依那西普治疗强直性脊柱炎的系统评价_《中国循证医学杂志》

作者：

1. 兰州大学循证医学中心，兰州大学基础医学院（兰州 730000）；2. 兰州大学免疫学研究所（兰州 730000）;

关键词：

依那西普强直性脊柱炎安全性有效性系统评价

DOI：

10.7507/1672-2531.20090080

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价依那西普治疗强直性脊柱炎的有效性和安全性。
方法　计算机检索Cochrane Library（2008 年第4 期）、MEDLINE（1966 ～ 2008. 9）、EMbase（1974 ～ 2008. 9）、中国生物医学文献数据库（1978 ～ 2008.9）、中国期刊全文数据库（1994 ～ 2008. 9）、中文科技期刊全文数据库（1989 ～ 2008. 9）。万方数据库，纳入依那西普治疗强直性脊柱炎的随机对照试验，由两名评价员独立提取资料，并对其方法学质量进行评价。对符合纳入标准的研究用RevMan5.0 软件进行Meta 分析。
结果　共纳入7 个随机对照试验，949 例患者。Meta 分析结果显示：依那西普组较安慰剂组能有效提高达到ASAS20 的病例数［OR=4.15，95% CI（2.90，5.93）］，达到ASAS50 例数［OR=6.88，95% CI（3.90，12.14）］，改善Bath 强直性脊柱炎活动指数［OR=6.52, 95%CI（3.18，13.37）］，降低红细胞沉降率 [WMD=16.27，95%CI（11.80，20.74）］。依那西普组与安慰剂比较，在注射部位不良反应发生率方面，差异有统计学意义［OR=3.91，95%CI（2.47，6.20）］，但其他不良反应的差异无统计学意义；25 mg 依那西普组和50 mg依那西普组在疗效和不良反应方面，差异无统计学意义。
结论依那西普较安慰剂能更有效地改善患者症状，缓解疾病的活动状态，但同时会增加注射部位反应的发生率，但现有有限证据尚不能证明不同剂量依那西普的有效性和安全性有差异，尚需高质量、大样本、长期的随机对照试验来验证依那西普治疗的最佳剂量。

引用本文： 李少红,马彬,谭继英,杨克虎. 依那西普治疗强直性脊柱炎的系统评价. 中国循证医学杂志, 2009, 09(4): 423-429. doi: 10.7507/1672-2531.20090080 复制

