论文部分内容阅读
目的系统评价双膦酸盐类药物治疗多发性骨髓瘤的效果和安全性。方法采用Cochrane系统评价方法,检索Cochrane Library、PubMed、EMbase、中国生物医学文献数据库、中国期刊全文数据库等数据库,由两名评价者共同纳入符合标准的研究,采用Cochrane系统评价手册4.2.7中RCT的质量评价标准评价研究的方法学质量后,对同质研究进行Meta分析。结果共纳入11个RCT,研究地点均在国外,研究质量均较高,各试验间具有基线可比性。Meta分析结果显示:双膦酸盐类药物有助于预防病理性脊柱骨折[OR=0.59,95%CI(0.45,0.78),P=0.000-2]和缓解疼痛[OR=0.59,95%CI(0.46,0.76),P=0.000-05],但在缓解疼痛方面,由于数据临床异质性较大,需谨慎对待这一结论。同时,在病死率[OR=0.98,95%CI(0.82,1.18),P=0.85]及高钙血症[OR=0.76,95%CI(0.56,1.03),P=0.07]方面与安慰剂组无差异。结论在治疗多发性骨髓瘤中加入双膦酸盐类药物可降低病理性脊柱骨折和疼痛,但无益于病死率及高钙血症的改善。
Objective To evaluate the efficacy and safety of bisphosphonates in the treatment of multiple myeloma. METHODS: The Cochrane Library, PubMed, EMbase, Chinese Biomedical Literature Database, Chinese Journal Full-text Database were searched by Cochrane systematic review method. Two reviewers were included in the criteria-based study. The Cochrane Review Manual 4.2.7 RCT Of the quality evaluation criteria to evaluate the methodological quality of the study, meta-analysis of the meta-analysis. Results A total of 11 RCTs were included. The research sites were all in foreign countries. The research quality was high and baseline comparability was found among all the trials. Meta-analysis showed that bisphosphonates could help prevent pathological spinal fractures (OR = 0.59, 95% CI 0.45, 0.78, P = 0.000-2) and pain relief [OR = 0.59, 95% CI (0.46, 0.76), P = 0.000-05]. However, in the area of pain relief, this conclusion should be treated with caution due to the large clinical heterogeneity of the data. In the meantime, patients with placebo (OR = 0.98, 95% CI 0.82, 1.18, P = 0.85) and hypercalcemia (OR = 0.76, 95% CI No difference between groups. Conclusions The addition of bisphosphonates to multiple myeloma may reduce pathologic spine fractures and pain but not benefit mortality and hypercalcemia.