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·循证药学·
贝那利珠单抗治疗重度嗜酸粒细胞性哮喘疗效和安全性的Meta
分析 Δ
1*
王华玉 ,李艳奎 ,王凯强 ,王荣环 (1.天津医科大学第二医院药学部,天津 300211;2.天津医科大学第二医
1 #
2
2
院血管外科,天津 300211)
中图分类号 R956;R562 文献标志码 A 文章编号 1001-0408(2021)14-1770-06
DOI 10.6039/j.issn.1001-0408.2021.14.18
摘 要 目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检
索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组)
对比安慰剂+常规治疗(对照组)的随机对照试验,检索时限均为建库起至2020年12月,并同时手工检索相关研究的参考文献。对
符合纳入标准的研究进行资料提取后,采用Cochrane 系统评价员手册 6.1推荐的偏倚评估工具2.0版本对纳入文献的质量进行评
价。采用Rev Man 5.4软件进行Meta分析。结果:共纳入5项研究,合计2 646例患者。Meta分析结果显示,试验组患者的哮喘急
性发作率 [RR=0.67,95%CI(0.61,0.74),P<0.000 01]、哮喘控制问卷评分[MD=-0.29,95%CI(-0.37,-0.21),P<0.000 01]、
严重不良事件发生率 [RR=0.67,95%CI(0.53,0.84),P=0.000 6]均显著低于对照组,第1秒用力呼气量[MD=0.13,95%CI(0.09,
0.17),P<0.000 01]、哮喘生活质量问卷评分[MD=0.23,95%CI(0.13,0.33),P<0.000 01]均显著高于对照组,而两组患者的不良事
件发生率比较差异无统计学意义[RR=0.97,95%CI(0.92,1.02),P=0.28]。结论:贝那利珠单抗治疗重度嗜酸粒细胞性哮喘患者
安全、有效。但因数据相对有限,该结论还有待更多的研究来证实。
关键词 贝那利珠单抗;嗜酸粒细胞性哮喘;疗效;安全性;Meta分析
Efficacy and Safety of Benralizumab for Severe Eosinophilic Asthma:A Meta-analysis
2
1
1
2
WANG Huayu ,LI Yankui ,WANG Kaiqiang ,WANG Ronghuan(1. Dept. of Pharmacy,the Second Hospital of
Tianjin Medical University,Tianjin 300211,China;2. Dept. of Vascular Surgery,the Second Hospital of
Tianjin Medical University,Tianjin 300211,China)
ABSTRACT OBJECTIVE:To systematically evaluate the efficacy and safety of benralizumab in the treatment of severe
eosinophilic asthma,and to provide evidenced-based reference for clinical treatment. METHODS:Retrieved from PubMed,
Embase,Cochrane Library,ClinicalTrials.gov,CNKI,VIP and Wanfang database,randomized controlled trials (RCTs) about
benralizumab+routine treatment(trial group)versus placebo+routine treatment(control group)were collected during the inception
to Dec. 2020. The relevant references were also retrieved manually. After data extraction,the quality of included literatures was
evaluated with bias risk evaluation tool 2.0 recommended by Cochrane systematic evaluator manual 6.1. Meta-analysis was
conducted by using Rev Man 5.4 software. RESULTS:Totally 5 studies involving 2 646 patients were included. Results of
Meta-analysis showed that acute exacerbation rate of asthma [RR=0.67,95% CI(0.61,0.74),P<0.000 01],asthma control
questionnaire score [MD=-0.29,95%CI(-0.37,-0.21),P<0.000 01] and the incidence of severe adverse event [RR=0.67,95%CI
(0.53,0.84),P=0.000 6] in trial group were significantly lower than control group. FEV 1[MD=0.13,95%CI(0.09,0.17),P<0.000 01]
and asthma quality of life questionnaire score [MD=0.23,95%CI(0.13,0.33),P<0.000 01] in trial group were significantly higher
than control group. There was no statistical significance in the incidence of adverse event between 2 groups [RR=0.97,95%CI
(0.92,1.02),P=0.28]. CONCLUSIONS:Benralizumab is effective and safe in the treatment of severe eosinophilic asthma. Due to
the relatively limited data,this conclusion needs to be confirmed by more studies.
KEYWORDS Benralizumab;Eosinophilic asthma;Efficacy;Safety;Meta-analysis
Δ 基 金 项 目 :天 津 医 科 大 学 第 二 医 院 青 年 科 研 基 金 项 目 哮喘是一种慢性气道炎症性疾病,由多种细胞(嗜
(No.2019ydey17) 酸性粒细胞、肥大细胞、T淋巴细胞、气道上皮细胞等)和
*主管药师,硕士。研究方向:临床药学。E-mail:wanghua- [1]
细胞组分共同参与 。2019年全球疾病负担研究结果显
yu001@126.com
示,全球约有 2.62 亿人患有哮喘,其中 3.7%为重度哮
# 通信作者:副主任药师。研究方向:药物临床研究。E-mail:
wrh1964@126.com 喘 [2-3] 。重度哮喘是指在过去1年中,需要使用全球哮喘
·1770 · China Pharmacy 2021 Vol. 32 No. 14 中国药房 2021年第32卷第14期