背景:炎症性肠病(IBD)是一种严重影响生活质量的慢性炎症性疾病。常规治疗的成功有限。这项研究评估了1-磷酸鞘氨醇受体调节剂(S1PrMs)作为IBD潜在治疗的安全性和有效性.
方法:我们对PubMed上已发表的文献进行了彻底的搜索,EMBASE,和谷歌学者从2000年到2023年。纳入标准是随机对照试验(RCT),目标人群包括接受S1PrM或安慰剂的IBD患者,并比较2。使用RevMan(版本5.4)进行统计分析。森林地块将结果呈现为风险比(RR),置信区间为95%。
结果:共纳入7项RCTs,涉及2471例患者。报告了治疗的诱导和维持阶段的结果。在诱导阶段,干预组的组织学缓解发生率明显较高(RR=2.67;95%CI[1.97,3.60];P<.00001),内镜改善(RR=2.06;95%CI[1.66,2.56];P<.00001),与安慰剂组相比,临床缓解(RR=2.23;95%CI[1.43,3.46];P<.0004)和临床缓解(RR=1.37;95%CI[1.01,1.84];P=.04).在维持阶段评估的结果显着有利于干预组,而不是安慰剂,组织学缓解(RR=2.39;95%CI[1.83,3.11];P<.00001),内镜改善(RR=2.20;95%CI[1.28,3.77];P=.004),临床缓解(RR=3.03;95%CI[1.84,4.99];P<0.0001),和临床反应(RR=1.74;95%CI[1.25,2.42];P=.001)。
结论:S1PrMs显示出有希望的建立组织学缓解的潜力,内窥镜改进,临床缓解,和无皮质类固醇的临床缓解。随着更多的研究和临床试验,这些调节剂可能成为UC患者的可靠治疗选择.
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic inflammatory condition that significantly affects quality of life. Conventional treatments have had limited success. this study evaluates the safety and efficacy of Sphingosine 1-phosphate receptor modulators (S1PrMs) as a potential treatment for IBD.
METHODS: We conducted a thorough search of published literature on PubMed, EMBASE, and Google Scholar from 2000 to 2023. The inclusion criteria were randomized controlled trials (RCTs) with a target population comprising of IBD patients receiving either S1PrMs or placebo and a comparison of the 2. The statistical analysis was conducted using RevMan (version 5.4). Forest plots presented the results as risk ratios (RR) with a 95% confidence interval.
RESULTS: A total of 7 RCTs involving 2471 patients were included. The results were reported for both the induction and maintenance phases of treatment. in the induction phase, the intervention group proved to have a significantly higher incidence of histological remission (RR = 2.67; 95% CI [1.97, 3.60]; P < .00001), endoscopic improvement (RR = 2.06; 95% CI [1.66, 2.56]; P < .00001), clinical remission (RR = 2.23; 95% CI [1.43, 3.46]; P < .0004) and clinical response (RR = 1.37; 95% CI [1.01, 1.84]; P = .04) compared to the placebo group. Outcomes assessed in maintenance phase significantly favored the intervention group over placebo as well, histologic remission (RR = 2.39; 95% CI [1.83, 3.11]; P < .00001), endoscopic improvement (RR = 2.20; 95% CI [1.28, 3.77]; P = .004), clinical remission (RR = 3.03; 95% CI [1.84, 4.99]; P < .0001), and clinical response (RR = 1.74; 95% CI [1.25, 2.42]; P = .001).
CONCLUSIONS: S1PrMs show promising potential for establishing histologic remission, endoscopic improvement, clinical remission, and corticosteroid-free clinical remission. With more studies and clinical trials, these modulators may become a reliable therapeutic choice for UC patients everywhere.