。由两名评价员独立提取资料,并对其方法学质量进行评价。对符合纳入标准的研究用RevMan5.2软件进行Meta分析。结果共纳入7个研究940例患者,Meta分析结果示：益赛普较柳氮磺胺吡啶治疗强直性脊柱炎患者能有效提高达到ASA20的病例数[OR=2.71,95%CI（2.22,3.32）],改善治疗终点时Bath强直性脊柱炎测量指数（BASMI）[MD=-0.43,95%CI（-0.46,-0.40）],提高脊柱活动度（Schober试验）[MD=0.54,95%CI（0.04,1.03）],降低红细胞沉降率[MD=-6.23,95%CI（-7.83,-4.63）],降低C-反应蛋白[MD=-5.12,95%CI（-6.79,-3.45）]。在骶髂关节MRI炎症评分两药间差异无统计学意义[MD=-0.26,95%CI（-0.76,0.24）]。两种药物用药期间发生呼吸道感染事件差异无统计学意义[OR=1.33,95%CI（0.26,6.85）],发生胃肠道反应事件差异有统计学意义[OR=0.33,95%CI（0.12,0.89）]。结论益赛普较柳氮磺胺吡啶在改善患者功能,降低红细胞沉降率,炎症反应蛋白更有效,而且发生胃肠道反应的事件更少。

Objective To assess the efficacy and adverse events of Etanercept versus Sulfasalazine for patients with Ankylosing spondylitis. Methods We searched the Cochrane Library （ Issue 3. 2013）, MEDLINE （1966 to October 2013）,EMBASE （1974 to October 2008）,CBM （1978 to October 2013）, CNKI （1994 to October 2013 ）, VIP （ 1989 to October 2013）, and Wanfang （ 1999 to October 2013）. The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration＇s RevMan 5.2 software. Results Seven randomized controlled trials with total of 940 patients met the included criteria. The meta analysis showed the effective rate of ASAS 20 and BASMI and the reduction of ESR and CRP receiving Etanercept was significantly higher than in patients receiving sulfasalazine. There was no statistical significance in the MRI sacroiliac joint score and the respiratory infection. The difference of causing the gastrointestinal re- action during treatment was statistically significant. Conclusions Etanereept compared with sulfasalazine in improving patient~ activities function,reducing the erythroeyte sedimentation rate, C -Reactive protein is more effective, what is more, also decreased the incidence of the gastrointestinal reaction.