Efficacy and safety of monoclonal antibodies in neuromyelitis optica spectrum disorders:A survival meta-analysis of randomized controlled trials

作     者：Xintong Xu Lindan Xie Lili Wei Meixuan Li Hao Wang Huanfen Zhou Mingming Sun Mo Yang Quangang Xu Kehu Yang Shihui Wei 

作者机构：Medical School of Chinese PLABeijingChina Department of OphthalmologyChinese PLA General HospitalBeijingChina Evidence-Based Medicine CenterLanzhou UniversityLanzhouChina Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu ProvinceLanzhouChina Gansu Medical Guideline Technology CenterLanzhou UniversityLanzhouChina Department of OphthalmologyLanzhou University Second HospitalLanzhouChina 

出 版 物：《Advances in Ophthalmology Practice and Research》 (眼科实践与研究新进展（英文）)

年 卷 期：2022年第2卷第3期

页      面：8-16页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the Ministry of Science and Technology of the People's Republic of China Core Project(2018YFE0113900) 

主　　题：NMOSD Randomized controlled trials Monoclonal antibody Meta-analysis Free-relapse Adverse events 

摘      要：Background Monoclonal antibodies such as rituximab(RTX),eculizumab,inebilizumab,satralizumab,and tocilizumab have been found to be effective therapies for neuromyelitis optica spectrum disease(NMOSD)in several clinical randomized controlled *** The purpose of this meta-analysis of randomized controlled trials was to assess the efficacy and safety of monoclonal antibodies in the treatment of *** We searched the following databases for relevant English language literature from the establishment of the database to June 2021:PubMed,Embase,Cohorane Library,the Central Register of Controlled Trials(CENTRAL),and Web of *** controlled trials of monoclonal antibodies were the targets of the *** We included seven trials containing 775 patients(485 in the monoclonal antibody group and 290 in the control group).Patients in the monoclonal group(HR 0.24,95%CI:0.14 to 0.40,P0.00001),as well as patients with seropositive AQP4-IgG(HR 0.18,95%CI:0.11 to 0.29,P0.00001),both had a higher free recurrence rate than that in the control *** the first year(HR 0.25,95%CI:0.09 to 0.71,P=0.009)and the second year(HR 0.32,95%CI:0.13 to 0.81,P=0.02),no relapses were *** average changes of the expanded disability status scale(EDSS)score decreased by 0.29(95%CI:−0.09 to 0.51,P=0.005).Upper respiratory tract infection(OR 1.52,95%CI:0.76 to 3.04,P=0.24),urinary tract infection(OR 0.79,95%CI:0.51 to 1.21,P=0.27),and headache(OR 1.30,95%CI:0.78 to 2.17,P=0.31)were three most frequent adverse *** Monoclonal antibodies are particularly effective treatments in avoiding recurrence for NMOSD patients,according to this *** associated adverse responses are not significantly different from those seen with traditional immunosuppressants.