【作者】 吴逢波； 徐萍蓉； 贾苹； 李健； 唐尧；

【Author】 Wu Feng-bo~1 Xu Ping-rong~1 Jia Ping~2 Li Jian~1 Tang Yao~1 1.Department of Pharmacy,West China Hospital,Sichuan University,Chengdi 610041 2.Department of Pharmacy,Sichuan Province Hospital For Women and Children,Chengdu 610013

【机构】 四川大学华西医院药剂科； 四川省妇幼保健院药剂科；

【摘要】 目的评价不同剂量免疫球蛋白治疗复发—缓解型多发性硬化的疗效与安全性。方法检索有关不同剂量免疫球蛋白治疗复发—缓解行多发性硬化的随机对照试验(RCT)与半随机对照试验,根据纳入和排除标准筛选文献、提取资料和进行质量评价,并采用RevMan5.0.0软件进行Meta分析.结果共纳入3个试验,均为随机对照试验。1篇为高质量研究,2篇为较高质量研究评价。其中1个研究是治疗产后复发—缓解型多发性硬化,存在异质性,对其进行描述性分析。有2个研究报告了未复发率,结果显示没有统计学差异.有2个研究报告了年复发率,结果显示差异无统计学意义[OR=-0.00,95%(-0.36,0.36),P=0.98]。有2个研究报告了MRI显示的病症变化,结果显示MRI病症变化无统计学差异。不良反应的发生情况没有统计学差异。结论免疫球蛋白治疗复发—缓解行多发性硬化的量效关系尚缺乏大规模的临床证据。因此在使用IVIG治疗RRMS时,应根据患者的耐受性和经济情况等个体化给药有效控制RRMS.更多还原

【Abstract】 Objective To evaluate the efficacy and safety of different doses of IVIG in the treatment of RRMS.Methods We searched for randomized controlled trials of different doses of IVIG in the treatment of RRMS.We screened relevant stud- ies according to predefined inclusion and exclusion criteria,evaluated the quality of the included studies,and performed meta- analuses by using The Cochrane Collaborations Revman 5.0.0 software.Results Three randomized controlled trials of differ- ent dose of IVIG in the treatment of RRMS were included.One were of high quality and the other two were of lower quality. There has heterogeneity in one study that reported IVIG in postpartum RRMS.Two studies reported the relapse-free pa- tients,there were no statistics difference;Two studies reported the ARR,there were no statistics difference[OR=-0.00,95 % (-0.36,0.36),P= 0.98];Two studies reported the MRI leisons,there were no statistics difference,there were no statistics difference of the adverse drug reactions.Conclusion The evidence of the dose-effect relationship was not enough.Therefore, in the treatment of RRMS with IVIG,an individualized dosing regimen can be applied according to the patient’s tolerance and the economics condition.更多还原