来氟米特与甲氨蝶呤治疗类风湿性关节炎的Meta分析

目的评价来氟米特与甲氨蝶呤治疗类风湿性关节炎有效性和安全性。方法检索来氟米特与甲氨蝶呤治疗类风湿性关节炎的临床实验。Jadad量表评价临床实验。计算治疗后两组达到ACR20%标准的相对危险度和相关指标的加权均值差,两组患者全部和常见不良事件发生率的相对危险度。结果治疗后两组达到ACR20%标准的百分率差异无统计学意义,RR0.99(95%CI0.80～1.22),P=0.91。两组患者全部不良事件的发生率差异无统计学意义,RR1.32(95%CI0.74～2.36),P=0.35。来氟米特组腹泻、高血压、脱发、皮疹和瘙痒的发生率多于甲氨蝶呤组,仅口腔溃疡的发生率少于甲氨蝶呤组。结论来氟米特治疗类风湿关节炎的有效性与甲氨蝶呤相当,但安全性略逊于甲氨蝶呤。

A mate-analysis of efficacies of leflunomide and methotrexate in treatment of patients with rheumatoid arthritis

Objective To evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) in patients with rheumatoid arthritis (RA). Methods Searching clinical trials about treatment RA with leflunomide and MTX. Jadad scale identify qualified clinical trails. The relative risk of achievement of 20% improvement in ACR criteria (ACR 20%) in two groups at the end of study and the values of weighted means difference of relative indexes were calculated. The relative risk of whole adverse events and specific adverse events in two groups were also calculated. Results The rate of achievement of ACR 20% in two groups was no difference, RR 0.99 (95%CI 0.80-1.22),P=0.91. Although no statistical difference of whole adverse events in two groups was found, RR 1.32 (95%CI 0.74-2.36),P=0.35. The specific adverse events incidence such as diarrhea, hypertension, alopecie, rash and tinnitus in leflunomide group were more higher than those in MTX group. Only oral ulcer in leflunomide was less than that in MTX group. Conclusion The efficacy of leflunomide was comparable of MTX in patients with RA. While the safety of leflunomide was little less than MTX.