■这项研究的目的是通过荟萃分析评估接受阿仑单抗治疗的多发性硬化症患者继发性免疫性血小板减少症的风险。
■我们搜索了包括PubMed,WebofScience,OVID和EMBASE用于报告从开始到2023年5月接受阿仑珠单抗治疗的MS患者血小板水平变化的研究,并进行了荟萃分析。由两名研究人员筛选和提取信息和数据。根据PICOS原则建立纳入和排除标准。采用R软件meta软件包进行数据分析,采用纽卡斯尔-渥太华量表(NOS)进行质量评价。使用亚组分析和敏感性分析对异质性的原因进行分析。使用漏斗图和Egger检验评估发布偏差。
■共包括15项研究,涵盖1,729名多发性硬化症患者。纳入研究的整体继发性ITP的荟萃分析得出的汇总率为0.0243。继发性自身免疫事件的总发生率为0.2589。此外,使用研究区域和研究类型进行亚组分析.结果显示,欧洲继发性ITP的发生率约为0.0207,而自身免疫事件(AE)的发生率为0.2158。北美继发性ITP和AEs的发病率明显高于欧洲,分别为0.0352和0.2622。分析表明,前瞻性研究中继发性ITP和AE的发生率分别为0.0391和0.1771。回顾性研究显示,继发性ITP的发生率为2.16,AE的发生率为0.2743。
■这项研究发现,多发性硬化症患者在接受阿仑珠单抗治疗后,有一定的免疫性血小板减少症发生率。Alemtuzumab可能对血小板水平有一些干扰,机制可能与Treg细胞有关。但是由于纳入的文献中没有对照组,我们无法确定Alemtuzumab对MS患者血小板水平的具体影响。因此,临床医师在开始使用阿仑单抗前,应全面评估患者的获益/风险比.
■Inplasy网站,DOI编号为10.37766/inplasy2024.3.0007。
UNASSIGNED: The purpose of this study was to evaluate the risk of secondary immune thrombocytopenia in multiple sclerosis patients treated with alemtuzumab through a meta-analysis.
UNASSIGNED: We searched databases including PubMed, Web of Science, OVID and EMBASE for studies reporting changes in platelet levels in MS patients treated with alemtuzumab from their inception until May 2023 and performed a meta-analysis. Information and data were screened and extracted by two researchers. The inclusion and exclusion criteria were established according to the PICOS principle. The obtained data were analyzed using the R software meta package and the quality assessment was conducted using Newcastle-Ottawa Scale (NOS). The causes of heterogeneity were analyzed using subgroup analysis and sensitivity analysis. Publication bias was evaluated using funnel plots and Egger test.
UNASSIGNED: A total of 15 studies were included, encompassing 1,729 multiple sclerosis patients. Meta-analysis of overall secondary ITP in the included studies yielded a pooled rate of 0.0243. The overall incidence of secondary autoimmune events was 0.2589. In addition, subgroup analysis was applied using study regions and study types. The results showed that the incidence rate of secondary ITP in Europe was about 0.0207, while the incidence of autoimmune events (AEs) was 0.2158. The incidence rate of secondary ITP and AEs in North America was significantly higher than in Europe, being 0.0352 and 0.2622. And the analysis showed that the incidence rates of secondary ITP and AEs in prospective studies were 0.0391 and 0.1771. Retrospective studies had an incidence rate of secondary ITP at 2.16, and an incidence rate of AEs at 0.2743.
UNASSIGNED: This study found that there was a certain incidence of Immune thrombocytopenia in multiple sclerosis patients after treatment with alemtuzumab. Alemtuzumab may have some interference with platelet levels, and the mechanism may be associated with Treg cells. But due to the absence of a control group in the included literature, we cannot determine the specific impact of Alemtuzumab on platelet levels in patients with MS. Therefore, clinical physicians should perform a comprehensive assessment of the patient\'s benefit-to-risk ratio before initiating alemtuzumab.
UNASSIGNED: Inplasy website, DOI number is 10.37766/inplasy2024.3.0007.