■本系统综述和荟萃分析的目的是评估波生坦的治疗效果,一种双重内皮素受体拮抗剂,用于患有数字溃疡(DU)的系统性硬化症(SSc)患者。
■对MEDLINE的系统搜索,Embase,WebofScience,Scopus使用适当的关键字完成,直到2021年9月。加权平均差(WMD)作为波生坦治疗疗效对连续结果的影响是一个估计值。此外,计算弥漫性SSc和局限性SSc的合并患病率.在适当时使用固定或随机效应模型进行数据合成。
■完全,469名患者,平均年龄为48.1至63.7岁,系统评价和荟萃分析纳入了8项研究.弥漫性SSc和限制性SSc的合并频率为56%(95%置信区间[CI]:39%,73%)和44%(95%CI:27%,61%)。波生坦治疗后新的DU的合并患病率为21%(95%CI:10%,33%)。荟萃分析结果显示WMD的合并平均下降:-0.09(95%CI:-0.020,0.02,P=0.10),大规模毁灭性武器:-2.82(95%CI:-5.91,0.27,P=0.07),和WMD:-6.65(95%CI:-9.49,-3.82,P<0.001)在平均SSc健康评估问卷中,疼痛,和Rodnan得分,分别。我们的荟萃分析还表明,与安慰剂受试者相比,SSc患者的新DU数量显着减少(WMD:-0.89[95%CI:-1.40,-0.37;P=0.001])和基线值(WMD:-1.34(95%CI:-1.95,-0.73;P<0.001)。
■波生坦可能是SSc相关DUs的有效治疗选择。尽管需要进一步的大规模随机临床试验来确认初步发现和潜在的作用机制。
UNASSIGNED: The aim of the present systematic review and meta-analysis was to evaluate the therapeutic efficacy of bosentan, a dual endothelin receptor antagonist, for systemic sclerosis (SSc) patients with digital ulcers (DUs).
UNASSIGNED: A systematic search of MEDLINE, Embase, Web of Science, and Scopus was done using appropriate keywords till September 2021. Weighted mean difference (WMD) as the effect of therapeutic efficacy of bosentan on continuous outcomes was an estimate. Furthermore, the pooled prevalence of diffuse SSc and limited SSc was computed. Fixed or random effects models when appropriate were used for data synthesis.
UNASSIGNED: Totally, 469 patients, with a mean age ranging from 48.1 to 63.7 years, from 8 studies were included in the systematic review and meta-analysis. The pooled frequency of diffuse SSc and limited SSc was 56% (95% confidence interval [CI]: 39%, 73%) and 44% (95% CI: 27%, 61%). The pooled prevalence of new DUs following bosentan treatment was 21% (95% CI: 10%, 33%). The results of the meta-analysis showed a pooled mean decrease of WMD: -0.09 (95% CI: -0.020, 0.02, P = 0.10), WMD: -2.82 (95% CI: -5.91, 0.27, P = 0.07), and WMD: -6.65 (95% CI: -9.49, -3.82, P < 0.001) in mean SSc-Health Assessment Questionnaire, pain, and Rodnan score, respectively. Our meta-analysis also indicated a significant pooled decrease in the number of new DUs in SSc patients compared to placebo subjects (WMD: -0.89 [95% CI: -1.40, -0.37; P = 0.001]) and baseline values (WMD: -1.34 (95% CI: -1.95, -0.73; P < 0.001).
UNASSIGNED: Bosentan possibly is an efficacious treatment option for SSc-related DUs. Although further large-scale randomized clinical trials are required to confirm the preliminary finding and underlying mechanisms of action.