中国临床药理学与治疗学2018，Vol.23Issue(10)：1132-1140,9.DOI:10.12092/j.issn.1009-2501.2018.10.008
艾拉莫德联合甲氨蝶呤治疗类风湿关节炎有效性和安全性的系统评价和Meta分析
Efficacy and safety of iguratimod combined with methotrexate in rheu-matoid arthritis: A systematic review and Meta-analysis
摘要
Abstract
AIM: To evaluate the efficacy and the safety of the combination therapy of iguratimod (IGU) and methotrexate (MTX) as compared with MTX monotherapy in adults with rheumatoid arthritis ( RA) through a Meta-analysis on randomized con-trolled trials ( RCTs) . METHODS: A systematic review was conducted by searching multiple databas-es including PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure ( CNKI) , VIP, the Chinese Biomedical Literature Database, Wanfang Data, the Chinese Scientific and Technological Journals Database. The systematic lit-erature search was carried out up to June 2017. RCTs related the efficacy and/or safety of IGU com-bined with MTX to treat RA were selected. The quality of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Inter-ventions and Jadad scoring, and Meta-analysis was performed using Rev2Man5. 3 software. RESULTS:Six RCTs involving 553 patients were included. Compared with MTX, IGU combined with MTX showed better effects in ACR20 [RR:1. 53, 95% CI (1.13,2.06), P =0.006], ACR50[RR:2. 15, 95%CI(1.64,2.81), P <0.001], ACR70[RR:2. 93, 95% CI(1. 54,3. 72), P<0. 001], and had a better result in lowering ESR, physician VAS and DAS28 level with the similar adverse effects ( AEs) [RR:1.06, 95% CI(0.91,1.24),P = 0.46]. Meanwhile, the systematic review shows that IGU combined with MTX was no less effective than MTX monotherapy in reducing CRP, TJC28, SJC28, Pain VAS, Patient VAS and HAQ after treatment. CON-CLUSION: For RA, IGU combined with MTX has a better clinical efficacy than MTX monotherapy, and adverse drug reactions remain stable of the com-bination therapy, which is referential for clinical ap-plication.关键词
艾拉莫德/甲氨蝶呤/类风湿关节炎/系统评价/Meta分析Key words
iguratimod/methotrexate/rheuma-toid arthritis/systematic review/Meta-analysis分类
医药卫生引用本文复制引用
伍嘉琪,杨俏雯,陈秀敏,黄闰月,黄清春,赵越,吴晓东..艾拉莫德联合甲氨蝶呤治疗类风湿关节炎有效性和安全性的系统评价和Meta分析[J].中国临床药理学与治疗学,2018,23(10):1132-1140,9.基金项目
广东省自然科学基金(2015A030313352) （2015A030313352）
广东省中医药科学院中医药科技转化医学研究专项(2014KT1642) （2014KT1642）
