生物制剂和托法替尼治疗中重度溃疡性结肠炎的疗效和安全性：荟萃分析的系统综述。
Efficacy and safety of biologic agents and tofacitinib in moderate-to-severe ulcerative colitis: A systematic overview of meta-analyses.
机构信息
Medical School, University of Cyprus, Nicosia, Cyprus.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
出版信息
United European Gastroenterol J. 2019 Dec;7(10):1285-1303. doi: 10.1177/2050640619883566. Epub 2019 Oct 17.
BACKGROUND
Ulcerative colitis (UC) is an inflammatory disease of the colon and rectum. Treatment options include biologics and tofacitinib.
OBJECTIVES
We aim to summarize the evidence on efficacy and safety of biologics and tofacitinib in moderate-to-severe UC.
METHODS
PubMed, Embase, Scopus, and the Cochrane Library were systematically searched to identify meta-analyses of randomized controlled trials assessing adalimumab, golimumab, infliximab, vedolizumab, and tofacitinib in UC. Efficacy outcomes included induction and maintenance of clinical response, clinical remission and mucosal healing. Safety outcomes included adverse events and serious adverse events.
RESULTS
The overview involved 31 meta-analyses. All four biologics and tofacitinib were superior to placebo regarding efficacy. Indirect comparisons suggested that infliximab may be better than adalimumab and golimumab to induce clinical response and mucosal healing. Safety analyses indicated no increased rates of adverse events, except for infliximab.
CONCLUSIONS
Biologics and tofacitinib are efficacious and safe for treating UC. These findings can support clinical decision-making.
背景
溃疡性结肠炎（UC）是一种结肠和直肠的炎症性疾病。治疗选择包括生物制剂和托法替尼。
目的
我们旨在总结生物制剂和托法替尼治疗中重度 UC 的疗效和安全性证据。
方法
系统检索了 PubMed、Embase、Scopus 和 Cochrane 图书馆，以确定评估阿达木单抗、古利昔单抗、英夫利昔单抗、维得利珠单抗和托法替尼治疗 UC 的随机对照试验的荟萃分析。疗效结局包括诱导和维持临床缓解、临床缓解和黏膜愈合。安全性结局包括不良事件和严重不良事件。
结果
综述涉及 31 项荟萃分析。所有四种生物制剂和托法替尼在疗效方面均优于安慰剂。间接比较表明，英夫利昔单抗在诱导临床缓解和黏膜愈合方面可能优于阿达木单抗和古利昔单抗。安全性分析表明，除英夫利昔单抗外，其他药物不良事件发生率没有增加。
结论
生物制剂和托法替尼治疗 UC 有效且安全。这些发现可以支持临床决策。
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