Objective:Deucravacitinib is a tyrosine kinase-2 inhibitor that shows promise as an emerging treatment option for psoriasis.We aimed to evaluate the efficacy and safety of different doses of deucravacitinib vs.placebo...Objective:Deucravacitinib is a tyrosine kinase-2 inhibitor that shows promise as an emerging treatment option for psoriasis.We aimed to evaluate the efficacy and safety of different doses of deucravacitinib vs.placebo or apremilast on psoriasis treatment.Methods:We performed a systematic review and pairwise and network meta-analyses of randomized controlled trials published in Web of Science,SCOPUS,EMBASE,PubMed,and Cochrane Central databases from the inception of databases until March 31,2023.We used the risk ratio for dichotomous outcomes,and the mean difference with corresponding 95%confidence interval for continuous outcomes.We registered our protocol in PROSPERO(ID:CRD42023413976).Results:We analyzed 4 randomized controlled trials involving 2,156 patients randomly assigned to receive placebo,60 mg of apremilast once daily,or various doses of deucravacitinib(3 mg every other day,3 mg once daily,3 mg twice daily,6 mg twice daily,or 12 mg once daily).Deucravacitinib achieved significantly better outcomes compared with placebo across multiple efficacy measures,including the Psoriasis Area and Severity Index score(P<0.01),Static Physician’s Global Assessment score(P<0.01),Psoriasis Symptoms and Signs Diary score(P<0.01),Dermatology Life Quality Index score(P<0.01),and scalp-specific Physician’s Global Assessment score(P<0.01).When comparing 3 mg of deucravacitinib twice daily with 60 mg of apremilast once daily,deucravacitinib exhibited superior outcomes in terms of the Psoriasis Area and Severity Index(P<0.01),Dermatology Life Quality Index(P<0.01),Static Physician’s Global Assessment(P<0.01),and scalp-specific Physician’s Global Assessment scores(P<0.01).Deucravacitinib and apremilast were associated with a higher incidence of adverse events compared with placebo,including diarrhea,nausea,headache,and infections.However,no significant differences were observed between interventions regarding serious adverse events or adverse events leading to discontinuation.Conclusion:Deucravacitinib and apremilast show promising efficacy as psoriasis treatments.While adverse events were more common with these treatments compared with placebo,the incidence of serious adverse events did not significantly differ between the intervention and placebo groups.展开更多
目的评估氘可来昔替尼在中重度斑块状银屑病治疗中的有效性、安全性和经济性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方等数据库和卫生技术评估(HTA)官方网站,收集氘可来昔替尼治疗中重度斑块状银屑病的相关HTA报...目的评估氘可来昔替尼在中重度斑块状银屑病治疗中的有效性、安全性和经济性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方等数据库和卫生技术评估(HTA)官方网站,收集氘可来昔替尼治疗中重度斑块状银屑病的相关HTA报告、系统评价(SR)/Meta分析和药物经济学研究,检索时限为建库起至2025年7月。通过文献筛选、数据提取及文献质量评价,对研究结果进行分析和汇总。结果最终纳入14篇文献,包括HTA报告1篇、SR/Meta分析10篇、药物经济学研究3篇。在有效性方面,与安慰剂或阿普米司特相比,氘可来昔替尼在升高银屑病皮损面积和严重程度指数50/75/90/100应答率、静态医师全面评估0/1应答率、皮肤病生活质量指数0/1应答率以及降低银屑病症状和体征日记评分方面均更具优势(P<0.05)。在安全性方面,氘可来昔替尼耐受性良好,虽然其总不良事件发生率高于安慰剂,但与阿普米司特相比差异无统计学意义;且其严重不良事件发生率、不良事件导致停药的发生率与安慰剂比较差异均无统计学意义(P>0.05)。在经济性方面,与阿普米司特相比,氘可来昔替尼在美国、日本和中国卫生系统视角下均具有成本-效果优势。结论氘可来昔替尼治疗中重度斑块状银屑病的有效性、安全性和经济性良好,但未来仍需开展更多真实世界研究进一步完善对其的评价。展开更多
文摘Objective:Deucravacitinib is a tyrosine kinase-2 inhibitor that shows promise as an emerging treatment option for psoriasis.We aimed to evaluate the efficacy and safety of different doses of deucravacitinib vs.placebo or apremilast on psoriasis treatment.Methods:We performed a systematic review and pairwise and network meta-analyses of randomized controlled trials published in Web of Science,SCOPUS,EMBASE,PubMed,and Cochrane Central databases from the inception of databases until March 31,2023.We used the risk ratio for dichotomous outcomes,and the mean difference with corresponding 95%confidence interval for continuous outcomes.We registered our protocol in PROSPERO(ID:CRD42023413976).Results:We analyzed 4 randomized controlled trials involving 2,156 patients randomly assigned to receive placebo,60 mg of apremilast once daily,or various doses of deucravacitinib(3 mg every other day,3 mg once daily,3 mg twice daily,6 mg twice daily,or 12 mg once daily).Deucravacitinib achieved significantly better outcomes compared with placebo across multiple efficacy measures,including the Psoriasis Area and Severity Index score(P<0.01),Static Physician’s Global Assessment score(P<0.01),Psoriasis Symptoms and Signs Diary score(P<0.01),Dermatology Life Quality Index score(P<0.01),and scalp-specific Physician’s Global Assessment score(P<0.01).When comparing 3 mg of deucravacitinib twice daily with 60 mg of apremilast once daily,deucravacitinib exhibited superior outcomes in terms of the Psoriasis Area and Severity Index(P<0.01),Dermatology Life Quality Index(P<0.01),Static Physician’s Global Assessment(P<0.01),and scalp-specific Physician’s Global Assessment scores(P<0.01).Deucravacitinib and apremilast were associated with a higher incidence of adverse events compared with placebo,including diarrhea,nausea,headache,and infections.However,no significant differences were observed between interventions regarding serious adverse events or adverse events leading to discontinuation.Conclusion:Deucravacitinib and apremilast show promising efficacy as psoriasis treatments.While adverse events were more common with these treatments compared with placebo,the incidence of serious adverse events did not significantly differ between the intervention and placebo groups.
文摘目的评估氘可来昔替尼在中重度斑块状银屑病治疗中的有效性、安全性和经济性。方法通过检索PubMed、Web of Science、Embase、中国知网、万方等数据库和卫生技术评估(HTA)官方网站,收集氘可来昔替尼治疗中重度斑块状银屑病的相关HTA报告、系统评价(SR)/Meta分析和药物经济学研究,检索时限为建库起至2025年7月。通过文献筛选、数据提取及文献质量评价,对研究结果进行分析和汇总。结果最终纳入14篇文献,包括HTA报告1篇、SR/Meta分析10篇、药物经济学研究3篇。在有效性方面,与安慰剂或阿普米司特相比,氘可来昔替尼在升高银屑病皮损面积和严重程度指数50/75/90/100应答率、静态医师全面评估0/1应答率、皮肤病生活质量指数0/1应答率以及降低银屑病症状和体征日记评分方面均更具优势(P<0.05)。在安全性方面,氘可来昔替尼耐受性良好,虽然其总不良事件发生率高于安慰剂,但与阿普米司特相比差异无统计学意义;且其严重不良事件发生率、不良事件导致停药的发生率与安慰剂比较差异均无统计学意义(P>0.05)。在经济性方面,与阿普米司特相比,氘可来昔替尼在美国、日本和中国卫生系统视角下均具有成本-效果优势。结论氘可来昔替尼治疗中重度斑块状银屑病的有效性、安全性和经济性良好,但未来仍需开展更多真实世界研究进一步完善对其的评价。
