Comparative efficacy and safety of thirteen biologic therapies for patients with moderate or severe psoriasis: A network meta-analysis
Comparative efficacy and safety of thirteen biologic therapies for patients with moderate or severe psoriasis: A network meta-analysis
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DOI：
10.1016/j.jphs.2018.12.006
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发表时间：
2019-04-01
影响因子：
3.5
通讯作者：
Duan, Xingwu
中科院分区：
文献类型：
--
作者：
Xu, Guomei;Xia, Meng;Duan, Xingwu
目的：本网络荟萃分析旨在加强有关生物治疗的有效性和安全性的相应证据。方法：检索PubMed和EMBASE数据库。比值比用于评价多方面比较。采用SUCRA分析各终点治疗的排序。以银屑病面积和严重程度指数50%、75%、90%、100%、PGA、皮肤病生活质量指数为结局，以不良事件和停药情况为安全性评价指标。结果：对于安全性问题，briakinumab与最少的头痛相关，itolizumab具有最低的感染风险。Ustekinumab在停药时表现最佳。SUCRA将briakinumab、brodalumab、英夫利昔单抗和ixekizumab列为疗效较好的治疗方法，而briakinumab和brodalumab似乎副作用轻微。这些比较之间没有观察到异质性。结论：Briakinumab在疗效和安全性方面表现相对稳定。英夫利昔单抗感染风险较低，是一个很好的选择。Brodalumab在PASI和PGA等疗效结局方面具有很好的潜力。需要更多的临床试验来提供更多关于英夫利昔单抗停药和brodalumab感染的数据，需要更大的随机对照试验来评估briakinumab。(c) 2019年作者。由Elsevier b.v.代表日本药理学会制作和主持。这是一篇基于CC BY-NC-ND许可（http://creativecommons）的开放获取文章。org/许可证/ by-nc-nd / 4.0 /)。
Purpose: This network meta-analysis was aimed to enhance the corresponding evidence with respect to the efficacy and safety of biologic treatments.Methods: PubMed and EMBASE database searches were conducted. Odds ratios were used to evaluate multi-aspect comparisons. SUCRA was used to analyze the ranking of treatments in each endpoint. Psoriasis Area and Severity Index 50%, 75%, 90%, 100%, PGA, dermatology quality of life index were considered as outcomes while adverse events and discontinuation were adopted to evaluate safety.Results: For safety issues, briakinumab was associated with least headache and itolizumab had the lowest risk of infection. Ustekinumab performed best in discontinuation. SUCRA ranked briakinumab, brodalumab, Infliximab and ixekizumab as the favorable efficacy therapies, while briakinumab and brodalumab seemed to have mild side effects. No heterogeneity was observed between these comparisons.Conclusions: Briakinumab performed relatively stable under efficacy and safety outcome. Infliximab can be a good choice for its lower risk of infection. Brodalumab present very good potential in efficacy outcome like PASI and PGA. More clinical trials are required to supply more data about discontinuation of infliximab and infection of brodalumab and larger RCT for assessment of briakinumab. (c) 2019 The Authors. Production and hosting by Elsevier B. V. on behalf of Japanese Pharmacological Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/ licenses/by-nc-nd/4.0/).