scholarly journals Eosinophilic Granulomatosis with Polyangiitis: A Systematic Review and Meta‐Analysis of Test Accuracy and Benefits and Harms of Common Treatments

2021 ◽  
Vol 3 (2) ◽  
pp. 101-110
Author(s):  
Jason M. Springer ◽  
Mohamad A. Kalot ◽  
Nedaa M. Husainat ◽  
Kevin W. Byram ◽  
Anisha B. Dua ◽  
...  
Keyword(s):  
Systematic Review ◽  
Granulomatosis With Polyangiitis ◽  
Meta Analysis ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Test Accuracy ◽  
Eosinophilic Granulomatosis

Rituximab for Eosinophilic Granulomatosis with Polyangiitis: a Systematic Review of Observational Studies

Rheumatology ◽  
2021 ◽  
Author(s):  
Vincenzo G Menditto ◽  
Giulia Rossetti ◽  
Diletta Olivari ◽  
Alessia Angeletti ◽  
Marco Rocchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Granulomatosis With Polyangiitis ◽  
Case Reports ◽  
Case Series ◽  
Biologic Agents ◽  
Cochrane Library ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Extensive Literature ◽  
Eosinophilic Granulomatosis

Abstract Objective to analyze the available evidence about the use of rituximab (RTX) and other biologic agents in Eosinophilic Granulomatosis with Polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials. Methods A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases and an extensive literature search on other biologic agents. Results 45 papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in pANCA positive subgroup. Conclusion Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impairs a clear interpretation of results and limits their transferability in clinical practice. Differences in design, enrollment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable.

scholarly journals Efficacy of plasma exchange for antineutrophil cytoplasmic antibody-associated systemic vasculitis: a systematic review and meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Yosuke Yamada ◽  
Makoto Harada ◽  
Yuuta Hara ◽  
Ryohei Iwabuchi ◽  
Koji Hashimoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasma Exchange ◽  
Granulomatosis With Polyangiitis ◽  
Disease Incidence ◽  
Meta Analysis ◽  
Antineutrophil Cytoplasmic Antibody ◽  
World Health ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Link Type ◽  
Pulse Steroid

Abstract Objective To assess through systematic review and meta-analysis whether plasma exchange (PE) is associated with prognosis in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients. Methods A systematic search of PubMed, MEDLINE, Embase, and CENTRAL databases from inception to 17 June 2020 was conducted. Ongoing or unpublished trials were also searched in ClinicalTrials.gov and the World Health Organization trials portal. Randomised controlled trials (RCTs) comparing PE vs. non-PE in AAV patients (microscopic polyangiitis [MPA], granulomatosis with polyangiitis [GPA], or eosinophilic granulomatosis with polyangiitis [EGPA]) were included. The combined risk ratio (RR) was calculated by the random-effects model using the Mantel-Haenszel method. Heterogeneity was measured using the I2 statistic. Primary outcomes were mortality, clinical remission (CR), and adverse events (AEs). Results Four RCTs comparing PE vs. no PE (N = 827) and 1 RCT comparing PE vs. pulse steroid treatment (N = 137) were included. All participants were MPA or GPA patients (no EGPA patients). PE was not associated with main primary outcomes compared with no PE (mortality RR 0.93 [95% confidence interval {CI} 0.70–1.24], I2 = 0%; CR RR 1.02 [95% CI 0.91–1.15], I2 = 0%; and AE RR 1.10 [95% CI 0.73–1.68], I2 = 37%) or pulse steroid (mortality RR 0.99 [95% CI 0.71–1.37]; CR [the Birmingham Vasculitis Activity score] mean difference − 0.53 [95% CI − 1.40–0.34]; and AE RR 1.05 [95% CI 0.74–1.48]). Focusing on the early treatment phases, PE was associated with a reduction in end-stage renal disease incidence compared with both no PE (PE 1/43 vs. no PE 10/41; RR 0.14 [0.03–0.77] at 3 months) and pulse steroid (PE 11/70 vs. pulse steroid 23/67; RR 0.46 [0.24–0.86] at 3 months). Conclusion We carried out a systematic review and meta-analysis targeting all AAV patients, including MPA, GPA, and EGPA. In AAV patients, performing PE was not associated with the risk of mortality, CR, and AE. No RCT exists evaluating the efficacy of PE for EGPA; hence, this is required in the future. The results may affect the development of guidelines for AAV and may indicate the direction of future clinical research on AAV. Trial registration UMIN R000045239, PROSPERO CRD42020182566.

