特应性皮炎患者使用生物疗法和选择性 Janus 激酶-1 抑制剂发生恶性肿瘤风险的系统回顾和网络荟萃分析。

IF 1.4 4区 医学 Q3 ALLERGY
Postepy Dermatologii I Alergologii Pub Date : 2024-06-01 Epub Date: 2024-06-30 DOI:10.5114/ada.2024.141125
Daud Manzar, Nikhil Nair, Emmanuel Suntres, Myanca Rodrigues, Logain Alghanemi, Mohannad Abu-Hilal
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引用次数: 0

摘要

简介特应性皮炎(AD)是一种具有多因素病理生理学的慢性炎症性皮肤病。生物疗法,包括dupilumab(IL-4/IL-13抑制剂)和tralokinumab(IL-13抑制剂),以及选择性Janus激酶-1(JAK-1)抑制剂,如upadacitinib和abrocitinib,已被批准用于治疗中度至重度特应性皮炎。目的:我们进行了一项系统性综述和网络荟萃分析(NMA),以研究和比较接受阿昔替尼、乌帕替尼、曲妥珠单抗或杜比单抗治疗的中重度AD患者的恶性肿瘤发病率和风险:在 Ovid MEDLINE 和 EMBASE 中进行了系统检索,包括 AD、恶性肿瘤、生物制剂和先进疗法。主要研究结果是接受安慰剂或至少一种以下晚期疗法(杜匹单抗、曲妥珠单抗、阿昔替尼或奥达帕替尼)的AD患者的恶性肿瘤发生率。我们利用几率比和频数模型进行了随机效应NMA分析:我们的搜索发现了11项试验,共10097名患者。NMA结果显示,在平均41周的治疗期内,dupilumab或选择性JAK-1抑制剂与恶性肿瘤发病率之间没有任何统计学意义上的显著关联:我们的分析显示,选择性JAK-1抑制剂和杜比鲁单抗治疗AD的恶性肿瘤风险在统计学上没有明显增加,平均随访41周的恶性肿瘤发病率也没有明显差异。不过,还需要进一步开展随访时间更长的前瞻性研究,以确认这些疗法的安全性及其对恶性肿瘤风险的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic review and network meta-analysis of the risk of malignancy with biologic therapies and selective Janus kinase-1 inhibitors in atopic dermatitis.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease with multifactorial pathophysiology. Biologic therapies, including dupilumab (IL-4/IL-13 inhibitor) and tralokinumab (IL-13 inhibitor), as well as selective Janus kinase-1 (JAK-1) inhibitors such as upadacitinib and abrocitinib, have been approved for the treatment of moderate to severe AD. However, their association with the incidence of malignancy in AD patients remains uncertain.

Aim: We conducted a systematic review and network meta-analysis (NMA) to investigate and compare the indidence and risk of malignancy in individuals with moderate-to-severe AD treated with abrocitinib, upadacitinib, tralokinumab, or dupilumab.

Material and methods: Systematic searches were conducted in Ovid MEDLINE and EMBASE that included AD, malignancy, biologic and advanced therapies. The primary outcome was incidence of malignancy in AD patients receiving placebo or at least one of the following advanced therapies: dupilumab, tralokinumab, abrocitinib or upadacitinib. A random-effects NMA was conducted with odds ratios and a frequentist model.

Results: Our search identified 11 trials comprising 10097 patients. The NMA did not show any statistically significant association between dupilumab or selective JAK-1 inhibitors and the incidence of malignancy up to an average of 41 weeks of treatment.

Conclusions: Our analysis revealed no statistically significant increased risk of malignancy and no significant difference in the incidence of malignancy between selective JAK-1 inhibitors and dupilumab for the treatment of AD up to an average follow-up of 41 weeks. Nevertheless, further prospective studies with longer follow-up periods are warranted to confirm the safety of these therapies and their impact on the risk of malignancy.

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来源期刊
CiteScore
2.60
自引率
7.10%
发文量
107
审稿时长
6-12 weeks
期刊介绍: Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii is a bimonthly aimed at allergologists and dermatologists.
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