BACKGROUND:
The safety and efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute-on-chronic liver failure (ACLF) remain uncertain. Therefore, we conducted a meta-analysis to draw a firmer conclusion.
METHODS:
We searched the Cochrane library, PubMed, Embase, and China Biology Medicine disc to identify relevant RCTs performed before January 2020. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were calculated using a random effects model.
MAIN OUTCOME MEASURES:
RRs (95% CI) for 1-, 2-, and 3-month survival rates.
SAMPLE SIZE:
Six RCTs, including three open-label studies.
RESULTS:
The six studies included 246 subjects (121 in a G-CSF group and 125 in a control group). G-CSF administration significantly improved the 1-, 2-, and 3-month survival rates in patients with ACLF. The pooled RRs (95% CI, P) were 0.43 (0.27–0.69,
P
=.0004), 0.44 (0.32–0.62,
P
<.00001), and 0.39 (0.22–0.68,
P
=.0009), respectively.
CONCLUSION:
G-CSF may be beneficial and effective in the treatment of ACLF, but further studies are needed to verify this conclusion.
LIMITATIONS:
The sample size was small, and studies were restricted to countries in Asia.
PROSPERO REGISTRATION NUMBER:
CRD42021225681
CONFLICT OF INTEREST:
None.
Immunomodulatory Activity of Granulocyte Colony-Stimulating Factor and its Therapeutic effect on Liver Failure
