Efficacy and Safety of Guselkumab in the Treatment of Moderate-to-severe Plaque Psoriasis ：A Systematic Re- view / 中国药房

ABSTRACT

OBJECTIVE：To systematically evaluate the efficacy and safety of guselkumab in the treatment of moderate-to- severe plaque psoriasis ，and to provide evidence-based reference for the clinical treatment. METHODS ：Retrieved from PubMed ， Embase，Cochrane Library ，CNKI，VIP，Wanfang database during inception to Oct. 2019，randomized controlled trials （RCTs） about guselkumab versus placebo/positive control in the treatment of moderate-to-severe plaque psoriasis were collected. After literature screening and data extraction ，quality evaluation was performed by using the bias risk evaluation tool recommended by the Cochrane System evaluator manual 5.1.0. Meta-analysis was performed by using Stata 16.0 software. RESULTS ：Eight RCTs with a total of 3 488 patients were included. The results of Meta-analysis indicated that the proportion of patients who achieved 90％ reduction or more from baseline of psoriasis area and severity index （PASI）in guselkumab group was significantly higher than that placebo group [RR ＝26.72，95％CI（15.98，44.70），P＜0.001]，adaliumumab group [RR ＝1.45，95％CI（1.32，1.59）， P＜0.001] and secukinumab group （P＜0.000 1）. The proportion of patients with Investigator ’s Global Assessment （IGA）score of 0 or 1 in guselkumab group was significantly better than placebo group [RR ＝11.15，95％ CI（8.22，15.14），P＜0.001] and adaliumumab group [RR ＝1.27，95％CI（1.19，1.35），P＜0.001]. The proportion of patients with IGA score of 0，the proportion of patients who achieved 75％ reduction or more from baseline of PASI ，dermatology life qu ality index score of 0 or 1 in guselkumab group were signifi cantly superior than placebo group and adaliumumab gr oup，the proportion of patients who achieved 100％ reduction from baseline of PASI in guselkumab group Lewx- was significantly superior than placebo group （P＜0.05）， inn@outlook.com there was no significant difference compared with adaliumumab group （P＞0.05）. There was no statistical significance in the proportion of patients with IGA score of and other secondary outcome indicators between guselkumab and secukinumab group （P＞0.05）. In the safety indicators as total incidence rate of ADR ，rate of withdrawl due to ADR ，etc. ，there was no statistical significance between guselkumab and placebo/ adalimumab groups （P＞0.05）. CONCLUSIONS ：Guselkumab is superior to placebo ，adaliumumab and secukinumab in improving the symptoms of moderate-to-severe plaque psoriasis with good safety .