不同剂量依那西普治疗类风湿关节炎的系统评价

Systematic Review of Different Doses of Etanercept in the Treatment of Rheumatoid Arthritis

目的系统评价不同剂量依那西普治疗类风湿关节炎的有效性和安全性。方法计算机检索Medline、Embase、Cochrane图书馆、中国期刊全文数据库、维普数据库、中国生物医学文献数据库、万方数据库,检索时限均从建库起截止2016年10月,根据Cochrane系统评价方法对纳入的随机对照试验进行方法学质量评价,并用RevMan 5.3软件进行Meta分析。结果共纳入7个研究,1353例患者。结果显示,在ACR方面,依那西普50mg/周组仅在ACR50(第13周和104周)优于依那西普20mg/周组,差异有统计学意义(P<0.05),其他组间差异均无统计学意义(P>0.05);在CRP、ESR、RF和ADR方面,各组间差异均无统计学意义(P>0.05)。结论不同剂量依那西普治疗类风湿关节炎的疗效和安全性的差异不显著,可适当选用低剂量方案,药物使用更加经济。

Objective To evaluate the efficacy and safety of different doses of etanercept in the treatment of rheumatoid arthritis.Methods We searched Medline,Embase,Cochrane library,China Journal Full-text Database,VIP database,Chinese biomedical literature database and Wanfang database,and the retrieval time was from the establishment of the database until October2016.The methodological quality of randomized controlled trials included was evaluated according to the Cochrane system evaluation method,and we used RevMan 5. 3 software to make Meta-analysis.Results A total of 7 studies and 1353 patients were included.The results showed that in ACR,etanercept 50mg/week group was better than that of etanercept 20mg/week group only in ACR50（ the thirteenth week and 104 th week）,the difference was statistically significant（ P〈0. 05）,the differences between other groups were not statistically significant（ P〈0. 05）; in CRP,ESR,RF and ADR,There was no statistical difference between the groups（ P〈0. 05）.Conclusion The difference of efficacy and safety of different doses of etanercept in the treatment of rheumatoid arthritis is not significant,so low dose program can be appropriately selected to make the use of drugs more economical.