Dupilumab treatment in moderate-to-severe atopic dermatitis: A systematic review and meta-analysis
Dupilumab treatment in moderate-to-severe atopic dermatitis: A systematic review and meta-analysis
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Dupilumab 治疗中重度特应性皮炎：系统评价和荟萃分析
DOI：
10.1016/j.jdermsci.2018.01.016
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发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Luo, Feng-Ming
中科院分区：
文献类型：
--
作者：
Wang, Fa-Ping;Tang, Xiao-Ju;Luo, Feng-Ming
背景资料：Dupilumab是一种抗白细胞介素-4受体α亚基的全人源单克隆抗体，已开发并用于治疗特应性皮炎（AD）的临床试验。目的：我们旨在评估dupilumab治疗AD的总体疗效和安全性。方法：检索PubMed、Embase、科克伦图书馆数据库和截至2017年9月发表的中国生物医学（CBM）。纳入了dupilumab治疗成人AD患者的所有随机对照试验（RCT）。固定或随机效应模型被用来计算合并标准的平均差异或相对风险（SMD或RR，分别）。汇总分析显示，在EASI评分中，（SMD =-0.89，95% CI：-1.0至-0.78），体表面积百分比（BSA）（SMD =-0.83，95% CI：-0.90至-0.75），瘙痒数字评定量表（NRS）评分（SMD =-0.81，95% CI：-0.96至-0.66）和皮肤病生活质量指数（DLQI）评分（SMD =-0.78，95% CI：-0.89至-0.66）。Dupilumab治疗还与达到研究者总体评估（伊加）缓解的患者比例显着增加相关（RR = 3.82; 95% CI：3.23 - 4.51）和相似的不良事件发生率（RR = 1.0; 95% CI：0.96 - 1.04）。我们的分析提供的证据表明，dupilumab具有可接受的安全性特征，并导致临床相关的体征和症状改善，AD. 300 mg qw和q2 w的剂量方案似乎具有相似的获益。需要进一步的长期试验来确认。(C)2018日本皮肤病研究学会。Elsevier B. V.出版，保留所有权利。
Background: Dupilumab, a fully human monoclonal antibody against the interleukin-4-receptor alpha subunit, has been developed and used in clinical trials to treat atopic dermatitis (AD). Objective: We aimed to assess the overall efficacy and safety of dupilumab treatment in AD.Methods: PubMed, Embase, Cochrane library databases, and the Chinese Biological Medicine (CBM) published up to September 2017 were searched. All randomized controlled trials (RCTs) of dupilumab treatment on adult patients with AD were included. Fixed- or random-effects models were used to calculate pooled standard mean differences or relative risks (SMD or RR, respectively).Results: Six trials involving 2447 patients were identified. Pooled analysis revealed significant improvements in Eczema Area and Severity Index (EASI) score (SMD = -0.89, 95% CI: -1.0 to -0.78), percentage of body surface area (BSA) (SMD = -0.83, 95% CI: -0.90 to -0.75), pruritus numeric rating scale (NRS) scores (SMD = -0.81, 95% CI: -0.96 to -0.66), and Dermatology Life Quality Index (DLQI) scores (SMD = -0.78, 95% CI: -0.89 to -0.66). Dupilumab treatment was also associated with a significant increase in the proportion of patients achieving Investigator's Global Assessment (IGA) response (RR = 3.82; 95% CI: 3.23 to 4.51) and a similar incidence of adverse events (RR = 1.0; 95% CI: 0.96 to 1.04).Conclusions: Our analysis provided evidence that dupilumab had an acceptable safety profile and resulted in clinically relevant improvements in signs and symptoms of AD. Dose regimens of 300 mg qw and q2 w seemed to have similar benefits. Further long-term trials are required for confirmation. (C) 2018 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.