目的:本研究的目的是评估生物治疗对类风湿性关节炎患者心血管危险因素的影响,以确定其临床疗效。
方法:在PubMed,Embase,和Cochrane图书馆数据库。使用标准化平均差异(SMD)和95%置信区间(CIs)进行Meta分析,以评估心血管危险因素和动脉粥样硬化。异质性,敏感性分析,并评估发表偏倚.P<0.05时具有统计学意义。
结果:荟萃分析显示,与对照组相比,RA患者的生物治疗与高密度脂蛋白胆固醇(HDL-C)水平降低有关(MD:-0.10,95%CI:[-0.14,-0.05],P<0.0001)。基于治疗持续时间的亚组分析显示异质性和治疗12个月后总胆固醇水平的潜在降低(MD=-0.03,95%CI[-0.21,-0.15],P=0.76)。与对照组相比,生物治疗显着降低了甘油三酸酯水平(MD=-0.23,95%CI[-0.37,-0.09],P=0.001),在亚组分析中观察到。此外,生物制剂可有效降低低密度脂蛋白胆固醇(LDL-C)水平(MD:-0.10,95%CI:[-0.14,-0.05],P<0.0001)。然而,生物治疗与颈内动脉厚度增加相关(MD:0.05,95%CI:[0.03,0.07],P<0.0001),表明对心血管健康的潜在不利影响。未观察到对脉搏波速度(PWV)的显着影响(MD:-0.23,95%CI:[-0.80,0.34],P=0.43,I2=0%,P=0.55)。
结论:生物制剂可以改善RA患者的血脂状况,但也可能对心血管健康产生不利影响。需要进一步的研究来全面了解生物治疗对RA患者脂质代谢和心血管预后的影响。
背景:https://www.crd.约克。AC.英国/PROSPERO/,CRD42024504911。
OBJECTIVE: The purpose of the study is to evaluate the effects of biologic therapy on cardiovascular risk factors in rheumatoid arthritis patients to determine its clinical efficacy.
METHODS: Relevant literature was systematically searched in PubMed, Embase, and Cochrane Library databases. Meta-analysis was conducted using standardized mean differences (SMDs) and 95% confidence intervals (CIs) to evaluate cardiovascular risk factors and atherosclerosis. Heterogeneity, sensitivity analysis, and publication bias were assessed. Statistical significance was set at P<0.05.
RESULTS: The meta-analysis revealed that biologic treatment in RA patients was associated with decreased high-density lipoprotein cholesterol (HDL-C) levels compared to controls (MD: -0.10, 95% CI: [-0.14, -0.05], P<0.0001). Subgroup analysis based on treatment duration showed heterogeneity and a potential decrease in total cholesterol levels after 12 months of treatment (MD = -0.03, 95% CI [-0.21, -0.15], P = 0.76). Biologic therapy significantly reduced triglyceride levels compared to controls (MD = -0.23, 95% CI [-0.37, -0.09], P = 0.001), as observed in subgroup analysis. Moreover, biologics effectively decreased low-density lipoprotein cholesterol (LDL-C) levels (MD: -0.10, 95% CI: [-0.14, -0.05], P<0.0001). However, biologic treatment was associated with increased inner carotid artery thickness (MD: 0.05, 95% CI: [0.03, 0.07], P<0.0001), indicating potential adverse effects on cardiovascular health. No significant effect on pulse wave velocity (PWV) was observed (MD: -0.23, 95% CI: [-0.80, 0.34], P = 0.43, I2 = 0%, P = 0.55).
CONCLUSIONS: Biologic agents may improve lipid profiles in RA patients but could also have adverse effects on cardiovascular health. Further research is needed to comprehensively understand the impact of biologic therapy on lipid metabolism and cardiovascular outcomes in RA patients.
BACKGROUND: https://www.crd.york.ac.uk/PROSPERO/, CRD42024504911.