Impact of clinicopathological features on survival in patients treated with immune-based combinations for metastatic urothelial carcinoma: A meta-analysis of randomized clinical trials.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16534-e16534
Author(s):  
Veronica Mollica ◽  
Alessandro Rizzo ◽  
Matteo Santoni ◽  
Andrea Marchetti ◽  
Matteo Rosellini ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Liver Metastases ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Clinicopathological Features ◽  
Cochrane Library ◽  
Risk Of Death ◽  
Metastatic Urothelial Carcinoma ◽  
Ecog Ps ◽  
The Impact

e16534 Background: Immune checkpoint inhibitors (ICIs) have recently revolutionized the treatment landscape of metastatic urothelial carcinoma (mUC). Nonetheless, little is known regarding the impact of clinicopathological features in this setting. We performed a meta-analysis aiming to evaluate the predictive value of ECOG-PS, age, gender, liver metastases, and histology in randomized controlled trials (RCTs) comparing ICI-based combinations versus chemotherapy in mUC patients. Methods: We retrieved all the relevant RCTs through PubMed/Med, Cochrane library, and EMBASE; additionally, proceedings of the main international oncological meetings were also searched for relevant abstracts. Eligible studies included RCTs comparing ICI-based combinations versus chemotherapy alone in mUC patients. The primary endpoint was overall survival (OS), measured as hazard ratio (HR) with corresponding 95% confidence interval (CI). All statistical analyses were performed using R studio software. Results: Overall, 1032 mUC patients were included in the analysis. Compared with chemotherapy, ICI-based combinations significantly decreased the risk of death in several clinicopathological subgroups, including no liver metastases (HR, 0.84; 95% CI, 0.74-0.95) and ECOG-PS 0 patients (HR, 0.84; 95% CI, 0.72-0.97). Similarly, ICI-based combinations were associated with prolonged OS in mUC patients who were < 65 years old (HR, 0.82; 95% CI, 0.72-0.95), as well as in male (HR, 0.90; 95% CI, 0.82-0.99) and female patients (HR, 0.81; 95% CI, 0.68-0.97). Conversely, a non-statistically significant benefit was observed for chemotherapy alone in mUC patients with liver metastases (HR, 1.06; 95% CI, 0.86-1.31). Conclusions: According to our results, the magnitude of benefit of ICI-based combinations over chemotherapy in mUC was consistent across a number of clinicopathological subgroups, while a proportion of patients could respond to chemotherapy alone.Despite several limitations affect our analysis, we believe these results could guide in everyday treatment decision-making, also assisting in the design and interpretation of future clinical trials on ICIs in mUC.

scholarly journals Comparison of Survival Benefits of Combined Chemotherapy and Radiotherapy Versus Chemotherapy Alone for Uterine Serous Carcinoma: A Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Yanying Lin ◽  
Jingyi Zhou ◽  
Yuan Cheng ◽  
Lijun Zhao ◽  
Yuan Yang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Publication Bias ◽  
Meta Analysis ◽  
Serous Carcinoma ◽  
Cochrane Library ◽  
Combined Chemotherapy ◽  
Risk Of Death ◽  
Stage Disease ◽  
Uterine Serous Carcinoma ◽  
The Impact

ObjectiveTo date, there is no convincing evidence comparing the impact of combined chemotherapy and radiotherapy with chemotherapy alone in postoperative uterine serous carcinoma (USC), which remains an unclear issue. We conducted a meta-analysis assessing the impact of combined chemotherapy and radiotherapy compared to chemotherapy alone on overall survival in postoperative USC.MethodsA comprehensive search was performed in the databases of EMBASE, PubMed, Web of Science, and Cochrane Library from inception to March 2016. Studies comparing survival among patients who underwent combined chemotherapy and radiotherapy or chemotherapy alone after surgery for USC were included. Quality assessments were carried out by the Newcastle–Ottawa Scale. Hazard ratio (HR) for overall survival was extracted, and a random-effects model was used for pooled analysis. Publication bias was assessed using both funnel plot and the Egger regression test. Statistical analyses were performed using Stata version 13.0 software.ResultNine retrospective studies with relatively high quality containing 9354 patients were included for the final meta-analysis. The pooled results demonstrated that combined chemotherapy and radiotherapy significantly reduced the risk of death (HR, 0.72; P < 0.0001) compared to chemotherapy alone with a low heterogeneity (I2 = 21.0%, P = 0.256). Subgroup analyses indicated that calculating HR by unadjusted method may cause the heterogeneity among studies. Exploratory analyses showed that either patients with early stage disease (HR, 0.73; P = 0.011) or advanced stage disease (HR, 0.80; P < 0.0001) have survival benefits from combined chemotherapy and radiotherapy. No significant evidence of publication bias was found.ConclusionsThis is the first meta-analysis examining the role of combined chemotherapy and radiotherapy compared to chemotherapy alone in USC. Our results suggest the potential survival benefits of combined chemotherapy and radiotherapy. Further studies, preferably randomized clinical trials, are needed to confirm our results.

scholarly journals Acupuncture Treatments for Post-stroke Depression: A Systematic Review and Network Meta-analysis

