阿帕他赛在临床前类风湿性关节炎中的疗效和安全性：随机对照试验的系统回顾和荟萃分析。

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2024-10-04 DOI:10.1016/j.semarthrit.2024.152562

Maheen Asif , Aliza Asif , Ummi Aiman Rahman , Abdullah Haseeb , Uzair Jafar , Hareem Farooq

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引用次数: 0

摘要

研究目的阿巴他赛普是一种生物 DMARD，已被用于治疗类风湿性关节炎。然而，有关其在临床前类风湿性关节炎（RA）中应用的文献十分有限。我们进行了这项荟萃分析，以评估阿帕赛普在临床前 RA 中的安全性和有效性：本荟萃分析旨在评估阿帕他赛在临床前阶段对类风湿性关节炎（RA）高危人群的有效性和安全性。该分析包括三项随机对照试验（RCT），共有367人参与。结果：荟萃分析发现，与安慰剂相比，阿帕他赛能显著降低罹患RA的风险（RR：0.67；95 % CI：0.51~0.89；P = 0.006），并能改善关节触痛数（SMD：-0.40；95 % CI：-0.63~-0.18；P = 0.0004）。此外，阿帕他赛还能显著减少功能性残疾（SMD：-1.51；95 % CI：-1.91至-1.11；P <0.00001），但在减轻疼痛方面未观察到显著差异。安全性分析显示，阿帕他赛普特组和安慰剂组在感染、恶性肿瘤或因不良事件而停药方面没有明显差异：结论：阿巴特赛普是一种很有前景的治疗方案，可延缓高危人群的RA发展。阿巴他赛普的安全性良好。要验证这些研究结果并提供更多实质性数据，还需要进行更多延长随访期的研究。

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Efficacy and safety of abatacept in preclinical rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials

Objective

Abatacept is a biological DMARD that has been used for the treatment of rheumatoid arthritis. However, the literature on its use in preclinical Rheumatoid arthritis (RA) is limited. We conducted this meta-analysis to evaluate the safety and efficacy of abatacept in preclinical RA.

Study design

This meta-analysis intends to assess the effectiveness and safety of abatacept in persons who are at a high risk of developing rheumatoid arthritis (RA) during the pre-clinical phase. The analysis comprises of three randomized controlled trials (RCTs) involving atotal of 367 participants. The study follows the procedures specified in the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA statemen

Results

The meta-analysis found that abatacept significantly reduced the risk of developing RA compared to placebo (RR: 0.67; 95 % CI: 0.51 to 0.89; P = 0.006) and improved tender joint count (SMD: -0.40; 95 % CI: -0.63 to -0.18; P = 0.0004). Additionally, abatacept demonstrated a significant reduction in functional disability (SMD: -1.51; 95 % CI: -1.91 to -1.11; P < 0.00001), though no significant difference was observed in pain reduction. Safety analysis revealed no significant differences in the occurrence of infections, malignancy, or discontinuation due to adverse events between the abatacept and placebo groups.

Conclusion

Abatacept is a promising treatment option for slowing down the development of RA in people who are at high risk. It has a positive safety profile. Additional studies with extended follow-up periods are required to validate these findings and offer more substantial data.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.