...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>British Journal of Haematology >Rituximab before splenectomy in adults with primary idiopathic thrombocytopenic purpura: A meta-analysis
【24h】

Rituximab before splenectomy in adults with primary idiopathic thrombocytopenic purpura: A meta-analysis

机译：成人原发性特发性血小板减少性紫癜脾切除前利妥昔单抗的荟萃分析

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Primary immune thrombocytopenia (ITP) is an acquired immune-mediated disorder with absence of any underlying cause. Corticosteroids are the standard initial treatment. Splenectomy is the main second-line treatment. A trend to delay or avoid splenectomy has developed thanks to new agents like rituximab. Few studies have assessed the response rate to rituximab in chronic ITP. We performed the first meta-analysis of randomized clinical trials and observational studies on rituximab as an effective splenectomy-avoiding option in adult chronic ITP. Overall methods were adapted from published guidelines for meta-analysis (meta-analysis of observational studies in epidemiology and preferred reporting items for systematic reviews and meta-analyses). Two haematologist investigators carried out study selection and data extraction independently, recording overall response rate (ORR) and complete response (CR) as primary assessment criteria. Of 364 records were identified through electronic databases. Of 19 retrospective or prospective observational studies were retained after removing duplicate studies and full-text analyses. The ORR was 57% (95% confidence interval [CI]: 48-65), for 368 non-splenectomized patients after rituximab; CR was 41% (95% CI: 0·33-0·51) for 346 patients. Results were stable for ORR and CR in all sub-analyses. In univariate or multivariate mixed-effect meta-regression, age was the most relevant effect. According to our results, rituximab should be used in earlier in non-splenectomized patients.
机译：原发性免疫性血小板减少症（ITP）是一种获得性免疫介导的疾病，无任何潜在原因。皮质类固醇是标准的初始治疗方法。脾切除术是二线治疗的主要方法。由于利妥昔单抗等新药的出现，延迟或避免脾切除的趋势已经发展。很少有研究评估慢性ITP对利妥昔单抗的反应率。我们对利妥昔单抗作为成人慢性ITP的一种有效的脾切除术选择进行了随机临床试验和观察性研究的首次荟萃分析。整体方法改编自已发表的荟萃分析指南（流行病学观察性研究的荟萃分析，以及系统评价和荟萃分析的首选报告项目）。两名血液学家调查员独立进行研究选择和数据提取，并将总体缓解率（ORR）和完全缓解（CR）记录为主要评估标准。通过电子数据库确定了364条记录。在删除重复研究和全文分析后，保留了19项回顾性或前瞻性观察性研究。 368例未接受利妥昔单抗治疗的未脾切除患者的ORR为57％（95％置信区间[CI]：48-65）; 346例患者的CR为41％（95％CI：0·33-0·51）。在所有子分析中，ORR和CR的结果均稳定。在单变量或多变量混合效应的元回归中，年龄是最相关的效应。根据我们的结果，非脾切除患者应更早使用利妥昔单抗。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号