中国麻风皮肤病杂志 ›› 2020, Vol. 36 ›› Issue (8): 454-460.doi: 10.12144/zgmfskin202008454

• 论著 • 上一篇    下一篇

司库奇尤单抗300 mg和150 mg治疗银屑病性关节炎长期疗效比较meta分析

陆晓鸥,王海彦,曹馨元,鄢洁,陈宏泉,王少燕   

  1. 青岛大学附属医院，山东青岛，266003
  • 出版日期:2020-08-15 发布日期:2020-08-11
  • 通讯作者: 陈宏泉，E-mail：chhq6198@163.com

Long-termed efficacy of secukinumab 300 mg and 150 mg in the treatment of psoriatic arthritis: a meta-analysis

LU Xiaoou, WANG Haiyan, CAO Xinyuan, YAN Jie, CHEN Hongquan, WANG Shaoyan   

  1. Affiliated Hospital of Qingdao University, Qingdao 266003, China
  • Online:2020-08-15 Published:2020-08-11
  • Contact: CHEN Hongquan, E-mail: chhq6198@163.com

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摘要： 目的：比较司库奇尤单抗300 mg和150 mg治疗银屑病性关节炎(PsA)长期疗效的差异。方法：在Pubmed、Cochrane Library、 MEDLINE、EMBASE、中国知网、万方数据库和维普数据库中检索司库奇尤单抗300 mg和150 mg治疗PsA的随机对照试验（RCTs），提取相关数据，用RevMan5.3软件进行meta分析。结果：根据纳入标准共纳入5篇文献进行分析，包括3项RCTs。52周时，司库奇尤单抗300 mg治疗后美国风湿病学会疗效标准改善20%、50%及70%（ACR 20/50/70）的应答率、起止点炎缓解率、指趾炎缓解率与150 mg相比无显著差异，而300 mg治疗的PASI提高75%、90%（PASI 75/90）应答率均高于150 mg（P=0.002，0.01）。52周时，接受过肿瘤坏死因子抑制剂治疗(TNFi-exposed)的患者司库奇尤单抗300 mg治疗后ACR 20和PASI 75应答率均高于150 mg（P=0.006，0.04），而在未接受过肿瘤坏死因子抑制剂治疗(TNFi-naive)患者中300 mg和150 mg治疗后ACR 20和PASI 75应答率无显著差异(P=0.85，0.59)。结论：在长期疗效方面，司库奇尤单抗300 mg对PsA患者关节损害及功能的改善与150 mg无显著差异，而对皮损的改善有优势；对TNFi-exposed的PsA患者，司库奇尤单抗300 mg比150 mg有更好的疗效。

关键词: 银屑病性关节炎, 司库奇尤单抗, meta分析

Abstract: Objective: To compared the long-termed efficacy of 300 mg and 150 mg secukinumab  in the treatment of psoriatic arthritis (PsA). Methods: The studies about the efficacy of secukinumab 300 mg vs 150 mg in the treatment of psoriatic arthritis were searched in Pubmed, Cochrane Library, MEDLINE, EMBASE, CNKI, Wanfang and VIP. Meta-analysis was performed by RevMan 5.3 software. Results: Five papers were found, including 3 RCTs. There was no significant difference in response rate of 20%/50%/70% improvement of American College of Rheumatology (ACR 20/50/70), remission rate of enthesitis, and dactylitis between 300 mg and 150 mg secukinumab for the treatment of psoriatic arthritis at week 52. But compared with 150 mg secukinumab, 300 mg showed a greater improvement in response of PASI 75 and PASI 90 (P=0.002,0.01). Secukinumab 300 mg showed significantly higher ACR 20 and PASI 75 response rate than 150 mg in the TNFi-exposed group (P=0.006,0.04). There was no significant difference of these in the TNFi-naive group. Conclusion: There is no difference in improvement of joint damage between secukinumab 300 mg and 150 mg at week 52. However secukinumab 300 mg has an advantage in improvement of skin lesions. For TNFi-exposed patients with PsA, secukinumab 300 mg is more effective than 150 mg.

Key words: psoriatic arthritis, secukinumab, meta-analysis