OBJECTIVE:To evaluate clinical efficacy of Shenling baizhu powder combined with aminosalicylic acid in the treatment of ulcerative colitis (UC),and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Cochrane library,CJFD,VIP,Wanfang database and CBM,randomized controlled trials (RCTs) about Shenling baizhu powder combined with aminosalicylic acid preparations (trial group) vs.aminosalicylic acid preparations alone (control group) in the treatment of UC were collected.Meta-analysis was performed by using Rev Man 5.2 statistical software afder data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 14 RCTs were included,involving 1 177 patients.Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=3.40,95％ CI (2.44,4.74),P＜0.001],while Sutherland DAI score [MD=-1.31,95％ CI (-2.07,-0.56),P＜0.001],the levels of TNF-α [SMD=-1.90,95％CI(-2.90,-0.90),P＜0.001],IL-17[MD=-85.18,95％CI(-100.51,-69.85),P＜0.001] and IL-23 [MD=-113.27,95％CI(-132.34,-94.21),P＜0.001] in trial groups were significantly lower than control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Shenling baizhu powder combined with aminosalicylic acid preparation is better than aminosalicylic acid preparation alone in the treatment of UC,and can significantly reduce Suthedand DAI and the levels of serum cytokines.

OBJECTIVE To comprehensively evaluate the three oral Janus kinase inhibitors （JAKi） such as upadacitinib， abrocitinib and baricitinib in the treatment of atopic dermatitis. METHODS The six dimensions of safety， efficacy， economy， appropriateness， accessibility and innovativeness were used for evaluation. Meta-analysis was conducted to evaluate the safety and efficacy of three oral JAKi； pharmacoeconomic studies were searched， and the treatment costs were calculated to evaluate the economy of each JAKi. Appropriateness was described based on literature review and drug labels. Accessibility of three oral JAKi was assessed by using a questionnaire survey. The innovation of JAKi was elucidated from the perspective of its mechanism of action. RESULTS In terms of safety， the incidence of upper respiratory tract infection （OR＝1.47， 95%CI of 1.04-2.08， P＝0.03） and nasopharyngitis （OR＝1.44， 95%CI of 1.06-1.95， P＝0.02） in the upadacitinib 30 mg group was significantly higher than that in the placebo group； the incidence of nasopharyngitis in baricitinib 4 mg group was significantly higher than that in the placebo group （OR＝2.24， 95%CI of 1.39-3.61， P＝0.000 8） and baricitinib 2 mg group （OR＝0.48， 95%CI of 0.31-0.74，P＝0.001）. In terms of efficacy， regardless of the dosage， all three JAKi groups were superior to the placebo group， and the high-dose groups of upadacitinib and abrocitinib were superior to the low-dose groups （P＜0.000 1）. In terms of economy， the annual treatment cost of baricitinib was the lowest （13 870.0 yuan）， but it has not been approved for atopic dermatitis indication in China； next was upadacitinib （27 192.5 yuan）. In terms of appropriateness， the overall appropriateness of the three JAKis was good， but none of them was suitable for patients with severe liver injury. In terms of accessibility， baricitinib had the highest availability rate （59.4%）， but the affordability of upadacitinib was relatively good under China’s medical insurance system. In terms of innovation， among the three types of JAKi， upadacitinib and abrocitinib had better innovation. CONCLUSIONS Three oral JAKi treatments for atopic dermatitis have controllable safety and good efficacy. Considering the issue of medical insurance reimbursement， it is recommended that Chinese patients use upadacitinib.