ABSTRACT
OBJECTIVE:To systematically evaluate therapeutic efficacy of thalidomide in the treatment of ankylosing spondylitis,and to provide evidence-based reference for clinic.METHODS:Retrieved from Chinese Journal Full-text Database,China Science and Technology Journal Database,China Biology Medicine disc,Wanfang database,Medline,PubMed,Elsevier database and Cochrane library,the references of the included literatures were also reviewed,randomized controlled trials (RCTs) about thalidomide alone or combined with other routine drug (trial group) versus routine treatment or other drug (control group) in the treatment of ankylosing spondylitis were collected.After data extraction,quality evaluation of included studies by modified Jadad scale,Meta-analysis of response rate,bath ankylosing spondylitis disease activity index (BASDAI) score,erythrocyte sedimentation rate (ESR),C-reaction protein (CRP) level,thoracic mobility,pillow wall distance,Schober trial result,morning stiffness time and the number of peripheral joints with swelling and pain were conducted by using Rev Man 5.1 statistical software.RESULTS:A total of 10 RCTs were included,involving 636 patients.Results of Meta-analysis showed that response rate [OR=2.50,95％CI(1.36,4.62),P=0.003],thoracic mobility [MD=0.22,95％ CI (0.01,0.42),P=0.04],occipital wall distance [MD=-0.82,95％ CI (-1.32,-0.32),P=0.001],Schober trial result [MD=0.64,95％CI(0.28,0.99),P=0.000 4] and morning stiffness time [MD=-2.33,95 ％ CI (-3.92,-0.73),P=0.004] of trial group were significantly better than those control group,with statistical significance.There were no statistical significance in BASDAI score [MD=-4.40,95％CI(-8.96,0.16),P=0.06],ESR [MD=-3.51,95％CI(-7.76,0.74),P=0.11],CRP level [MD=-1.60,95％CI(-3.22,0.03),P=0.05] or the number of peripheral joints with swelling and pain [MD=-0.06,95％CI(-0.29,0.17),P=0.60] between 2 groups.CONCLUSIONS:Thalidomide shows significant improve effect on ankylosing spondylitis.Thalidomide is more effective than conventional drugs in the improvement of peripheral joint function and the control of inflammatory indicators.