度普利尤单抗治疗中度至重度特应性皮炎的有效性和安全性的Meta分析

Efficacy and Safety of Dupriumab in the Treatment of Moderate to Severe Atopic Dermatitis:A Meta-analysis

目的系统评价度普利尤单抗治疗中度至重度特应性皮炎的有效性与安全性。方法利用计算机检索知网、万方、维普、PubMed、Embase、Cochrane Library和Web of Science等数据库及ClinicalTrials.gov网站,收集有关度普利尤单抗治疗中度至重度特应性皮炎的随机对照试验。检索时间均为自建库之日起到2022年6月。对所获得的文献进行筛选、数据提取及质量评价后,采用RevMan 5.4统计软件进行定量分析。结果共纳入13项研究,4270例患者。Meta分析结果显示,治疗组的IGA反应率为[RR=3.64,95%CI(3.18,4.17),P<0.00001],EASI-50反应率为[RR=2.49,95%CI(2.30,2.70),P<0.00001],EASI评分为[MD=-28.51,95%CI(-31.86,-25.16),P<0.00001],NRS评分为[MD=-4.92,95%CI(-5.49,-4.36),P<0.00001],SCORAD评分为[MD=-30.81,95%CI(-31.01,-30.61),P<0.00001],均优于对照组,差异具有统计学意义。在安全性方面,两组总体不良事件发生率没有明显差别[RR=0.98,95%CI(0.94,1.02),P=0.38];治疗组严重不良事件发生率较对照组更低[RR=0.47,95%CI(0.33,0.67),P<0.0001],差异具有统计学意义。结论当前证据表明度普利尤单抗治疗中度至重度特应性皮炎疗效确切,能明显改善患者皮损面积、严重程度、瘙痒及睡眠情况,安全性较高。

Objective Systematically evaluate the efficacy and safety of Dupriumab in the treatment of moderate to severe atopic dermatitis(AD).Methods CNKI,VIP database,PubMed,WanFang data,Embase,Web of Science,Cochrane Library and ClinicalTrials.gov were searched to collect RCTs of Dupriumab in the treatment of moderate to severe AD.The retrieval time is from the date of database construction to June 2022.After screening,data extraction and quality evaluation of the obtained literatures,RevMan 5.4 statistical software was used for quantitative analysis.Results 13 studies were included involving 4270 patients.Results of Meta-analysis showed that response rate of IGA[RR=3.64,95%CI(3.18,4.17),P<0.00001],response rate of EASI-50[RR=2.49,95%CI(2.30,2.70),P<0.00001],improvement of EASI[MD=-28.51,95%CI(-31.86,-25.16),P<0.00001],improvement of NRS[MD=-4.92,95%CI(-5.49,-4.36),P<0.00001],and improvement of SCORAD[MD=-30.81,95%CI(-31.01,-30.61),P<0.00001]in the treatment group were all better than that in the control group,and the difference was statistically significant.In terms of safety,there was no significant difference in adverse event rate between two groups[RR=0.98,95%CI(0.94,1.02),P=0.38],and the incidence of serious adverse events in the treatment group was lower than that in the control group[RR=0.47,95%CI(0.33,0.67),P<0.0001],and the difference was statistically significant.Conclusion The current evidences show that Dupriumab is effective in the treatment of moderate to severe AD,which can significantly improve the itching situation,the area of skin lesions and sleeping conditions of patients with good safety.