دورية أكاديمية
Induction and maintenance of remission with mycophenolate mofetil in ANCA-associated vasculitis: a systematic review and meta-analysis
| العنوان: | Induction and maintenance of remission with mycophenolate mofetil in ANCA-associated vasculitis: a systematic review and meta-analysis |
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| المساهمون: | Alvise Berti, Mouaz Alsawas, Tabinda Jawaid, Larry J Prokop, Jiwon M Lee, Gwang Hun Jeong, Luis F Quintana, Sergey Moiseev, Augusto Vaglio, Vladimir Tesar, Duvuru Geetha, Jae I L Shin, Andreas Kronbichler, Shin, Jae Il |
| بيانات النشر: | Oxford University Press |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / drug therapy OR Antibodies, Antineutrophil Cytoplasmic OR Humans OR Immunosuppressive Agents / therapeutic use OR Microscopic Polyangiitis* OR Mycophenolic Acid / therapeutic use OR Peroxidase OR Remission Induction, ANCA-associated vasculitis, MMF, granulomatosis with polyangiitis, microscopic polyangiitis, mycophenolate mofetil |
| الوصف: | Background: Uncertainties exist about the use of mycophenolate mofetil (MMF) in anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis (AAV), particularly for remission maintenance. Methods: Systematic review and meta-analysis of phase II and III trials assessing the use of MMF in AAV, granulomatosis with polyangiitis and microscopic polyangiitis (MPA). A comprehensive search of several databases (Medline, EMBASE, Cochrane, Web of Science, Scopus) from inception to 5 May 2020 has been conducted. Trial data were extracted to estimate odds ratios (ORs) and estimates (ES) for MMF efficacy (remission-induction and maintenance). Severe adverse effects (SAEs) were collected. Results: From 565 articles captured, 10 met the predefined criteria, 5 phase II and 5 III trials; 4 assessed remission-induction, 3 remission maintenance and 3 both. The pooled OR for remission-induction at 6 months was 1.06 (95% confidence interval 0.74, 1.52), with no significant difference by subgroup meta-analysis of trials stratified by different study-level features (i.e. kidney disease, MPA, myeloperoxidase-ANCA positivity, newly diagnosed disease) (P > 0.05). The overall ES for remission maintenance at the end of follow-up ranged between 51% and 91% (I2 = 74.8%). Subgroup meta-analysis identified kidney involvement as a possible source of heterogeneity, yielding a significantly higher rate of sustained remission in trials enrolling only patients with kidney involvement (92%, 76-100%) versus those enrolling patients with and without kidney involvement (56%, 45-66%). Results were similar in multiple sensitivity analyses. During follow-up, the frequency of SAEs in MMF-based treatment arms was 31.8%. Conclusions: In AAV, MMF use was significantly associated with higher sustained remission rates in trials enrolling only patients with kidney involvement. These findings might influence clinical practice. ; restriction |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 0931-0509 1460-2385 |
| العلاقة: | NEPHROLOGY DIALYSIS TRANSPLANTATION; J02316; OAK-2022-10325; https://ir.ymlib.yonsei.ac.kr/handle/22282913/193288Test; https://academic.oup.com/ndt/article/37/11/2190/6462928Test; T9992022517; NEPHROLOGY DIALYSIS TRANSPLANTATION, Vol.37(11) : 2190-2200, 2022-10 |
| DOI: | 10.1093/ndt/gfab357 |
| الإتاحة: | https://doi.org/10.1093/ndt/gfab357Test https://ir.ymlib.yonsei.ac.kr/handle/22282913/193288Test https://academic.oup.com/ndt/article/37/11/2190/6462928Test |
| حقوق: | CC BY-NC-ND 2.0 KR |
| رقم الانضمام: | edsbas.22B636E3 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 09310509 14602385 |
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| DOI: | 10.1093/ndt/gfab357 |