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摘要
Background: Tumor necrosis factor alpha (INF alpha) antagonists, namely, golimumab, adalimumab, infliximab, etanercept and certolizumab have been prescribed to alleviate and treat ankylosing spondylitis (AS). However, the lack of comparative evidence does not enable us to make constructive recommendations particularly for AS patient populations. Methods: Eligible controlled trials regarding the above 5 anti-TNF alpha therapies were searched electronically through PubMed. Embase and Cochrane until April 1, 2015. Odds ratios (ORs) were estimated and compared for efficacy (ASAS20, ASAS40, ASAS5/6 responses and ASAS partial remission) and acceptability (serious adverse effects (SAE)) among the anti-TNF alpha reagents. Results: Totally, 25 trials with 2989 participants were incorporated in this mixed treatment comparison. All the 5 TNF alpha blockers achieved better ASAS20, ASAS40, ASAS5/6 and ASAS-PR responses than the placebo. Furthermore, there was no significant distinction existed among inter-drug comparisons, except that unfavorable effects induced by certolizumab seemed to be less severe than those by etanercept (OR = 0.22, 95% CI: 0.05-0.93). Apart from that, etanercept was estimated to arrive at the most favorable ASAS20 response (90.6%) and SAE (83.6%), while infliximab seemed to accomplish the best ASAS40 (83.6%) and ASAS-PR responses (77.3%). In addition, adalimumab was estimated to rank the highest ASAS5/6 response (75.0%). Conclusions: Etanercept, infliximab and adalimumab might be prioritized among the commonly recognized 5 anti-TNF alpha therapies specific for AS patients, though existing evidence did not suffice to confirm significant superiority among the above 5 anti-TNF alpha reagent.
- 出版日期2016
- 单位徐州医科大学