scholarly journals POS0246 THE WORLDWIDE INCIDENCE AND PREVALENCE OF ANCA VASCULITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF EPIDEMIOLOGICAL STUDIES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 344.1-345
Author(s):  
R. Redondo Rodriguez ◽  
N. Mena-Vázquez ◽  
A. M. Cabezas-Lucena ◽  
F. Godoy-Navarrete ◽  
M. Morales-Águila ◽  
...  
Keyword(s):  
Systematic Review ◽  
Granulomatosis With Polyangiitis ◽  
Meta Analysis ◽  
Geographic Area ◽  
Epidemiological Studies ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Anca Vasculitis ◽  
Pooled Prevalence ◽  
The Individual ◽  
Incident Cases

Objectives:To evaluate the worldwide incidence and prevalence of ANCA vasculitis through a systematic review of the literature and meta-analysis.Methods:A systematic search of MEDLINE and EMBASE search engines was carried out for studies that analyzed the incidence and prevalence of ANCA vasculitis in different geographical areas. Inclusion criteria: patients diagnosed with ANCA vasculitis according to ACR criteria/ Chapel Hill Consensus and adult patients (> 16 years). All ANCA vasculitis (microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis) were considered. Exclusion criteria: editorials, conference abstracts, case or cases series reports and narrative reviews; insufficient description of the methods; lack of data to compute incidence or prevalence; and duplicate studies.Variables: Main variable: the pooled prevalence measured by the number of prevalent cases per million / person-year (95% CI) and the pooled incidence measured as the number of incident cases per million / person-year (95% CI). Secondary variables: the prevalence and incidence of each vasculitis ANCA and according geographic area. A meta-analysis was undertaken to estimate the pooled incidence and the pooled prevalence per million / person-years. The 95% CI and I2 for heterogeneity were calculated.Results:Twenty four studies were included. The pooled incidence (95% CI) was 12.2 per million / person-year (8.4-16.5) and the pooled prevalence (95% CI) was 130 per million / person-year (67.5-213). The individual incidence for each vasculitis was: GPA (6.7), MPA (5.9) and EGPA (1.6). The individual prevalence for each vasculitis was: GPA (69.3), MPA (21.9) and EGPA (13.5).In the analysis by continents, the pooled incidence for GPA vasculitis was higher in Europe (7.5), while the pooled incidence for MPA vasculitis was higher in America (6.9) and for EGPA vasculitis it was higher in Asia (1.8). The pooled prevalence for GPA and MPA vasculitis was higher in Europe (83.9,24.4 respectively) than in America (14.2, 12.8 respectively).Conclusion:The pooled incidence and the pooled prevalence are higher in the case of GPA vasculitis compared to the rest of ANCA vasculitis. In general there is a predominance of incidence and prevalence of all ANCA vasculitis in the northern hemisphere compared to the south.Figure 1.The pooled incidence ANCA vasculitis.Figure 2.The pooled prevalence ANCA vasculitisDisclosure of Interests:None declared

scholarly journals Burden of illness associated with eosinophilic granulomatosis with polyangiitis: a systematic literature review and meta-analysis

2021 ◽  
Author(s):  
Rupert W. Jakes ◽  
Namhee Kwon ◽  
Beth Nordstrom ◽  
Rebecca Goulding ◽  
Kyle Fahrbach ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Disease Burden ◽  
Granulomatosis With Polyangiitis ◽  
Healthcare Resource ◽  
Meta Analysis ◽  
Emergency Department Visits ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Eosinophilic Granulomatosis ◽  
Incidence Prevalence

