青霉胺类风湿性关节炎。

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Suarez-Almazor我,斯普纳C, Belseck E

青霉胺类风湿性关节炎。

科克伦数据库系统启2000;(2):CD001460。

PubMed ID

10796440 (在PubMed

]

文摘

目的:估计的短期影响D-penicillamine治疗类风湿性关节炎(RA)。必威国际app搜索策略:我们搜查了Cochrane肌肉骨骼组织的试验注册,Cochrane对照试验注册,Medline,包括1998年12月和Embase从1988 - 1998。我们还进行了handsearch引用列表的试验从电子必威国际app检索搜索。选择标准:所有随机对照试验和比较D-penicillamine和安慰剂的对照临床试验患者风湿性关节炎。数据收集和分析:试验的方法学质量评价由两个独立评论员(CS, EB)和检查了三分之一(MS)使用质量评估工具进行验证。类风湿性关节炎结果措施从六个月的出版物中提取端点和分层D-penicillamine剂量:低(< 500毫克/天),中等(500 < 1000 mg /天)和高(1000毫克/天或更大)。数据抽象和一位评论家的检查第二个(CS, MS)。使用标准平均差的集中分析联合计数,痛苦和全球评估。加权平均差用于红细胞沉降率(ESR)。毒性评估集中优势比提款和不良反应。 A chi-square test was used to assess heterogeneity among trials. Fixed effects models were used throughout, since no statistical heterogeneity was found. MAIN RESULTS: Six trials were identified, with 425 patients randomized to D-penacillamine and 258 to placebo. A statistically significant benefit was observed for D-penicillamine when compared to placebo for all three-dose ranges and for most outcome measures including: tender joint counts, pain, physician's global assessments and ESR. The standardized weighted mean differences between treatment and placebo in moderate doses were -0. 51 [95% CI -0.88, -0.14] for tender joint counts, -0.56 (95% CI -0. 87, -0.26) for pain and -0.97 (95% CI -1.25, -0.70) for global assessment. The difference for ESR was -10.6 mm/hr. Similar results were observed for the higher dose group. Total withdrawals were significantly higher in the moderate and high dosage D-penicillamine groups (OR=1.63 and 2.13 respectively), mostly due to increased adverse reactions (OR = 2.60 and 4.95 respectively), including renal and hematological abnormalities. REVIEWER'S CONCLUSIONS: D-penicillamine appears to have a clinically and statistically significant benefit on the disease activity of patients with rheumatoid arthritis. Its efficacy appears to be similar to that of other disease modifying anti-rheumatic drugs (DMARDs), but with a significantly higher toxicity. Its effects on long-term functional status and radiological progression are not clear from this review.

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青霉胺