论文部分内容阅读
目的系统评价奥马珠单抗对12~75岁难治性哮喘患者的治疗效果及临床应用。方法计算机检索Pubmed、Web of Science、Embase等数据库,纳入研究奥马珠单抗辅助治疗过敏性哮喘效果的随机对照试验,由两位研究者进行资料提取和质量评价后,采用Review Manage 5.1软件进行Meta分析。结果共纳入10个随机对照试验。与对照组比较,奥马珠单抗组能显著降低12~75岁难治性哮喘患者的激素稳定期急性发作率[RR=0.56,95%CI(0.42,0.75),P<0.000 1]以及激素减量期急性发作率[RR=0.53,95%CI(0.48,0.60),P<0.000 01],显著减少至少急性恶化发作1次患者的比例[RR=0.71,95%CI(0.61,0.84),P<0.000 01],并显著降低糖皮质激素用量(≥50%)[RR=1.51,95%CI(1.24,1.84),P<0.001]。另外,奥马珠单抗能显著改善哮喘患者生活质量[RR=1.25,95%CI(1.13,1.38),P<0.000 01];但对难治性哮喘患者急诊就诊率无显著影响[RR=0.63,95%CI(0.28,1.44),P<0.001]。结论在哮喘指南常规治疗基础上加用奥马珠单抗,可减少难治性哮喘患者急性发作率并降低糖皮质激素用量,改善患者生活质量。
Objective To systematically evaluate the therapeutic effect and clinical application of omalizumab in patients with refractory asthma aged 12 to 75 years. Methods The databases of Pubmed, Web of Science and Embase were searched by computer and included in the randomized controlled study of the effect of omalizumab in adjuvant treatment of allergic asthma. After the data were extracted and evaluated by two researchers, Meta analysis. Results A total of 10 randomized controlled trials were included. Compared with the control group, the omalizumab group was able to significantly reduce the acute stable rate of hormone seizures in patients with refractory asthma aged 12-75 years [RR = 0.56, 95% CI (0.42, 0.75), P <0.0001] and hormones Acute episodes of reduction episodes (RR = 0.53, 95% CI 0.48, 0.60, P <0.000 01) significantly reduced the proportion of patients with at least 1 episode of acute exacerbation (RR 0.71, 95% CI 0.61, 0.84) , P <.0001 01], and significantly decreased glucocorticoid dosage (≥50%) [RR = 1.51, 95% CI (1.24, 1.84, P <0.001]. In addition, omalizumab significantly improved the quality of life in asthmatic patients [RR = 1.25, 95% CI (1.13, 1.38), P <.0001]; however, no significant effect was observed in the emergency attendance of patients with refractory asthma [RR = 0.63 , 95% CI (0.28, 1.44), P <0.001]. Conclusion Opazarizumab can be used to reduce the acute attack rate of patients with refractory asthma and reduce the dosage of glucocorticoids and improve the quality of life of patients based on the routine treatment of asthma guidelines.