古塞奇尤单抗治疗中重度斑块状银屑病疗效与安全性的meta分析

Meta-analysis of the efficacy and safety of guselkumab in the treatment of moderate to severe plaque psoriasis

目的评价古塞奇尤单抗治疗中重度斑块状银屑病的疗效与安全性。方法检索PubMed、www.clinctrials.gov、Cochrane Library、中国知网、维普网和万方数据库中古塞奇尤治疗中、重度斑块状银屑病的所有文献,检索时间从建库起至2020年1月,并由2名研究者严格按照纳入与排除标准独立筛选文献、评价文献质量、提取数据。使用RevMan5.3软件进行meta分析。结果根据纳入和排除标准最终纳入3篇文献,共计1956例中重度斑块型银屑病患者。在疗效方面,古塞奇尤单抗组达到各项疗效指标[银屑病皮损改善指标银屑病面积和严重程度指数(PASI)评分改善75%(PASI 75)、PASI 90及PASI 100,研究者总体评估(IGA)评分为0分或1分(IGA 0/1),以及皮肤病生活质量指数(DLQI)评分为0分或1分(QLQI 0/1)]的患者比例显著高于安慰剂组和阿达木单抗组,差异均有统计学意义(P<0.01)。在安全性方面,古塞奇尤单抗组各种不良反应与安慰剂组或阿达木单抗组比较,差异无统计学意义(均P>0.05)。结论古塞奇尤单抗治疗中重度银屑病的短期疗效肯定且优于阿达木单抗,在安全性上,古塞奇尤单抗与安慰剂比较无明显差异。

Objective To evaluate the efficacy and safety of guselkumab in the treatment of moderate to severe plaque psoriasis.Methods All the literatures about guselkumab in treatment of moderate and severe plaque psoriasis in PubMed,www.clinctrials.gov,Cochranelibrary,CNKI,VIP and Wanfang database were searched from the establishment of the database to January 2020.Two researchers screened the literatures,evaluated the quality of the literatures and extracted the data strictly according to the inclusion and exclusion criteria.RevMan5.3 software was used for meta analysis.Results According to the inclusion and exclusion criteria,three articles were included,1956 patients diagnosed as moderate and severe plaque psoriasis were enrolled.In terms of efficacy,the proportion of patients in the guselkumab group who reached various efficacy indicators(PASI75,PASI90 and PASI100,IGA score 0 or 1 and DLQI score 0 or 1)were significantly higher than that in the placebo group and the adalimumab group(P<0.01).In terms of safety,there were no significant differences in adverse reactions between the guselkumab group and the placebo group and/or the adalimumab group(P>0.05).Conclusion The short-term efficacy of guselkumab in the treatment of moderate and severe psoriasis is better than that of adalimumab,and there is no significant difference in safety between guselkumab and placebo.