中国临床药理学与治疗学2024，Vol.29Issue(7)：735-743,9.DOI:10.12092/j.issn.1009-2501.2024.07.002
甲状腺相关眼病治疗中不同单克隆抗体有效性与安全性的系统评价再评价
Umbrella review of the efficacy and safety of monoclonal antibodies in the treatment of thyroid-associated ophthalmopathy
摘要
Abstract
AIM:To comprehensively evaluate the efficacy and safety of rituximab(RTX),tocilizumab(TCZ),and teprotumumab(TMB)in the treatment of thyroid-associated ophthalmopathy(TAO).METHODS:A systematic search was conducted in PubMed,Embase and Cochrane Library databases for systematic reviews/meta-analyses on TAO treat-ment,with the search time limited to January 2024.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 state-ment,Assessment of Multiple Systematic Reviews(AMSTAR)2 tool,and Grading of Recommenda-tions,Assessment,Development,and Evaluation(GRADE)were used to assess the reporting quality,methodological quality,and evidence quality of the included studies.RESULTS:The current systematic reviews on the three monoclonal antibodies in TAO treatment exhibited deficiencies in reporting quali-ty,methodological quality,and evidence quality.Di-rect comparative evidence between the three monoclonal antibodies is still lacking.Based on indi-rect comparative evidence,TCZ appears to be the most promising treatment option,followed by TMB and RTX.In terms of efficacy,TCZ and TMB signifi-cantly reduced the Clinical Activity Score(CAS),pro-ptosis,and improved quality of life.TCZ also signifi-cantly reduced the incidence of diplopia.RTX signif-icantly reduced disease response,while RTX and TCZ both significantly improved disease inactiva-tion rates.RTX showed no significant difference in diplopia,lid fissure changes,NOSPECS score and quality of life.The conclusions regarding safety are inconsistent,with TCZ and TMB potentially increas-ing the incidence of adverse events,while RTX showed no significant difference in safety com-pared to glucocorticoids or placebo.CONCLUSION:This study provides evidence-based insights for the selection of three monoclonal antibodies in the treatment of TAO.While TCZ may have advantages in efficacy,considering the limitations of existing evidence,more high-quality studies are needed to further verify and compare the efficacy and safety of different monoclonal antibodies in TAO treat-ment.关键词
甲状腺相关眼病/利妥昔单克隆抗体/托珠单克隆抗体/替妥木单克隆抗体/伞形综述Key words
thyroid-associated ophthalmopathy/rituximab/tocilizumab/teprotumumab/umbrella review分类
医药卫生引用本文复制引用
刘爽,蒋函錞,吴晶晶,赵荣生..甲状腺相关眼病治疗中不同单克隆抗体有效性与安全性的系统评价再评价[J].中国临床药理学与治疗学,2024,29(7):735-743,9.基金项目
国家自然科学基金项目(72074005) （72074005）
