文章摘要
刘自强 ，缪锦峰 ，朱舟.药物治疗肌萎缩性脊髓侧索硬化症有效性和安全性的网状Meta分析[J].神经损伤功能重建,2022,17(6):320-323
药物治疗肌萎缩性脊髓侧索硬化症有效性和安全性的网状Meta分析
Efficacy and Safety of Pharmacological Interventions for Amyotrophic Lateral Sclerosis: A Net⁃work Meta-Analysis
  
DOI：
中文关键词: 肌萎缩侧索硬化  网状Meta分析  利鲁唑  依达拉奉
英文关键词: amyotrophic lateral sclerosis  network meta-analysis  riluzole  edaravone
基金项目:1. 十三五国家重 点研发项目（No. 2017YFC131000 0）； 2. 华中科技大学 自主创新研究基 金（No. 2018KF YXMPTO15）
作者单位
刘自强1 ，缪锦峰2 ，朱舟2 1. 泰康同济（武 汉）医院综合医 疗科 2. 华中科技大学 同济医学院附属 同济医院神经内 科 
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中文摘要:
      目的：运用网状Meta分析比较利鲁唑、依达拉奉、马赛替尼、Tirasemtiv和Arimoclomol 5种药物治疗肌 萎缩性脊髓侧索硬化症（ALS）的有效性和安全性。方法：检索建库至2020年7月30日的国内外数据库中与5 种药物相关的随机对照试验，依据纳入排除标准对文献进行筛选，提取相关资料并使用R软件进行网状Meta 分析。结果：共纳入合格文献14篇，共2767例患者。网状Meta分析结果显示，与安慰剂相比，利鲁唑能减少 死亡或特定疾病状态的发生（OR=0.75, 95%CI: 0.58-0.96）；Tirasemtiv 能明显增加一般副作用的发生（OR= 3.1, 95%CI：2-4.8），Arimoclomol能引起更多严重副作用的发生（OR=8, 95%CI：2.2-36)。相对治疗排序结果和 聚类分析结果显示利鲁唑和依达拉奉在有效性和安全性排名均靠前。结论：利鲁唑和依达拉奉在治疗ALS 患者时兼顾了有效性和安全性，而Arimoclomol 在ALS患者身上的应用还需更多的临床实验证实其安全性。
英文摘要:
      To evaluate the efficacy and safety of Riluzole, Edaravone, Mosaitini, Tirasemtiv and Arimoclomol for amyotrophic lateral sclerosis (ALS) using network meta-analysis. Methods: Domestic and foreign literature databases were searched from their establishment to July 30, 2020 for randomized controlled trials that involve the above 5 medications for ALS. The literature was screened according to established criteria. Data were extracted, and network meta-analysis was performed with R software. Results: Fourteen studies involving 2767 patients were included in the analysis. Compared with the placebo, Riluzole reduced the incidence of death or disease progression in specific states (OR=0.75, 95% CI: 0.58-0.96), Tirasemtiv caused more general adverse events (OR= 3.1, 95%CI: 24.8), and Arimoclomol caused more serious adverse events (OR=8, 95%CI: 2.2-36). Relative treatment ranking and cluster analysis showed that Riluzole and Edaravone ranked first in efficacy and safety. Conclu⁃ sion: Riluzole and Edaravone are effective and safe in the treatment of ALS. More clinical trials are needed to confirm the safety of Arimoclomol in ALS patients.
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