Beneficial effects of apremilast on genital ulcers, skin lesions, and arthritis in patients with Beh?et’s disease: A systematic review and meta-analysis
Beneficial effects of apremilast on genital ulcers, skin lesions, and arthritis in patients with Beh?et’s disease: A systematic review and meta-analysis
复制标题
阿普斯特对白塞氏病患者生殖器溃疡、皮肤损伤和关节炎的有益作用：系统评价和荟萃分析
DOI：
10.1093/mr/roab098
复制
发表时间：
2021
影响因子：
2.2
通讯作者：
Nakajima Hideaki
中科院分区：
文献类型：
--
作者：
Iizuka Yuki;Takase-Minegishi Kaoru;Hirahara Lisa;Kirino Yohei;Soejima Yutaro;Namkoong H o;Horita Nobuyuki;Yoshimi Ryusuke;Takeuchi Masaki;Takeno Mitsuhiro;Mizuki Nobuhisa;Nakajima Hideaki
本研究旨在探讨阿帕司特治疗Behçet‘s病(BD)患者口腔溃疡(OU)的临床疗效、口腔外表现和疾病活动性。方法系统检索PubMed、Embase、Cochrane图书馆和Web of Science核心文献。评估阿波司特对BD的治疗效果的研究包括在内。采用随机模型Meta分析，计算12周和24 时无症状个体症状的优势比(OR)和Behçet病现行活动表评分的平均差值(MD)，95%可信区间(CI)。治疗12周后，无症状的OR值分别为：OU，45.76(95%CI，13.23~158.31)；生殖器溃疡，4.56(95%CI，2.47~8.44)；结节性红斑，3.59(95%CI，1.11~11.61)；假性毛囊炎，2.81(95%CI，1.29~6.15)；关节炎，3.55(95%CI，1.71~7.40)。此外，12 时BDCAF评分显著降低(MD=−1.38；−1.78至−0.99)。然而，在24 周时，无口腔溃疡患者的比例增加(OR = 14.88；4.81to 46.07)。结论目前积累的数据表明，BD患者通过短期的早期治疗可以改善黏膜皮肤和关节症状。
ObjectivesThis study aimed to determine the clinical efficacy of apremilast for oral ulcers (OUs), extra-oral manifestations, and overall disease activity in patients with Behçet’s disease (BD).MethodsA systematic literature search was performed in PubMed, Embase, Cochrane Library, and Web of Science Core Collection. Studies assessing the treatment effects of apremilast in BD were included. The odds ratios (ORs) of being symptom-free for individual manifestations and mean difference (MD) of Behçet’s Disease Current Activity Form (BDCAF) scores were calculated with 95% confidence intervals (CIs) at 12 and 24 weeks using a random-model meta-analysis.ResultsOf 259 screened articles, eight were included. After 12 weeks of apremilast treatment the OR of symptom-free was as followings: OUs, 45.76 (95% CI, 13.23–158.31); genital ulcers, 4.56 (95% CI, 2.47–8.44); erythema nodosum, 3.59 (95% CI, 1.11–11.61); pseudofolliculitis, 2.81 (95% CI, 1.29–6.15); and arthritis, 3.55 (95% CI, 1.71–7.40). Furthermore, BDCAF scores at 12 weeks were significantly reduced (MD=−1.38; −1.78 to −0.99). However, the proportion of oral-ulcer-free patients increased at 24 weeks (OR = 14.88; 4.81 to 46.07).ConclusionsThe currently accumulated data indicate an improvement in mucocutaneous and articular symptoms by short-term apremilast treatment in patients with BD.