1.	donors. Arthritis Rheum, 1998, 41: 58-67.
2.	assessment group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum, 2001, 44: l876-1886.
3.	Sieper J, Braun J, Rudwaleit M, et al. Ankylosing spondylitis: an overview. Ann Rheum Dis, 2002, 61(Suppl 3): iii8–iii18.
4.	Br aun J , Bol low M, Remlinge r G, etal . Prevalenc e of spondylarthropathies in HLA-B27 positive and negative blood.
5.	Gran JT, Husby G, Hordvik M. Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Tromso, northern Norway. Ann Rheum Dis, 1985, 44: 359-67.
6.	Braun J, Listing J, Sieper J. Reply. Arthritis Rheum, 2005, 52: 4049-4059.
7.	Toussirot E, Wendling D. Current guidelines for the drug treatment of ankylosing spondylitis. Drugs, 1998, 56: 225-240.
8.	Immunex Corporation. Enbrel (etanercept) for subcutaneous injection (2006). Available from URL: http://www.amgen.com/pdfs/misc/enbrel_pi.pdf .
9.	Braun J, Heijde VD. Novel approaches in the treatment of ankylosing spondylitis and other spondyloarthritides. Expert Opin Investing Drugs, 2003, 12(7): 1097-1109.
10.	Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. Arthritis Rheum, 1984, 27: 361-368.
11.	Heijde VD, Linden S, Ballamy N, et a1. Which domains should be included in a core set for endpoints in ankylosing spondylitis? Introduction to the ankylosing spondylitis module of omeractive. The Journal of Rheumatology, l999, 26(76): 495-497.
12.	Heijde VD, Braun J, McGonagle D, et a1.Treatment trials in ankylosing spondylitis: current and future considerations. Ann Rheum Dis, 2002, 6 l(Suppl 3): iii24-iii32.11 Anderson JJ, Baron G, Heijde VD, et a1．Ankylosing spondylitis.
13.	Millicent A, Stone SD, Robert D, et a1．Validation exercise of the ankylosing spondylitis assessment study (ASAS)group response criteria in ankylosing spondylitis patients treated with biologics. Arthritis Rheum, 2004, 51: 316-320.
14.	Heijde DV, Silva JC, Dougados M, et al. Etanercept 50 mg once weekly is as effective as 25 mg twice weekly in patients with ankylosing spondylitis. Ann Rheum Dis, 2006, 65(12): 1572-1577.
15.	Braun J, McHugh N, Singh A, et al. Improvement in patientreported outcomes for patients with ankylosing spondylitis treated with etan- ercept 50 mg once-weekly and 25 mg twice weekly. Rheumatology, 2007, 46: 999-1004.
16.	Davis JC, Heijde VD, Braun J, et al. Recombinant Human Tumor Necrosis Factor Receptor (Etanercept) for Treating Ankylosing Spondylitis. Arthritis Rheum, 2003, 48(11): 3230-3236.
17.	Davis JC, Heijde VD, Braun J, et al. Sustained durability and tolerability of etanercept in ankylosing spondylitis for 96 weeks. Ann Rheum Dis, 2005, 64(11): 1557-1562.
18.	Davis JC, Heijde VD, Braun J, et al. Efficacy and safety of up to 192 weeks of etanercept therapy in patients with ankylosing spondylitis. Ann Rheum Dis, 2008, 67: 346-352.
19.	Brandt J, Khariouzov A, Listing J, et al. Six-Month Results of a Double-Blind, Placebo-Controlled Trial of Etanercept Treatment in Patients With Active Ankylosing Spondylitis. Arthritis Rheum, 2003, 48(6): 1667-1675.
20.	Brandt J, Listing J, Haibel H, et al. Long-term efficacy and safety of etanercept after readministration in patients with active ankylosing spondylitis .Rheumatology, 2005, 44(3): 342-348.
21.	Jennifer D, Gorman, Kenneth E, et al. Treatment of ankylosing spondylitis by inhibition of tumor necrosis factors a. N Engl J Med, 2002, 346(18): 1349-1356.
22.	Calin A, Dijkmans B, Emery P, et al. Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis. Ann Rheum Dis, 2004, 63(12): 1594-1600.
23.	王莉莎, 黄烽, 张江林, 等. 肿瘤坏死因子拮抗剂在治疗强直性脊柱炎中的安全性分析. 中国新药杂志, 2007, 16(7): 556-561.
24.	郝慧琴, 黄烽, 邓小虎, 等. 依那西普不同用药方案治疗强直性脊柱炎疗效比较. 中国药物与临床, 2008, 8(6): 432-436.

