RT info:eu-repo/semantics/article
T1 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
A1 Bernuy Guevara, Coralina Melissa
A1 Chehade, Hassib
A1 Muller, Yannick D.
A1 Vionnet, Julien
A1 Cachat, François
A1 Guzzo, Gabriella
A1 Ochoa Sangrador, Carlos
A1 Álvarez González, Francisco Javier
A1 Teta, Daniel
A1 Martín García, Débora
A1 Adler, Marcel
A1 Paz Fernández, Félix Jesús de
A1 Lizaraso Soto, Frank
A1 Pascual, Manuel
A1 Herrera Gómez, Francisco Magno
K1 Meta-analysis
K1 Biological products - Analysis
K1 Productos biológicos
K1 Complement inactivating
K1 Agents
K1 3209 Farmacología
AB 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.
PB MDPI
SN 2227-9059
YR 2020
FD 2020
LK https://uvadoc.uva.es/handle/10324/59002
UL https://uvadoc.uva.es/handle/10324/59002
LA eng
NO Biomedicines, 2020, Vol. 8, Nº. 9, 355
NO Producción Científica
DS UVaDOC
RD 24-nov-2024