单克隆抗tnf抗体治疗血管性behet综合征的疗效和安全性：一项系统综述和荟萃分析。

IF 8.3 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews Pub Date : 2025-06-30 DOI:10.1016/j.autrev.2025.103862

Yeling Liu , Jingwen Wu , Yiyuan Ao , Lu Li , Xiaoou Wang , Menghao Zhang , Xin Yu , Luxi Sun , Jinjing Liu , Wenjie Zheng

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引用次数: 0

摘要

目的：本研究是首个评价单克隆抗tnf抗体治疗血管性behaperet综合征（VBS）的疗效和安全性的荟萃分析。方法：在PubMed、Embase、Cochrane Library、Medline Complete和Web of Science上进行综合文献检索。在3个月、6个月和12个 月时计算临床反应的综合估计，包括完全缓解（CR）和部分缓解（PR）。根据使用的特异性单克隆抗tnf抗体进行亚组分析。此外，评估6 个月前后影像学反应的总比例。结果：纳入12项研究，共297例患者。临床CR的总比例64.1 %(95 %可信区间28.7 - -93.9 %),89.1 %(95 %可信区间72.4 - -98.6 %),和94.5 %(95 %可信区间82.5 - -99.8 %)在3、6和12 个月分别。92.9 %（95 %CI 77.2-100 %）的患者在6 个月内达到影像学应答，92.5 %（95 %CI 74.8-99.9 %）的患者在6 个月后达到影像学应答。在随访期间，26例患者在接受单克隆抗tnf抗体治疗时复发。在43名因缓解而停止治疗的患者中，28% % （n = 12）复发。在涉及42例患者的10项研究中报告了不良事件（ae），其中31例患者出现严重ae，包括5例死亡。结论：单克隆抗tnf抗体是治疗VBS的有效方法，具有显著的临床和放射学疗效，且具有良好的安全性。预防复发和控制疾病进展仍然是VBS管理的关键目标。通过按动脉和静脉受累程度分层的随机对照试验（RCTs）进一步验证其疗效，有必要加强证据基础并优化治疗策略。

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The efficacy and safety of monoclonal anti-TNF antibodies in the treatment of vascular Behçet's syndrome: A systematic review and meta-analysis

Objectives

This study is the first meta-analysis to evaluate the efficacy and safety of monoclonal anti-TNF antibodies in patients with vascular Behçet's syndrome (VBS).

Methods

A comprehensive literature search was conducted on PubMed, Embase, Cochrane Library, Medline Complete, and Web of Science. Pooled estimates of clinical response including complete response (CR) and partial response (PR), were calculated at 3, 6, and 12 months. Subgroup analyses were performed based on the specific monoclonal anti-TNF antibodies used. Additionally, pooled proportions of imaging response before and after 6 months were assessed.

Results

Twelve studies involving 297 patients were included. The pooled proportions of clinical CR were 64.1 % (95 %CI 28.7–93.9 %), 89.1 % (95 %CI 72.4–98.6 %), and 94.5 % (95 %CI 82.5–99.8 %) at 3, 6, and 12 months, respectively. Imaging response was achieved in 92.9 % (95 %CI 77.2–100 %) of patients within 6 months and 92.5 % (95 %CI 74.8–99.9 %) after 6 months. During follow-up, 26 patients experienced a relapse while on monoclonal anti-TNF antibodies treatment. Of the 43 patients who discontinued therapy due to response, 28 % (n = 12) experienced a relapse. Adverse events (AEs) were reported in 10 studies involving 42 patients, with 31 patients experiencing severe AEs, including 5 deaths.

Conclusions

Monoclonal anti-TNF antibodies are an effective treatment for VBS, demonstrating significant clinical and radiological efficacy with a favorable safety profile. Prevention of relapses and control of disease progression remain critical objectives in VBS management. Further validation of their efficacy through randomized controlled trials (RCTs) stratified by arterial and venous involvement is warranted to strengthen the evidence base and optimize therapeutic strategies.

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来源期刊

Autoimmunity reviews 医学-免疫学

CiteScore

24.70

自引率

4.40%

发文量

164

审稿时长

21 days

期刊介绍： Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.