■生物制剂用于治疗中度至重度斑块状银屑病(MSPP),这代表了皮肤病学最重要的治疗进步之一。到目前为止,MSPP的已批准和研究生物制剂的相对有效性和安全性尚不清楚.
■本研究旨在比较通过PASI75,PASI90和PASI100测量的MSPP的各种生物治疗方法的有效性(银屑病面积和严重程度指数(PASI)降低≥75%的患者比例,与基线相比,90%和100%分别)。此外,随机模型与贝叶斯方法一起使用,比较生物制剂与安慰剂的直接和间接不良事件(AE),对其AE进行概率陈述和预测。分析数据集由54项试验的汇总数据组成,包括27,808名病人,治疗17种生物制剂。建立了三个具有非参数安慰剂评估的数学模型,以表征上述三种功效措施的纵向轮廓。
■我们的结果显示处理之间存在显著差异。Bimekizumab,sonelokimab,发现ixekizumab是生物制剂中最有效的治疗方法。进一步评估了协变量的影响,患者年龄,体重,疾病持续时间和以前接受过生物治疗的患者百分比对疗效有影响.此外,我们发现ixekizumab和risankizumab的疗效和安全性相对稳定.
■我们的发现为生物制剂治疗MSPP的相对有效性和安全性提供了有价值的见解。这些结果可能有助于临床决策并最终改善患者预后。
Biologics is used for treating moderate to severe plaque psoriasis (MSPP), which represent one of the foremost therapeutic advancements in disease of dermatology. Up to now, the relative efficacy and safety across approved andinvestigational biologics for MSPP is still unclear.
This study aimed to comparative effectiveness of various biological treatments for MSPP measured by PASI75, PASI90 and PASI100 (The ratio of patients whose Psoriasis Area and Severity Index score (PASI) decreased by ≥ 75%, 90% and 100% compared with baseline, respectively). In addition, random models were used together with a Bayesian method to compare direct and indirect Adverse Events (AEs) of biologics with placebo, to make probabilistic statements and predictions on their AEs. The analytic data set was made up of summarized data from 54 trials, including 27,808 patients, with treatment of 17 biologics. Three mathematic models with nonparametric placebo evaluations were established to characterize the longitudinal direction profile for the three efficacy measures as above mentioned.
Our results showed significant differences among treatments. Bimekizumab, sonelokimab, and ixekizumab were found to be the most effective treatments among the biologics. The effects of covariate were further evaluated, patients\' age, body weight, duration of disease and percentage of patients previously treated with a biological therapy showed impact on the efficacy. In addition, we found that ixekizumab and risankizumab displayed relatively stable as for efficacy and safety.
Our findings provide valuable insights into the comparative effectiveness and safety of biologics for MSPP treatment. These results may aid in clinical decision-making and ultimately improve patient outcomes.