这项研究的目的是比较长效生长激素(LAGH)作为生长激素替代疗法在患有生长激素缺乏症(GHD)的青春期前儿童中的相对疗效和安全性。我们搜查了PubMed,Embase,CNKI,和万方数据库从成立到2023年7月,并确定了11项相关研究。PEG-LAGH对高度速度的影响(平均差[MD]:-0.031,95%可信区间[CrI]:-0.278,0.215)比somatrogon(MD:0.105,95%CrI:-0.419,0.636)更好,与每日生长激素(DGH)相比,索马帕西坦(MD:0.802,95%CrI:-0.451,2.068)和lonapegsomatropin(MD:1.335,95%CrI:-0.3,2.989)。此外,就身高标准差得分而言,PEG-LAGH表现出比somatrogon(MD:-0.055,95%CrI:-1.3,0.51)和somapacitan(MD:0.22,95%CrI:-0.91,1.3)更好的改善(MD:-0.15,95%CrI:-1.1,0.66)。PEG-LAGH(风险比[RR]:1.00,95%CrI:0.82,1.2)与其他LAGH(somatrogon,RR:1.1,95%CrI:0.98,1.2;索马帕西坦,RR:1.1,95%CrI:0.96,1.4;lonapegomatropin,RR,1.1,95%CrI:0.91,1.3),与DGH相当。这是第一项通过网络荟萃分析间接比较LAGH的研究,并提供了各种LAGH特别是PEG-LAGH在青春期前GHD儿童中的最佳疗效和可接受的安全性的证据。
The purpose of this study is to compare the relative efficacy and safety of long-acting growth hormone (LAGH) as a growth hormone replacement therapy in prepubertal children with growth hormone deficiency (GHD). We searched the PubMed, Embase, CNKI, and Wanfang databases from inception to July 2023 and identified eleven relevant studies. PEG-LAGH showed better effect on height velocity (mean difference [MD]: - 0.031, 95% credibility interval [CrI]: - 0.278, 0.215) than somatrogon (MD: 0.105, 95% CrI: - 0.419, 0.636), somapacitan (MD: 0.802, 95% CrI: - 0.451, 2.068) and lonapegsomatropin (MD: 1.335, 95% CrI: - 0.3, 2.989) when compared with daily growth hormone (DGH). Furthermore, in terms of height standard deviation score, PEG-LAGH demonstrated better improvement (MD: - 0.15, 95% CrI: - 1.1, 0.66) than somatrogon (MD: - 0.055, 95% CrI: - 1.3, 0.51) and somapacitan (MD: 0.22, 95% CrI: - 0.91, 1.3). PEG-LAGH (risk ratio [RR]: 1.00, 95% CrI: 0.82, 1.2) reduced the risk of adverse events compared with other LAGH (somatrogon, RR: 1.1, 95% CrI: 0.98, 1.2; somapacitan, RR: 1.1, 95% CrI: 0.96, 1.4; lonapegsomatropin, RR, 1.1, 95% CrI: 0.91, 1.3) and was comparable with DGH. This is the first study to indirectly compare the LAGH thorough a network meta-analysis and provide evidence of the optimal efficacy of various LAGH specifically PEG-LAGH and acceptable safety profile in prepubertal children with GHD.