Abstract Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease associated with vascular inflammation and multisystem organ damage. The literature reporting EGPA incidence or prevalence is limited. We performed a systematic literature review and meta-analysis to describe the incidence, prevalence, and disease burden associated with EGPA. Real-world, observational, English-language studies in MEDLINE, MEDLINE In-Process, and Embase up to 6 June, 2019, were included. A single investigator screened all identified titles/abstracts and extracted data; an additional, independent investigator repeated the screening and validated the extracted data. A random-effects meta-analysis was conducted to generate pooled estimates for EGPA incidence and prevalence. Data from 100 eligible publications were extracted (32 with incidence/prevalence data, 65 with morbidity/healthcare resource data; 3 with both types of data). Significant evidence of between-study heterogeneity for reported incidence (p = 0.0013–0.0016) and prevalence (p = 0.0001–0.0006) estimates was observed. Global and European pooled estimates (95% confidence interval) of EGPA incidence were 1.22 (0.93, 1.60) and 1.07 (0.94, 1.35) cases per million person-years, respectively; global and European pooled estimates (95% confidence interval) for EGPA prevalence were 15.27 (11.89, 19.61) and 12.13 (6.98, 21.06) cases per million individuals, respectively. The proportions of patients experiencing relapses, or who had nasal polyps or severe asthma, varied considerably across studies. EGPA healthcare resource use was high, with inpatient admissions and emergency department visits reported for 17–42% and 25–42% of patients, respectively. Our results indicate that although global and European EGPA incidence and prevalence is low, the associated disease burden is substantial. Key points• We performed a systematic literature review and meta-analysis of real-world, observational studies describing the incidence, prevalence, and disease burden associated with eosinophilic granulomatosis with polyangiitis (EGPA).• Based on meta-analysis data from 35 eligible studies reporting incidence and prevalence, the incidence and prevalence of EGPA were low (globally 1.22 cases per million person-years and 15.27 cases per million individuals, respectively).• Among the 49 studies with morbidity and/or healthcare resource data, most reported a large proportion of patients with EGPA relapses and comorbidities of nasal polyps and severe asthma.• Healthcare resource use was also high among patients with EGPA in these studies, with inpatient admissions and emergency department visits reported for 17–42% and 25–42% of patients, respectively. Taken together, these data indicate the substantial disease burden associated with EGPA.

Diagnostic test accuracy for use of machine learning in diagnosis of autism spectrum disorder: A Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Sun Jae Moon ◽  
Jin Seub Hwang ◽  
Rajesh Kana ◽  
John Torous ◽  
Jung Won Kim
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Autism Spectrum Disorder ◽  
Meta Analysis ◽  
Learning Algorithms ◽  
Structural Mri ◽  
Autism Spectrum ◽  
Machine Learning Algorithms ◽  
Spectrum Disorder ◽  
Test Accuracy

BACKGROUND Over the recent years, machine learning algorithms have been more widely and increasingly applied in biomedical fields. In particular, its application has been drawing more attention in the field of psychiatry, for instance, as diagnostic tests/tools for autism spectrum disorder. However, given its complexity and potential clinical implications, there is ongoing need for further research on its accuracy. OBJECTIVE The current study aims to summarize the evidence for the accuracy of use of machine learning algorithms in diagnosing autism spectrum disorder (ASD) through systematic review and meta-analysis. METHODS MEDLINE, Embase, CINAHL Complete (with OpenDissertations), PsyINFO and IEEE Xplore Digital Library databases were searched on November 28th, 2018. Studies, which used a machine learning algorithm partially or fully in classifying ASD from controls and provided accuracy measures, were included in our analysis. Bivariate random effects model was applied to the pooled data in meta-analysis. Subgroup analysis was used to investigate and resolve the source of heterogeneity between studies. True-positive, false-positive, false negative and true-negative values from individual studies were used to calculate the pooled sensitivity and specificity values, draw SROC curves, and obtain area under the curve (AUC) and partial AUC. RESULTS A total of 43 studies were included for the final analysis, of which meta-analysis was performed on 40 studies (53 samples with 12,128 participants). A structural MRI subgroup meta-analysis (12 samples with 1,776 participants) showed the sensitivity at 0.83 (95% CI-0.76 to 0.89), specificity at 0.84 (95% CI -0.74 to 0.91), and AUC/pAUC at 0.90/0.83. An fMRI/deep neural network (DNN) subgroup meta-analysis (five samples with 1,345 participants) showed the sensitivity at 0.69 (95% CI- 0.62 to 0.75), the specificity at 0.66 (95% CI -0.61 to 0.70), and AUC/pAUC at 0.71/0.67. CONCLUSIONS Machine learning algorithms that used structural MRI features in diagnosis of ASD were shown to have accuracy that is similar to currently used diagnostic tools.

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