背景:家族性腺瘤性息肉病(FAP)是一种遗传性疾病。目前,越来越多的药物被用来治疗FAP;然而,仅对少数患者的疗效和安全性进行了评估.因此,本研究旨在进行网络荟萃分析,以比较所有FAP相关药物的治疗结果和药物不良反应.
方法:检索了六个相关数据库,以确定相关的随机对照试验(RCT),并提取了各种药物的剂量和频率信息。此外,关于息肉数量和尺寸变化的数据,收集不同药物的治疗相关不良反应.采用贝叶斯方法直接或间接比较不同治疗方案对息肉数量和直径变化的影响。并对药物的安全性进行了调查。
结果:CXB在16mg/kg/天时显著减少息肉数量。8mg/kg/天的塞来昔布和舒林酸(150mg,每日两次)加厄洛替尼(75mg/天)对耐受FAP患者有效。此外,EPAFFA每天2g和舒林酸(150mg,每天两次)加厄洛替尼(75mg/天)是最有效的减少息肉大小。
结论:减少结直肠息肉数量最有效的治疗方法是塞来昔布16mg/kg/天。另一方面,每日剂量2gEPA-FFA在降低结直肠息肉直径方面显示最佳结果.
BACKGROUND: Familial adenomatous polyposis (FAP) is an inherited disorder. At present, an increasing number of medications are being employed to treat FAP; however, only a few have been assessed for their efficacy and safety. Therefore, this study aimed to conduct a network meta-analysis to compare the therapeutic outcomes and adverse drug reactions of all FAP-associated medications.
METHODS: Six relevant databases were searched to identify pertinent randomized controlled trials (RCTs), and information on the dosage and frequency of various drugs was extracted. Additionally, data on changes in polyp counts and dimensions, as well as treatment-related adverse reactions for different medications were collected. The Bayesian method was employed to directly or indirectly compare the impact of different treatment regimens on changes in polyp numbers and diameters, and the safety of the drugs was investigated.
RESULTS: CXB at 16 mg/kg/day significantly reduced polyp numbers. Celecoxib at 8 mg/kg/day and sulindac (150 mg twice daily) plus erlotinib (75 mg/day) were effective for tolerant FAP patients. Additionally, EPAFFA 2 g daily and sulindac (150 mg twice daily) plus erlotinib (75 mg/day) emerged as the most effective for reducing polyp size.
CONCLUSIONS: The most effective treatment for reducing the number of colorectal polyps is celecoxib 16 mg/kg/day. On the other hand, a daily dosage of 2 g EPA-FFA demonstrates the best results in terms of decreasing colorectal polyp diameter.