1. donors. Arthritis Rheum, 1998, 41: 58-67.
2. assessment group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum, 2001, 44: l876-1886.
3. Sieper J, Braun J, Rudwaleit M, et al. Ankylosing spondylitis: an overview. Ann Rheum Dis, 2002, 61(Suppl 3): iii8–iii18.
4. Br aun J , Bol low M, Remlinge r G, etal . Prevalenc e of spondylarthropathies in HLA-B27 positive and negative blood.
5. Gran JT, Husby G, Hordvik M. Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Tromso, northern Norway. Ann Rheum Dis, 1985, 44: 359-67.
6. Braun J, Listing J, Sieper J. Reply. Arthritis Rheum, 2005, 52: 4049-4059.
7. Toussirot E, Wendling D. Current guidelines for the drug treatment of ankylosing spondylitis. Drugs, 1998, 56: 225-240.
8. Immunex Corporation. Enbrel (etanercept) for subcutaneous injection (2006). Available from URL: http://www.amgen.com/pdfs/misc/enbrel_pi.pdf .
9. Braun J, Heijde VD. Novel approaches in the treatment of ankylosing spondylitis and other spondyloarthritides. Expert Opin Investing Drugs, 2003, 12(7): 1097-1109.
10. Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. Arthritis Rheum, 1984, 27: 361-368.
11. Heijde VD, Linden S, Ballamy N, et a1. Which domains should be included in a core set for endpoints in ankylosing spondylitis? Introduction to the ankylosing spondylitis module of omeractive. The Journal of Rheumatology, l999, 26(76): 495-497.
12. Heijde VD, Braun J, McGonagle D, et a1.Treatment trials in ankylosing spondylitis: current and future considerations. Ann Rheum Dis, 2002, 6 l(Suppl 3): iii24-iii32.11 Anderson JJ, Baron G, Heijde VD, et a1．Ankylosing spondylitis.
13. Millicent A, Stone SD, Robert D, et a1．Validation exercise of the ankylosing spondylitis assessment study (ASAS)group response criteria in ankylosing spondylitis patients treated with biologics. Arthritis Rheum, 2004, 51: 316-320.
14. Heijde DV, Silva JC, Dougados M, et al. Etanercept 50 mg once weekly is as effective as 25 mg twice weekly in patients with ankylosing spondylitis. Ann Rheum Dis, 2006, 65(12): 1572-1577.
15. Braun J, McHugh N, Singh A, et al. Improvement in patientreported outcomes for patients with ankylosing spondylitis treated with etan- ercept 50 mg once-weekly and 25 mg twice weekly. Rheumatology, 2007, 46: 999-1004.
16. Davis JC, Heijde VD, Braun J, et al. Recombinant Human Tumor Necrosis Factor Receptor (Etanercept) for Treating Ankylosing Spondylitis. Arthritis Rheum, 2003, 48(11): 3230-3236.
17. Davis JC, Heijde VD, Braun J, et al. Sustained durability and tolerability of etanercept in ankylosing spondylitis for 96 weeks. Ann Rheum Dis, 2005, 64(11): 1557-1562.
18. Davis JC, Heijde VD, Braun J, et al. Efficacy and safety of up to 192 weeks of etanercept therapy in patients with ankylosing spondylitis. Ann Rheum Dis, 2008, 67: 346-352.
19. Brandt J, Khariouzov A, Listing J, et al. Six-Month Results of a Double-Blind, Placebo-Controlled Trial of Etanercept Treatment in Patients With Active Ankylosing Spondylitis. Arthritis Rheum, 2003, 48(6): 1667-1675.
20. Brandt J, Listing J, Haibel H, et al. Long-term efficacy and safety of etanercept after readministration in patients with active ankylosing spondylitis .Rheumatology, 2005, 44(3): 342-348.
21. Jennifer D, Gorman, Kenneth E, et al. Treatment of ankylosing spondylitis by inhibition of tumor necrosis factors a. N Engl J Med, 2002, 346(18): 1349-1356.
22. Calin A, Dijkmans B, Emery P, et al. Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis. Ann Rheum Dis, 2004, 63(12): 1594-1600.
23. 王莉莎, 黄烽, 张江林, 等. 肿瘤坏死因子拮抗剂在治疗强直性脊柱炎中的安全性分析. 中国新药杂志, 2007, 16(7): 556-561.
24. 郝慧琴, 黄烽, 邓小虎, 等. 依那西普不同用药方案治疗强直性脊柱炎疗效比较. 中国药物与临床, 2008, 8(6): 432-436.

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依那西普治疗强直性脊柱炎的系统评价

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《中国循证医学杂志》

依那西普治疗强直性脊柱炎的系统评价

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