阿普斯特用于治疗银屑病关节炎的疗效和安全性的Meta分析

目的：评价阿普斯特（apremilast,APR）治疗银屑病关节炎（psoriatic arthritis,PsA）的有效性和安全性。方法：检索"PubMed"、"Cochrane Library"、"OVID"公开发表的相关研究,并查询"clinictrials.gov"。进行文献质量评价和资料提取,用Rev Man5.3.5软件进行Meta分析。结果：共纳入随机对照试验（randomized controlled trial,RCT）文献6篇,共计1 645例PsA患者。Meta分析结果显示,在治疗PsA的有效性方面,治疗12周或16周后,APR各剂量组合并后ACR20缓解率高于安慰剂对照组,RR=1.67[95% CI （1.36,2.05）,P<0.000 01];HAQ-DI （Health assessment questionnaire-disability index）也优于安慰剂对照组,WMD=-0.14[95% CI （-0.17,-0.11）,P<0.000 01]。在安全性方面,APR各剂量组合并后不良事件（adverse event,AEs）发生率高于安慰剂对照组,RR=1.91[95% CI （1.41,2.59）,P<0.000 1]。结论： APR治疗可有效延缓或改善PsA病情,虽然导致不良反应,但患者耐受性良好。

A Meta-analysis of clinical efficacy and safety of apremilast in psoriatic arthritis patients

OBJECTIVE To assess the clinical efficacy and safety of apremilast (APR) against psoriatic arthritis (PsA).METHODS Studies were searched in PubMed, Cochrane Library, OVID, ‘clinicaltrails.gov’. After information collection and methodology quality evaluation, Meta-analysis was performed using Rev Man 5.3 software.RESULTS A total of 6 randomized controlled trials (RCTs) and 1 645 patients were included. The results of Meta-analysis indicated that, compared with controlled studies, APR combined ACR20 had higher remission and superior Health Assessment Questionnaire-Disability Index (HAQ-DI) compared to placebo (PBO) (RR=1.67, 95% CI (1.36, 2.05), P<0.000 01; WMD=-0.14, 95% CI (-0.17, -0.11), P<0.000 01, respectively), and the incidence rates of adverse events (AEs) were higher than those of PBO (RR=1.91, 95% CI (1.41, 2.59), P<0.000 1).CONCLUSION APR is effective and safe in PsA patients.