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| 不同血清白介素-6抑制剂对重症COVID-19患者疗效和安全性的网状Meta分析 | |
| 引用本文： | 蒋书琴1,汪慧2,刘媛媛1,赵文恒3,朱元浩4,张嘉鹏5,罗雷2. 不同血清白介素-6抑制剂对重症COVID-19患者疗效和安全性的网状Meta分析[J]. 现代预防医学, 2022, 0(19): 3627-3636. DOI: 10.20043/j.cnki.MPM.202110427 |
| 作者姓名： | 蒋书琴1 汪慧2 刘媛媛1 赵文恒3 朱元浩4 张嘉鹏5 罗雷2 |
| 作者单位： | 1.广东药科大学公共卫生学院，广东 广州 5103150 ；2.广州市疾病预防控制中心传防科3.南方医科大学公共卫生学院；4.暨南大学公共卫生学院；5.广州医科大学公共卫生学院 |
| 摘 要： | 目的 系统评价IL-6抑制剂治疗重症新冠肺炎的疗效和安全性。方法 检索PubMed、Embase、Cochrane Library、中国知网、维普期刊数据库、万方数据库以及中国生物医学网，收集IL-6抑制剂治疗重症新冠肺炎的相关研究，检索的时间为建库至2021年4月6日，检索的语言仅限中文和英文。筛选并提取文献中死亡率、机械通气率、临床改善率以及严重不良反应发生率等数据，使用Stata 16.0软件进行网状Meta分析。结果 本次网状Meta分析共纳入28篇研究，涉及10 743例重症COVID-19患者。网状Meta分析结果显示:标准治疗（SOC）的死亡率高于托珠单抗（Tocilizumab），差异具有统计学意义［RR=1.31，95%CI（1.07～1.62）］；安慰剂（Placebo）的严重不良反应发生率高于托珠单抗（Tocilizumab），差异具有统计学意义［RR=1.46，95%CI（1.06～2.00）］；其余两两比较均无统计学意义。概率排序结果显示:鲁索利替尼（Ruxolitinib）治疗后的患者死亡率、机械通气率和严重不良反应发生率可能是最低的；鲁索利替尼（Ruxolitinib）治疗后患者临床改善率可能是最高的。结论 依据现有的文献证据，在IL-6抑制剂中，鲁索利替尼（Ruxolitinib）可能是治疗重症COVID-19疗效最好，安全性最高的药物。 |
| 关 键 词： | IL-6抑制剂 新冠肺炎 系统评价 机械通气 |
Efficacy and safety of different IL-6 inhibitors in patients with severe COVID-19: a network Meta-analysis |
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| JIANG Shu-qin,WANG Hui,LIU Yuan-yuan,ZHAO Wen-heng,ZHU Yuan-hao,ZHANG Jia-peng,LUO Lei. Efficacy and safety of different IL-6 inhibitors in patients with severe COVID-19: a network Meta-analysis[J]. Modern Preventive Medicine, 2022, 0(19): 3627-3636. DOI: 10.20043/j.cnki.MPM.202110427 | |
| Authors: | JIANG Shu-qin WANG Hui LIU Yuan-yuan ZHAO Wen-heng ZHU Yuan-hao ZHANG Jia-peng LUO Lei |
| Affiliation: | *School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong 5103150, China |
| Abstract: | Objective To systematically evaluate the efficacy and safety of IL-6 inhibitors in treating severe coronary pneumonia. Methods PubMed, Embase, Cochrane Library, CNKI, VIP Database, Wanfang Database, and Chinese Biomedical Network were searched to collect relevant studies on IL-6 inhibitors treating severe COVID-19. The search time was from database establishment to April 6, 2021, search language limited to Chinese and English. Data on mortality, mechanical ventilation rate, clinical improvement rate, and incidence of severe adverse reactions in the literature were screened and extracted, and the network Meta-analysis was performed using Stata 16.0 software. Results A total of 28 studies involving 10,743 patients with severe COVID-19 were included in this network Meta-analysis. The results of the network Meta-analysis showed that the mortality rate of standards of care (SOC) was higher than that of tocilizumab, and the difference was statistically significant ［RR=1.31, 95% CI (1.07, 1.62）］. The incidence of severe adverse reactions of Placebo was higher than that of tocilizumab, and the difference was statistically significant ［RR=1.46, 95% CI (1.06,2.00）］. The other pairwise comparisons were not statistically significant. The results of probability ranking showed that the mortality, mechanical ventilation rate, and incidence rate of severe adverse reactions in patients after Ruxolitinib treatment might be the lowest. The clinical improvement rate in patients after Ruxolitinib treatment might be the highest. Conclusion Based on the available literature evidence, among IL-6 inhibitors, Ruxolitinib may be the most effective and safe drug for the treatment of severe COVID-19. |
| Keywords: | IL-6 inhibitor New coronary pneumonia Systematic review Mechanical ventilation |
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