今日药学

2021, v.31(06) 454-459

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依那西普联合甲氨蝶呤与甲氨蝶呤单用比较治疗幼年特发性关节炎有效性和安全性的Meta分析
Meta-analysis of Efficacy and Safety of Etanercept and Methotrexate Versus Methotrexate Alone in the Treatment of Juvenile Idiopathic Arthritis

钟秀秀;陈拔群;陈怡禄;和凡;何艳玲;莫小兰;
ZHONG Xiuxiu;CHEN Baqun;CHEN Yilu;HE Fan;HE Yanling;MO Xiaolan;Guangzhou Women and Children's Medical Center;

摘要(Abstract):

目的利用Meta分析评价依那西普联合甲氨蝶呤与甲氨蝶呤单用比较治疗幼年特发性关节炎的有疗效和安全性。方法计算机检索CNKI、维普数据库、万方数据库、Cochrane Library、PubMed、Web of Science,检索时间为数据库建立至2020年8月,全面查找符合纳入标准的临床随机对照试验(randomized controlled trial, RCT),采用RevMan 5.3软件进行统计分析。结果本研究共纳入7个RCT,试验组和对照组各有272例。Meta分析结果显示依那西普联合甲氨蝶呤组在总有效率、ACR30、ACR50、ACR70、C-反应蛋白(CRP)、红细胞沉降率(ESR)等指标的改善方面均优于甲氨蝶呤单用组,差异有统计学意义(P<0.05);在药物不良反应(ADR)发生率方面,两组之间差异无统计学意义(P>0.05)。结论依那西普联合甲氨蝶呤的疗效优于甲氨蝶呤单用的方案,但由于本次研究纳入的研究数目有限,该结论还需高质量、大样本研究进一步验证。
OBJECTIVE To evaluate the efficacy and safety of etanercept combined with methotrexate and methotrexate alone in the treatment of juvenile idiopathic arthritis using Meta-analysis. METHODS CNKI,VIP database, Wanfang, the Cochrane Library, PubMed and Web of Science were searched during database establishment to August 2020.Randomized controlled trials(RCTs) meeting the inclusion criteria were comprehensively collected.Finally, the data were evaluated by RevMan 5.3 software. RESULTS 7 randomized controlled trials were included, including 272 patients in the experimental group and 272 patients in the control group.Meta-analysis results showed that the curative effect of etanercept combined with methotrexate was superior to methotrexate alone group in the total effective rate, ACR30,ACR50,ACR70,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),etc.The difference was statistically significant(P<0.05).As for the incidence of adverse drug reactions(ADR).There was no significant difference(P>0.05). CONCLUSION The efficacy of etanercept combined with methotrexate is better than that of methotrexate alone, but the number of tests included is limited.This conclusion needs to be further verified by high-quality and large sample studies.

关键词(KeyWords): 依那西普;甲氨蝶呤;幼年特发性关节炎;Meta分析
etanercept;methotrexate;juvenile idiopathic arthritis;Meta-analysis

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基金项目(Foundation): 国家自然科学基金(81603203);; 广东省医学科研基金(A2016400);; 广东省中医药局科研项目(20201302);; 广东省医院药学研究基金(2021A35);; 广州市妇女儿童医疗中心儿研所内部基金(GWCMC2020LH-3-003)

作者(Author): 钟秀秀;陈拔群;陈怡禄;和凡;何艳玲;莫小兰;
ZHONG Xiuxiu;CHEN Baqun;CHEN Yilu;HE Fan;HE Yanling;MO Xiaolan;Guangzhou Women and Children's Medical Center;

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