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    • Dpto. Biología Celular, Genética, Histología y Farmacología
    • DEP05 - Artículos de revista
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    Título
    The inhibition of complement system in formal and emerging indications: results from parallel one-stage pairwise and network meta-analyses of clinical trials and real-life data studies
    Autor
    Bernuy Guevara, Coralina Melissa
    Chehade, Hassib
    Muller, Yannick D.
    Vionnet, Julien
    Cachat, François
    Guzzo, Gabriella
    Ochoa Sangrador, Carlos
    Álvarez González, Francisco JavierAutoridad UVA Orcid
    Teta, Daniel
    Martín García, DéboraAutoridad UVA
    Adler, Marcel
    Paz Fernández, Félix Jesús deAutoridad UVA
    Lizaraso Soto, Frank
    Pascual, Manuel
    Herrera Gómez, Francisco MagnoAutoridad UVA Orcid
    Año del Documento
    2020
    Editorial
    MDPI
    Descripción
    Producción Científica
    Documento Fuente
    Biomedicines, 2020, Vol. 8, Nº. 9, 355
    Resumen
    This manuscript presents quantitative findings on the actual effectiveness of terminal complement component 5 (C5) inhibitors and complement component 1 (C1) esterase inhibitors through their formal and common “off-label” (compassionate) indications. The results emanated from pairwise and network meta-analyses to present evidence until September 2019. Clinical trials (CT) and real-life non-randomized studies of the effects of interventions (NRSI) are consistent on the benefits of C5 inhibitors and of the absence of effects of C1 esterase inhibitors (n = 7484): Mathematically, eculizumab (surface under the cumulative ranking area (SUCRA) >0.6) and ravulizumab (SUCRA ≥ 0.7) were similar in terms of their protective effect on hemolysis in paroxysmal nocturnal hemoglobinuria (PNH), thrombotic microangiopathy (TMA) in atypical hemolytic uremic syndrome (aHUS), and acute kidney injury (AKI) in aHUS, in comparison to pre-/off-treatment state and/or placebo (SUCRA < 0.01), and eculizumab was efficacious on thrombotic events in PNH (odds ratio (OR)/95% confidence interval (95% CI) in CT and real-life NRSI, 0.07/0.03 to 0.19, 0.24/0.17 to 0.33) and chronic kidney disease (CKD) occurrence/progression in PNH (0.31/0.10 to 0.97, 0.66/0.44 to 0.98). In addition, meta-analysis on clinical trials shows that eculizumab mitigates a refractory generalized myasthenia gravis (rgMG) crisis (0.29/0.13 to 0.61) and prevents new acute antibody-mediated rejection (AMR) episodes in kidney transplant recipients (0.25/0.13 to 0.49). The update of findings from this meta-analysis will be useful to promote a better use of complement inhibitors, and to achieve personalization of treatments with this class of drugs.
    Materias (normalizadas)
    Meta-analysis
    Biological products - Analysis
    Productos biológicos
    Materias Unesco
    3209 Farmacología
    Palabras Clave
    Complement inactivating
    Agents
    ISSN
    2227-9059
    Revisión por pares
    SI
    DOI
    10.3390/biomedicines8090355
    Version del Editor
    https://www.mdpi.com/2227-9059/8/9/355
    Propietario de los Derechos
    © 2020 The Authors
    Idioma
    eng
    URI
    https://uvadoc.uva.es/handle/10324/59002
    Tipo de versión
    info:eu-repo/semantics/publishedVersion
    Derechos
    openAccess
    Aparece en las colecciones
    • DEP05 - Artículos de revista [198]
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