药物治疗肌萎缩性脊髓侧索硬化症有效性和安全性的网状Meta分析

刘自强 ;缪锦峰 ;朱舟

神经损伤与功能重建 ›› 2022, Vol. 17 ›› Issue (6) : 320-323.

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神经损伤与功能重建 ›› 2022, Vol. 17 ›› Issue (6) : 320-323.
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药物治疗肌萎缩性脊髓侧索硬化症有效性和安全性的网状Meta分析

  • 刘自强1 ,缪锦峰2 ,朱舟2
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Efficacy and Safety of Pharmacological Interventions for Amyotrophic Lateral Sclerosis: A Net? work Meta-Analysis

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摘要

目的:运用网状Meta分析比较利鲁唑、依达拉奉、马赛替尼、Tirasemtiv和Arimoclomol 5种药物治疗肌 萎缩性脊髓侧索硬化症(ALS)的有效性和安全性。方法:检索建库至2020年7月30日的国内外数据库中与5 种药物相关的随机对照试验,依据纳入排除标准对文献进行筛选,提取相关资料并使用R软件进行网状Meta 分析。结果:共纳入合格文献14篇,共2767例患者。网状Meta分析结果显示,与安慰剂相比,利鲁唑能减少 死亡或特定疾病状态的发生(OR=0.75, 95%CI: 0.58-0.96);Tirasemtiv 能明显增加一般副作用的发生(OR= 3.1, 95%CI:2-4.8),Arimoclomol能引起更多严重副作用的发生(OR=8, 95%CI:2.2-36)。相对治疗排序结果和 聚类分析结果显示利鲁唑和依达拉奉在有效性和安全性排名均靠前。结论:利鲁唑和依达拉奉在治疗ALS 患者时兼顾了有效性和安全性,而Arimoclomol 在ALS患者身上的应用还需更多的临床实验证实其安全性。

Abstract

To evaluate the efficacy and safety of Riluzole, Edaravone, Mosaitini, Tirasemtiv and Arimoclomol for amyotrophic lateral sclerosis (ALS) using network meta-analysis. Methods: Domestic and foreign literature databases were searched from their establishment to July 30, 2020 for randomized controlled trials that involve the above 5 medications for ALS. The literature was screened according to established criteria. Data were extracted, and network meta-analysis was performed with R software. Results: Fourteen studies involving 2767 patients were included in the analysis. Compared with the placebo, Riluzole reduced the incidence of death or disease progression in specific states (OR=0.75, 95% CI: 0.58-0.96), Tirasemtiv caused more general adverse events (OR= 3.1, 95%CI: 24.8), and Arimoclomol caused more serious adverse events (OR=8, 95%CI: 2.2-36). Relative treatment ranking and cluster analysis showed that Riluzole and Edaravone ranked first in efficacy and safety. Conclu? sion: Riluzole and Edaravone are effective and safe in the treatment of ALS. More clinical trials are needed to confirm the safety of Arimoclomol in ALS patients.

关键词

肌萎缩侧索硬化 / 网状Meta分析 / 利鲁唑 / 依达拉奉

Key words

amyotrophic lateral sclerosis

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刘自强 ;缪锦峰 ;朱舟. 药物治疗肌萎缩性脊髓侧索硬化症有效性和安全性的网状Meta分析[J]. 神经损伤与功能重建. 2022, 17(6): 320-323
Efficacy and Safety of Pharmacological Interventions for Amyotrophic Lateral Sclerosis: A Net? work Meta-Analysis[J]. Neural Injury and Functional Reconstruction. 2022, 17(6): 320-323

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