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中国药学(英文版) ›› 2019, Vol. 28 ›› Issue (3): 195-202.DOI: 10.5246/jcps.2019.03.019

• 【药事管理与临床药学专栏】 • 上一篇    下一篇

基于伊马替尼治疗系统性硬化症疗效的meta分析

张琪, 张博, 林能明*   

  1. 南京医科大学附属杭州医院, 杭州市医学转化研究中心, 浙江 杭州 310006
  • 收稿日期:2018-11-05 修回日期:2019-01-16 出版日期:2019-03-30 发布日期:2019-02-20
  • 通讯作者: Tel.: +86-571-56007905; Fax: +86-571-87914773, E-mail: lnm1013@163.com
  • 基金资助:

    Hangzhou Major Science and Technology Project (Grant No. 20172016A01), Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents (Grant No. 2010-190-4), Clinical Pharmacy of Zhejiang Medical Key Discipline (Grant No. 2018-2-3) and Clinical Pharmacy of Hangzhou Medical Key Discipline (Grant No. 2017-68-7).

Implications for the therapeutic role of Imatinib in systemic sclerosis: a single-arm meta-analysis

Qi Zhang, Bo Zhang, Nengming Lin*   

  1. Hangzhou Translational Medicine Research Center, Affiliated Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou 310006, China
  • Received:2018-11-05 Revised:2019-01-16 Online:2019-03-30 Published:2019-02-20
  • Contact: Tel.: +86-571-56007905; Fax: +86-571-87914773, E-mail: lnm1013@163.com
  • Supported by:

    Hangzhou Major Science and Technology Project (Grant No. 20172016A01), Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents (Grant No. 2010-190-4), Clinical Pharmacy of Zhejiang Medical Key Discipline (Grant No. 2018-2-3) and Clinical Pharmacy of Hangzhou Medical Key Discipline (Grant No. 2017-68-7).

摘要:

硬皮病样慢性移植物抗宿主病(ScGVHD)或系统性硬化症(SSc)是慢性移植物抗宿主病中最严重的临床表现之一。目前, SSc仍缺少有效的临床治疗方法和干预手段。研究发现伊马替尼(酪氨酸激酶抑制剂)ScGVHDSSc存在潜在治疗效果, 但其有效性始终存在争议。本文旨在运用meta分析对其有效性进行系统性的评价。研究发, 伊马替尼治疗组中肺部受累的SSc患者的临床缓解率(CRR = 0.601)高于无肺部受累患者(P<0.001), 病程长的SSc患者的临床缓解率(CRR = 0.550)高于病程短的患者(P<0.001)。简言之, 伊马替尼可在一定程度上有效缓解SSc, 故可为以后SSc的临床治疗提供新的参考价值。

关键词: 伊马替尼, 系统性硬化症, 硬化性慢性移植物宿主病

Abstract:

Sclerotic chronic graft-versus-host disease (ScGVHD) or systemic sclerosis (SSc) is one of the most severe manifestations of chronic graft-versus-host disease (cGVHD) since the involvement of major organs significantly affects the mortality and morbidity of SSc patients. Currently, there are no effective therapeutic approaches or standard “second-line” therapy for SSc. Imatinib, a clinical tyrosine kinase inhibitor used to treat chronic myeloid leukemia and gastrointestinal tumor, has shown potential therapeutic effects in treating ScGVHD or SSc. Due to the current limitations of clinical trials using Imatinib in the treatment of SSc, the results vary among different studies, and the applications of Imatinib in SSc is still in vagueness. Here we conducted a single-arm meta-analysis to quantitatively and systematically interpret the results of previous studies, as to evaluate the potential therapeutic effect of Imatinib in SSc. The pooled clinical response rate (CRR) showed that Imatinib had higher CRR in SScpatients with longer disease duration (CRR = 0.550) and lung involvement (CRR = 0.601) than those without (P<0.001). Therefore, it was encouraging to conduct future clinical studies regarding Imatinib therapy in SSc patients, since the global response rate of Imatinib was higher than expected in specific subgroup patients.

Key words: Imatinib, Systemic sclerosis, Sclerotic chronic graft-versus-host disease

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