Abstract：
To explore the effectiveness and safety of upadacitinib for managing axial spondyloarthritis. Four databases (PubMed, EMBASE, Cochrane, and Web of Science) were applied to search randomized controlled trials (RCTs) for assessing upadacitinib treatment for axial spondyloarthritis published until January 2024. Five RCTs involving 1,246 participants were included. The upadacitinib group had significantly higher percentages of participants achieving Assessment of spondyloarthritis international society (ASAS) 20, ASAS40, ASAS partial remission, Bath ankylosing spondylitis disease activity index (BASDAI) 50, Ankylosing Spondylitis Disease Activity Score (ASDAS) low disease activity, ASDAS inactive disease, ASDAS clinically important improvement, and ASDAS major improvement, except for Work Productivity and Activity Impairment (WPAI) absenteeism. Obvious improvements were observed in the upadacitinib group for ASDAS (CRP), BASDAI, Modified BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Canadian Spondyloarthritis Research Consortium (SPARCC) MRI spine, SPARCC MRI sacroiliac joint, Ankylosing Spondylitis Quality of Life (ASQoLS), ASAS Health Index, Bath Ankylosing Spondylitis Metrology Index (BASMI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Total Back Pain, Nocturnal Back Pain, WPAI overall work impairment, WPAI presenteeism, and WPAI activity impairment. Adverse events (AEs) and serious adverse events (SAEs) incidence rates showed no significant difference differ between upadacitinib and placebo groups. Subgroup analysis revealed that disease subtype and age did not significantly affect efficacy, and upadacitinib demonstrated comparable efficacy to adalimumab for axial spondyloarthritis. Upadacitinib exhibited satisfactory efficacy in treating axial spondyloarthritis, reducing disease activity and significantly enhancing patients\' physical function, emotional well-being, and social engagement. This meta-analysis offers robust evidence supporting upadacitinib as a new treatment for axial spondyloarthritis patients.
摘要：
探讨upadacitinib治疗中轴型脊柱关节炎的有效性和安全性。四个数据库(PubMed，EMBASE,科克伦,和WebofScience）用于搜索截至2024年1月发表的评估upadacitinib治疗轴向脊柱关节炎的随机对照试验（RCT）。包括五个RCT，涉及1,246名参与者。upadacitinib组的参与者达到脊柱关节炎国际社会评估（ASAS）20，ASAS40，ASAS部分缓解的百分比明显更高，强直性脊柱炎疾病活动指数（BASDAI）50，强直性脊柱炎疾病活动评分（ASDAS）低，ASDAS非活动性疾病，ASDAS临床上重要的改善，和ASDAS的重大改进，除了工作生产力和活动损害(WPAI)缺勤。upadacitinib组的ASDAS（CRP）有明显的改善，BASDAI,改良的BASDAI,巴斯强直性脊柱炎功能指数（BASFI），加拿大脊柱关节炎研究协会（SPARCC）MRI脊柱，SPARCCMRI骶髂关节,强直性脊柱炎生活质量（ASQoLS），ASAS健康指数，巴斯强直性脊柱炎计量指数（BASMI），马斯特里赫特强直性脊柱炎附件炎评分（MASES），总背痛,夜间背痛,WPAI总体工作损害，WPAIpresenteeism,和WPAI活动受损。不良事件（AE）和严重不良事件（SAE）的发生率在upadacitinib组和安慰剂组之间没有显着差异。亚组分析显示疾病亚型和年龄对疗效无显著影响,和upadacitinib对轴性脊柱关节炎的疗效与阿达木单抗相当.Upadacitinib治疗中轴型脊柱关节炎疗效满意，减少疾病活动并显着增强患者的身体功能，情感幸福，和社会参与。这项荟萃分析提供了有力的证据，支持upadacitinib作为轴性脊柱关节炎患者的新疗法。
