【摘要】 目的 应用网状meta分析评估白细胞介素-17(IL-17)抑制剂治疗中重度斑块状银屑病的效果及安全性。方法 检索PubMed、Embase、Cochrane Library、中国知网、万方数据库、维普中文期刊全文数据从2000年1月1日至2020年12月30日发表的关于IL-17抑制剂治疗银屑病的文献，筛选后对实验数据进行网状meta分析。结果 共纳入18篇文献，包含21项临床随机对照试验(RCTs)。网状meta分析结果显示，PASI75和PASI100作为疗效评分时，IL-17抑制剂疗效均优于依那西普组(P<0.05),司库奇尤单抗高剂量组(300 mg)、依奇珠单抗高频组(80 mg,每2周1次)及布罗达单抗高剂量组(210 mg)疗效均优于其相对应的低剂量组及低频组(P<0.05);所有IL-17抑制剂不良反应发生率较安慰剂相比差异有统计学意义(P<0.05),依奇珠单抗组及司库奇尤单抗组不良反应发生率与依那西普组比较，差异无统计学意义(P>0.05)。SUCRA排序结果显示，PASI75作为疗效评分时，依奇珠单抗高频组(80 mg,每2周1次)表现出较好的疗效(SUCRA:93.13%);PASI100作为疗效评分时，布罗达单抗高剂量组(210 mg)疗效较优(SUCRA:96.94%);依奇珠单抗高频组在不良反应发生率表现出较高风险(SUCRA:14.93%)。结论 IL-17抑制剂治疗中重度斑块状银屑病效果较好，但使用前仍需要注意筛查各项指标，提高使用安全性。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of interleukin-17(IL-17) inhibitors in the treatment of moderate to severe plaque psoriasis by network meta-analysis.Methods The literatures were searched from PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP Chinese Journal from January 1, 2000 to December 30, 2020, then network meta-analysis was performed on the screened experimental data.Results A total of 18 literatures were included in this study, including 21 randomized controlled trials(RCTs). Results of network meta-analysis showed that when PASI75 and PASI100 were used as efficacy scores, the efficacy of all IL-17 inhibitors was better than etanercept group(P<0.05), and the high dose of secukinumab group(300 mg), the high frequency of ixekizumab group(80 mg, Once every two weeks) and the high dose of brodalumab group(210 mg) were better than their corresponding low dose and low frequency groups(P<0.05). There were statistical differences between all IL-17 inhibitors and placebo(P<0.05). There were no statistical differences between the incidence of adverse reactions in ixekizumab group and secukinumab group compared with etanercept group(P>0.05). SUCRA sequencing results showed that when PASI75 was used as efficacy score, the high frequency of ixekizumab group(80 mg, once every two weeks) showed better efficacy(SUCRA: 93.13%). When PASI100 was used as efficacy score, the high dose of brodalumab group(210 mg) showed better efficacy(SUCRA: 96.94%). The high frequency of ixekizumab group showed a higher risk of adverse reactions(SUCRA: 14.93%).Conclusion IL-17 inhibitors showed good efficacy and safety in the treatment of moderate to severe plaque psoriasis, but it is still necessary to screen indicators before using IL-17 inhibitors to improve the safety.更多还原