中国麻风皮肤病杂志 ›› 2024, Vol. 40 ›› Issue (10): 690-698.doi: 10.12144/zgmfskin202410690

• 论著 • 上一篇    下一篇

JAK抑制剂治疗中重度特应性皮炎有效性和安全性网状Meta分析

黄格日勒1,2,张文静2,杨宏昕2,郭浩2   

  1. 1内蒙古医科大学，内蒙古呼和浩特，010110； 2内蒙古自治区人民医院药学处，内蒙古呼和浩特，010017
  • 出版日期:2024-10-15 发布日期:2024-08-27

Efficacy and safety of Janus kinase inhibitors for moderate-to-severe atopic dermatitis: a network meta-analysis

HUANG Gerile1,2, ZHANG Wenjing2, YANG Hongxin2, GUO Hao2   

  1. 1 Inner Mongolia Medical University, Hohhot 010110, China; 2 Inner Mongolia Autonomous Region People's Hospital, Hohhot 010017, China
  • Online:2024-10-15 Published:2024-08-27

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摘要： 目的：评价JAK抑制剂阿布昔替尼、巴瑞替尼和乌帕替尼在治疗中重度特应性皮炎的有效性及安全性。方法：检索PubMed、CochraneLibrary、Embase、中国知网和维普数据库2024年3月之前有关上述三种药物治疗中重度特应性皮炎有效性及安全性的随机对照试验的文献，在Stata14.0和R4.3.2软件中进行网状Meta分析，采用相对危险度及95%可信区间进行统计学分析。结果：共纳入17项随机对照试验，特应性皮炎患者8807例。网状Meta分析结果显示，三种药物可以改善特应性皮炎患者的体征和症状，其中累积排序概率显示乌帕替尼30 mg疗效最佳，其次是乌帕替尼15 mg和阿布昔替尼200 mg。患者达到EASI-75、vIGA-AD 0/1等疗效评估指标的比例显著高于安慰剂组患者，阿布昔替尼和乌帕替尼不良反应发生率高于巴瑞替尼。结论：阿布昔替尼、巴瑞替尼和乌帕替尼治疗特应性皮炎均安全有效。应用乌帕替尼30 mg剂量虽然具有较高的短期疗效，但需要注意其可能带来的不良反应风险。

关键词: 特应性皮炎, Janus激酶抑制剂, 网状Meta分析

Abstract: Objective: To investigate the efficacy and safety of Janus kinase inhibitor(abrocitinib, baricitinib, upadacitinib) in the treatment of moderate to severe atopic dermatitis. Methods: Systematic search of the databases PubMed, Cochrane Library, Embase, CNKI and VIP for randomized controlled trials on the efficacy and safety of the above three drugs in the treatment of moderate to severe atopic dermatitis from the time of construction until March 2023. Network Meta-analysis was performed in Stata14.0 and R4.3.2 software, and statistical analysis was performed using relative risk and 95% confidence interval. Results: A total of 17 randomized controlled trials involving 8807 AD patients were included. The results of network meta-analysis showed that the three drugs could improve the symptoms of patients with atopic dermatitis, and the cumulative ranking probability showed that upadacitinib 30 mg had the best efficacy, followed by 15 mg of upadacitinib and 200 mg of abrocitinib. And the proportion of patients achieving EASI-75, vIGA-AD 0/1 improvement and other efficacy evaluation indicators was significantly higher than that of placebo group. However, compared with baricitinib, abrocitinib and upadacitinib cause more treatment-induced adverse events (TEAE). Conclusion: Different doses of abrocitinib, baricitinib and upadacitinib are safe and effective in the treatment of adult and adolescent atopic dermatitis. The 30 mg dose of upadacitinib have a higher short-term efficacy, it is also necessary to pay attention to the possible risk of adverse reactions.

Key words: atopic dermatitis, Janus kinase inhibitor, network meta-analysis