摘要
目的系统评价生物制剂和小分子药物治疗中重度克罗恩病(CD)的效果及安全性。方法检索PubMed、Embase、Cochrane、Web of Science、中国知网、万方数据库、维普网建库至2024年9月关于生物制剂和小分子药物治疗中重度CD疗效及安全性的随机、双盲、安慰剂对照试验。对纳入的文献进行筛选、资料提取,应用RevMan 5.4进行文献质量评价,R 4.4.3进行网状meta分析。结果纳入22项RCT、涉及37种药物干预措施、共6992例CD患者。在临床缓解方面,累积排序曲线下面积(SUCRA)排名首位的干预措施为古塞奇尤单抗200 mg(88.2%)。在临床反应方面,SUCRA排名首位的干预措施为古塞奇尤单抗200 mg(93.1%)。在不良反应方面,SUCRA排名末位的干预措施为古塞奇尤单抗1200 mg(14.1%)。结论在临床缓解、临床反应方面古塞奇尤单抗效果最佳,且该药安全性更好。
Objective To systematically evaluate the efficacy and safety of biological agents and small molecule drugs in the treatment of moderate-to-severe Crohn’s disease(CD).Methods Randomized,double-blind,placebo-controlled trials on the efficacy and safety of biologics and small molecule drugs for the treatment of moderate-to-severe CD were searched in PubMed,Embase,Cochrane,Web of Science,CNKI,Wanfang database,and VIP from the establishment of the library to September 2024.The included literature was screened,information was extracted,RevMan 5.4 was applied for literature quality assessment,and R 4.4.3 was used for net meta-analysis.Results Twenty-two RCTs,involving 37 pharmacologic interventions and a total of 6992 patients with CD were included.In terms of clinical remission,the top-ranked intervention in terms of cumulative sorted area under the curve(SUCRA)was guselkumab 200 mg(88.2%).In terms of clinical response,the top-ranked intervention in terms of SUCRA was guselkumab 200 mg(93.1%).In terms of adverse reactions,the intervention with the lowest SUCRA ranking was guselkumab 1200 mg(14.1%).Conclusion Guselkumab was the most effective in terms of clinical remission,clinical response and the drug was better in terms of safety.
作者
孔凯
张容
王涛
KONG Kai;ZHANG Rong;WANG Tao(Department of Gastroenterology,Jinan Third People’s Hospital,Shandong,Jinan 250100,China;Nursing Department,Jinan Third People’s Hospital,Shandong,Jinan 250100,China)
出处
《中国医药科学》
2025年第15期81-86,105,共7页
China Medicine And Pharmacy
关键词
生物制剂
小分子药物
克罗恩病
荟萃分析
Biologics
Small molecule drugs
Crohn’s disease
Net meta-analysis
