Network Meta-analysis Of The Efficacy And Safety Of Different Drugs In The Treatment Of Ankylosing Spondylitis

Objective:To compare the efficacy and safety of Secukinumab,Ixekizumab,Bimekizumab,N etakimab,Risankizumab,Tofacitinib and Upadacitinib in the treatment of active ankylosing spondylitis by using the method of network meta-analysis.Methods:Searching for science papers using combination of keywords and freewords in databases of Pub Med,EMBASE and Cochrane Library by computer.The search time is set from the establishment of the each library to January 24 th,2022.According to the incorporate and exclude criteria,the studies related to seven kinds of drugs in the treatment of ankylosing spondylitis were included.The Rev Man 5.4.1software was used to evaluate the quality of the literatures,then the Stata 16.0 software was used for network mata analysis.Results:A total of 10 studies with 1892 ankylosing spondylitis patients were enrolled finally.The results of the network meta-analysis are as following.(1)In terms of efficacy:In terms of assessment in ankylosing spondylitis twenty response rate,Netakimab versus placebo[RR=2.22,95%CI(1.32,3.74)],Ixekizumab versus placebo [RR=1.61,95%CI(1.28,2.02)],placebo versus Secukinumab [ RR=0.58,95%CI(0.48,0.71)],placebo versus Tofacitinib [RR=0.52,95%CI(0.39,0.70)],placebo versus Upadacitinib [RR=0.63,95%CI(0.47,0.84])],the incidence of assessment in ankylosing spondylitis twenty response of surface under the cumulative ranking resultare is Netakimab(85.6%)、Tofacitinib(74.1%)、Secukinumab(58.1%)、Ixekizumab(47%)、Upadacitinib(46.7%)、Bimekizumab(37.1%)and Placebo(1.3%).In terms of assessment in ankylosing spondylitis fourty remission rate,Netakimab versus placebo [RR=5.33,95%CI(1.81,15.74)],Bimekizumab versus placebo [RR=2.21,95%CI(1.04,4.70)],Ixekizumab versus placebo[ RR=2.15,95%CI(1.60,2.90)],placebo versus Secukinumab [RR=0.37,95%CI(0.27,0.52)],placebo versus Tofacitinib [RR=0.31,95%CI(0.19,0.50)],placebo and Upadacitinib [RR=0.49,95%CI(0.33,0.74)],the difference is statistically significant.In terms of assessment in ankylosing spondylitis fourty remission rate of surface under the cumulative ranking result is Netakimab(92.3 %)、Tofacitinib(79.1%)、Secukinumab(65.7%)、Bimekizumab(49.2%)、Ixekizumab(45.0%)、Upadacitinib(39.3%)、Risankizumab(26.1%)and Placebo(3.1%).(2)In terms of safety,the incidence of adverse events of surface under the cumulative ranking result is Netakimab(79.8%)、Tofacitinib(58.8%)、Placebo(53.2%)、Risankizumab(51.5%)、Bimekizumab(50.3%))、Upadacitinib(30.3%)、Ixekizumab(26.1%).The incidence of serious adverse events of surface under the cumulative ranking result is Bimekizumab(74.8%)、Risankizumab(73.6%)、Netakimab(62.7%)、Ixekizumab(41.4%)、Upadacitinib(39.0%)、Placebo(36.2%)、Tofacitinib(22.2%)Conclusion:Based on the analysis results of our study,Secukinumab,Ixekizumab,Bimekizumab,Netakimab,Risankizumab,Tofacitinib and Upadacitinib are superior to placebo in effectiveness.Netakimab is the best way in terms of effectiveness relatively.At the same time,its security is relatively best with the lowest adverse event rate.Bimekizumab have a relatively low incidence of serious adverse events.However,due to the limitations of our study,the conclusion needs to be verified by extensive high quality research.