阿普斯特治疗头皮银屑病的疗效与安全性Meta分析

Efficacy and Safety of Apremilast in Scalp Psoriasis:Meta-Analysis

目的 通过Meta分析,探讨阿普斯特在头皮银屑病治疗方面的疗效与安全性。方法 对国内外数据库自建库至2023年5月1日的文献进行检索,筛选后进行Meta分析。结果 根据纳入排除标准,最终纳入9项RCT。截至第16周结束,阿普斯特组(30 mg,2次/d)治疗头皮银屑病的有效率是安慰剂组(30 mg,2次/d)的2.40倍(RR=2.40,95%CI:2.12~2.72,P<0.000 01),明显降低银屑病患者生活质量评估指数(DLQI)评分(RR=1.86,95%CI:1.65~2.10,P<0.000 01),不良反应发生率是对照组的1.29倍(RR=1.29,95%CI:1.18~1.41,P<0.000 01),并且在不良反应致使患者停药方面,阿普斯特治疗组是安慰剂对照组的1.44倍,差异有统计学意义(RR=1.44,95%CI:1.02~2.02,P=0.04)。结论 口服阿普司特30 mg,2次/d可有效治疗头皮银屑病、改善患者的生活质量,会发生恶心、腹泻等不良反应,部分患者因严重不良反应会停药。

Objective To conduct a Meta-analysis,in order to provide an up-to-date understanding efficacy and safety of apremilast in the treatment of scalp psoriasis.Methods Literature was retrieved from domestic and overseas medical journals from inception to May 01 2023,and Meta-analysis was conducted after screening.Results According to inclusion and exclusion criteria,nine studies were finally included.As of 16 weeks,the efficacy rate of apremilast(30 mg,twice a day) in apremilast group in the treatment of scalp psoriasis was 2.40 times that of placebo(30 mg,twice a day) in placebo group(RR=2.40,95%CI:2.12-2.72,P<0.000 01),significantly lowered dermatology life quality index(DLQI) scores of psoriasis patients(RR=1.86,RR=1.86,95%CI:1.65-2.10,P<0.000 01).Apremilast(30 mg,twice a day) had more treatment-related adverse events(RR=1.29,95%CI:1.18-1.41,P<0.000 01) than placebo,and the incidence of patients discontinuing treatment due to adverse effects was 1.44 times that of placebo group,showing significant difference(RR=1.44,95% CI:1.02-2.02,P=0.04).Conclusion Oral administration of apremilast(30 mg,twice a day) can effectively treat scalp psoriasis,improve the quality of life of patients.However,nausea,diarrhea and other adverse effects will occur,and some patients will stop the drug due to serious adverse reactions.