抗白细胞介素5治疗嗜酸性粒细胞增多综合征的疗效:一项最新的系统综述和荟萃分析。

IF 2.6 3区 医学 Q2 ALLERGY
Saad Masood, Muhammad Rafay Paracha, Sophia Ahmed, Maha Malik, Abdur Rehman Khalid, Muhammad Hamza Khalid, Laveeza Fatima, Beena Muntaha Nasir, Shafiq Ur Rahman, Komal Khan, Farooq Ahmad
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引用次数: 0

摘要

背景:高嗜酸性粒细胞综合征(HES)的特征是持续嗜酸性粒细胞增多,无原发原因,有嗜酸性粒细胞介导的器官损伤的证据。HES表现出一系列的临床表现,根据亚型的不同,预后和治疗也不同,包括髓系/淋巴系肿瘤和慢性嗜酸性粒细胞白血病。主要的治疗目标是减少嗜酸性粒细胞水平,以防止器官损伤,通常使用糖皮质激素和免疫抑制剂。然而,这些治疗方法往往疗效有限,而且有相当大的副作用。目的:鉴于白细胞介素(IL) 5在嗜酸性粒细胞发育和生存中的核心作用,本研究旨在评估抗IL-5治疗在HES患者中的疗效和安全性。方法:对两个数据库进行系统的文献检索。主要结果是绝对嗜酸性粒细胞计数的减少,次要结果包括耀斑和不良事件的发生率。进行数据分析,并为每个结果绘制森林图。结果:4项试验被纳入分析。与安慰剂组41%的患者相比,抗il -5组95%的患者显示绝对嗜酸性粒细胞计数减少(风险比[RR] 2.32[95%可信区间{CI}, 1.67-3.22];结论:抗il -5治疗可有效降低HES患者的嗜酸性粒细胞计数,预防疾病发作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of anti-interleukin 5 therapy in hypereosinophilic syndrome: An updated systematic review and meta-analysis.

Background: Hypereosinophilic syndromes (HES) are marked by persistent eosinophilia, absence of a primary cause, and evidence of eosinophil-mediated organ damage. HES presents a spectrum of clinical manifestations, with prognosis and treatment varying based on the subtype, including myeloid/lymphoid neoplasms and chronic eosinophilic leukemia, not otherwise specified. The primary treatment goal is to reduce eosinophil levels to prevent organ damage, typically by using glucocorticoids and immunosuppressive agents. However, these treatments often have limited efficacy and considerable adverse effects. Objective: Given the central role of interleukin (IL) 5 in eosinophil development and survival, this study aimed to assess the efficacy and safety of anti-IL-5 therapies in patients with HES. Methods: A systematic literature search was conducted on two data bases. The primary outcome was the reduction in absolute eosinophil count, and secondary outcomes included the incidence of flares and adverse events. Data Analysis was conducted, and forest plots were made for each outcome. Results: Four trials were included in the analysis. Ninety-five percent of the patients in the anti-IL-5 group showed a reduction in the absolute eosinophil count compared with 41% in the placebo group (risk ratio [RR] 2.32 [95% confidence interval {CI}, 1.67-3.22]; p = <0.00001; tau statistic (I²) = 0%). Anti-IL-5 therapy was associated with a lower incidence of disease flares, with 15% of the patients in the anti-IL-5 group who experienced flares compared with 30% in the placebo group (RR 0.50 [95% CI, 0.31-0.86]; p = 0.01; I² = 0%). The incidence of adverse events was similar between the two groups (RR 0.99 [95% CI, 0.91-1.07]; p = 0.81; I² = 0%). Conclusion: Anti-IL-5 therapies are effective in reducing eosinophil count and preventing disease flares in patients with HES.

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来源期刊
CiteScore
5.70
自引率
35.70%
发文量
106
审稿时长
6-12 weeks
期刊介绍: Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
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