未经证实:抗白细胞介素(IL)-17生物制剂(BA)在治疗银屑病和银屑病关节炎方面具有显著疗效;然而,不良事件(AE)很常见,其安全性尚未得到系统评估。
UNASSIGNED:本系统综述和荟萃分析的目的是总结银屑病和银屑病关节炎患者中抗IL-17BA引起的AE的数量和相应发生率,以改善其使用的临床决策。
未经授权:PubMed,Embase,科克伦图书馆,和WebofScience数据库由3位作者独立检索,获得2022年3月1日前发表的关于用抗IL-17BA治疗银屑病的文章,其中包含至少一个AE.使用R软件(4.1.3版)和Meta和Metafor软件包分析二分变量和95%置信区间(CI)。漏斗图和元回归用于测试偏倚的风险,I2用于评估异质性的大小,亚组分析用于减少异质性。
UASSIGNED:共有57项研究纳入了接受抗IL-17BA治疗的28,424例银屑病患者。亚组分析表明,抗IL-17A(73.48%)和抗IL-17A/F(73.12%)的BA比抗IL-17RBA(65.66%)更容易引起AE。治疗时间超过1年的不良事件发生率高达72.70%。长期使用药物有可能导致精神障碍。感染(33.16%),鼻咽炎(13.74%),注射部位反应(8.28%)是最常见的不良事件。抗IL-17BA最可能引起α型AE(33.52%)。很少观察到δ型AE(1.01%)。
未经证实:用于治疗银屑病和银屑病关节炎的抗IL-17BA引起一系列不良事件,但症状一般较轻。
Anti-interleukin (IL)-17 biological agents (BAs) have significant efficacy in the treatment of psoriasis and psoriatic arthritis; however, adverse events (AEs) are common, and their safety has not been systematically evaluated.
The purpose of this systematic review and meta-analysis was to summarize the number and corresponding rates of AEs caused by anti-IL-17 BAs in patients with psoriasis and psoriatic arthritis to improve clinical decision-making regarding their use.
PubMed, Embase, Cochrane Library, and Web of Science databases were independently searched by three authors for articles on the treatment of psoriasis with anti-IL-17 BAs that were published before March 1, 2022, and included at least one AE. Dichotomous variables and 95% confidence intervals (CI) were analyzed using R software (version 4.1.3) and the Meta and Metafor software packages. Funnel plots and meta-regression were used to test for the risk of bias, I2 was used to assess the magnitude of heterogeneity, and subgroup analysis was used to reduce heterogeneity.
A total of 57 studies involving 28,424 patients with psoriasis treated with anti-IL-17 BAs were included in the meta-analysis. Subgroup analysis showed that anti-IL-17A (73.48%) and anti-IL-17A/F (73.12%) BAs were more likely to cause AEs than anti-IL-17R BAs (65.66%). The incidence of AEs was as high as 72.70% with treatment durations longer than one year, and long-term use of medication had the potential to lead to mental disorders. Infection (33.16%), nasopharyngitis (13.74%), and injection site reactions (8.28%) were the most common AEs. Anti-IL-17 BAs were most likely to cause type α (33.52%) AEs. Type δ AEs (1.01%) were rarely observed.
Anti-IL-17 BAs used for the treatment of psoriasis and psoriatic arthritis caused a series of AEs, but the symptoms were generally mild.