Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis

doi:10.3892/etm.2018.6063

科研成果详情

题名	Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis
作者	Lu, Feng-Bin 1; Hu, En-De 1; Xu, Lan-Man1; Hu, Yi-Bing 2; Chen, Lu1; Wu, Jin-Lu 1; Li, Hui 1; Chen, Da-Zhi 3; Chen, Yong-Ping1
发表日期	2018-06
发表期刊	EXPERIMENTAL AND THERAPEUTIC MEDICINE 影响因子和分区
语种	英语
原始文献类型	Review
关键词	autoimmune liver disease liver immunosuppression meta-analyses
其他关键词	CHRONIC ACTIVE HEPATITIS ; PRIMARY BILIARY-CIRRHOSIS ; MYCOPHENOLATE-MOFETIL ; CONTROLLED-TRIAL ; STANDARD THERAPY ; HISTOLOGICAL REMISSION ; URSODEOXYCHOLIC ACID ; NONSTANDARD DRUGS ; LIVER-DISEASE ; MURINE MODEL
摘要	The most suitable treatment regimen for autoimmune hepatitis (AIH) in adults remains unknown and requires further investigation. The current study therefore aimed to integrate evidence to provide hierarchies of the comparative efficacies of treatments measured by clinical and biochemical remission. A Bayesian-framework network meta-analysis of randomized controlled trials (RCTs) was preformed to compare eight treatments for AIH. Eligible RCTs were identified by searching Embase, Pubmed and the Cochrane Library for publications between 1966 and April 2017. All outcomes were independently extracted from the included studies by two authors. A total of six RCTs were subsequently included in the current study. The network of comparisons on remission indicated that patients treated with prednisone (pred) experienced significantly increased rates of remission compared with those treated with azathioprine [AZA; odds ratio (OR), 0.21; 95% confidence interval (CI), 0.06-0.71] and budesonide (bude) + AZA significantly increased remission compared with placebo treatment (OR, 36.66; 95% CI, 1.40-962.49) or AZA (OR, 10.30; 95% CI, 1.50-70.70). Based on the cumulative ranking probabilities, bude + AZA (89.4) was ranked first, pred (69.1) was ranked second, pred + AZA (63.2) was ranked third and placebo (7.8) treatment was ranked last. Bude + AZA may be the most appropriate candidate for the treatment of non-cirrhotic patients. However, bude + AZA as frontline therapy for AIH requires more large-scale studies with a longer duration of follow-up histology and a focus on dose-response. Additionally, development of other prospective treatments, which may be used as alternative therapy or first line therapy, and their subsequent evaluation in clinical RCTs is required.
资助项目	National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81570514, 81500477]; Natural Science Foundation of Zhejiang ProvinceNatural Science Foundation of Zhejiang Province [LY15H030017, LQ15H030006]; Public Welfare Science and Technology Project of Wenzhou [Y20150014]; Medical Award Fund (Beijing, China) [YJHYXKYJJ-162]; Scientific and Technological Innovation Team of the Early Warning and Intervention to End-stage Liver Disease of Wenzhou [C20150005]; National Major Scientific and Technological Special Project during the Twelfth Five-year Plan Period (China) [2013ZX10005002-001-008, 2013ZX10002003, 2012ZX10002004]
出版者	SPANDIDOS PUBL LTD
出版地	ATHENS
ISSN	1792-0981
EISSN	1792-1015
卷号	15 期号:6 页码:4838-4850
DOI	10.3892/etm.2018.6063
页数	13
WOS类目	Medicine, Research & Experimental
WOS研究方向	Research & Experimental Medicine
WOS记录号	WOS:000435174400035
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	29904396
PMC记录号	PMC5996682
SCOPUSEID	2-s2.0-85046537973
通讯作者地址	[Chen, Yong-Ping]Wenzhou Key Laboratory of Hepatology,Department of Infectious Diseases,Hepatology Institute of Wenzhou Medical University,The First Affiliated Hospital of Wenzhou Medical University,2 Fuxue Road,Wenzhou,325000,China
Scopus学科分类	Immunology and Microbiology (miscellaneous);Cancer Research
引用统计	被引频次：5[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/17183
专题	附属第一医院其他_附属第三医院（瑞安市人民医院）
通讯作者	Chen, Yong-Ping
作者单位	1.Wenzhou Key Laboratory of Hepatology,Department of Infectious Diseases,Hepatology Institute of Wenzhou Medical University,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325000,China; 2.Department of Gastroenterology,The Third Affiliated Hospital of Wenzhou Medical University,Jinhua,321000,China; 3.State Key Laboratory of Infectious Diseases,Medicine School of Zhejiang University,Hangzhou,310003,China
第一作者单位	附属第一医院; 第一临床医学院（信息与工程学院）、附属第一医院
通讯作者单位	附属第一医院; 第一临床医学院（信息与工程学院）、附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Lu, Feng-Bin,Hu, En-De,Xu, Lan-Man,et al. Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis[J]. EXPERIMENTAL AND THERAPEUTIC MEDICINE,2018,15(6):4838-4850.
APA	Lu, Feng-Bin., Hu, En-De., Xu, Lan-Man., Hu, Yi-Bing., Chen, Lu., ... & Chen, Yong-Ping. (2018). Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis. EXPERIMENTAL AND THERAPEUTIC MEDICINE, 15(6), 4838-4850.
MLA	Lu, Feng-Bin,et al."Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta-analysis".EXPERIMENTAL AND THERAPEUTIC MEDICINE 15.6(2018):4838-4850.