2021 ◽  
Author(s):  
Lam Wai Ching ◽  
Hui Juan Li ◽  
Jianwen Guo ◽  
Liang Yao ◽  
Janita Chau ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Rating Scale ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Post Stroke ◽  
Significant Difference ◽  
Post Stroke Depression ◽  
The Impact

Abstract Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

scholarly journals The Impact of Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy on Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma: A Comprehensive Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Łukasz Nowak ◽  
Wojciech Krajewski ◽  
Joanna Chorbińska ◽  
Paweł Kiełb ◽  
Michał Sut ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Cochrane Library ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Upper Tract ◽  
Oncological Outcomes ◽  
The Impact

Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It was suggested that preoperative diagnostic ureteroscopy (URS) could increase the IVR rate after RNU, however, the available data are often conflicting. Thus, in this systematic review and meta-analysis we sought to synthesize that available data for the impact of pre-RNU URS for UTUC on IVR and other oncological outcomes; Materials and methods: A systematic literature search of the PubMed, Embase and Cochrane Library databases was performed in June 2020. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CI) were conducted. The primary endpoint was intravesical recurrence-free survival (IVRFS), with the secondary endpoints being cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS); Results: Among a total of 5489 patients included in the sixteen selected papers, 2387 (43.4%) underwent diagnostic URS before RNU and 3102 (56.6%) did not. Pre-RNU diagnostic URS was significantly associated with worse IVRFS after RNU (HR=1.44, 95% CI: 1.29-1.61, p&amp;lt;0.001) than RNU alone. However, subgroup analysis including patients without biopsy during URS revealed no significant impact of diagnostic URS on IVRFS (HR=1.28, 95% CI: 0.90-1.80, p=0.16). The results of other analyses showed no significant differences in CSS (HR=0.94, p=0.63), OS (HR: 0.94, p=0.56), and MFS (HR: 0.91, p=0.37) between patients who underwent URS before RNU and those who did not. Conclusions: The results of this meta-analysis confirm that diagnostic URS prior to RNU is significantly associated with worse IVRFS, albeit with no concurrent impact on the other long-term survival outcomes. Our results indicate that URS has a negative impact on IVRFS only when combined with endoscopic biopsy. Future studies are warranted to assess the role of immediate postoperative intravesical chemotherapy in patients undergoing biopsy during URS for suspected UTUC.

scholarly journals The Impact of Diabetes on the Prognosis of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoshuai Gao ◽  
Liang Zhou ◽  
Jianzhong Ai ◽  
Wei Wang ◽  
Xingpeng Di ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Cochrane Library ◽  
Radical Nephroureterectomy ◽  
Cancer Specific Survival ◽  
Upper Tract ◽  
Patients With Diabetes ◽  
Newcastle Ottawa Scale ◽  
The Impact

BackgroundStudies have reported that diabetes is related to the prognosis of upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU), but this conclusion is still controversial. Here, we performed a meta-analysis to comprehensively explore the association between diabetes and UTUC prognosis.MethodsIn November 2020, we searched PubMed, Web of science and the Cochrane Library to find relevant studies that evaluated the effect of diabetes on the prognosis of UTUC. The Newcastle Ottawa Scale was used to assess the quality of the literature. Review Manager 5.3 was used to pool cancer-specific survival (CSS), overall survival (OS), recurrence-free survival (RFS) and intravesical recurrence (IVR).ResultsA total of 10 studies with 11,303 patients were included in this meta-analysis. Our pooled results showed that diabetes did not affect the survival outcome of UTUC, including CSS (HR: 1.33, 95% CI: 0.89-1.98; P = 0.16), OS (HR: 1.18, 95% CI: 0.77-1.80; P = 0.45) and RFS (HR: 1.37, 95% CI: 0.91-2.05; P = 0.13). However, diabetes increased the risk of IVR of UTUC patients (HR: 1.26, 95% CI: 1.11-1.43; P = 0.0004).ConclusionAlthough diabetes has no significant impact on the survival outcomes of UTUC after RNU, it increases the risk of IVR. Therefore, special attention should be paid to monitoring the IVR for UTUC patients with diabetes and the necessity of appropriate intravesical adjuvant treatment when needed.

scholarly journals Sarcomatoid variant urothelial carcinoma of the bladder: a systematic review and meta-analysis of the clinicopathological features and survival outcomes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liangyou Gu ◽  
Qing Ai ◽  
Qiang Cheng ◽  
Xin Ma ◽  
Baojun Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Clinicopathological Features ◽  
Cochrane Library ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Comprehensive Search ◽  
Carcinoma Of The Bladder

Abstract Background A systematic review and meta-analysis was performed to compare the clinicopathological features and survival outcomes between sarcomatoid variant (SV)-urothelial carcinoma of the bladder (UCB) and conventional UCB (C-UCB). Methods A comprehensive search of PubMed, Embase, and Cochrane Library was performed. Endpoints included clinicopathological features and survival outcomes (overall survival [OS], cancer-specific survival [CSS], and progression-free survival [PFS]). The survival benefits of neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy (AC) for SV-UCB also have been studied. Results A total of 8 observational studies were included. Patients with SV-UCB had a higher rate of ≥ stage pT3 (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.64–2.59; p < 0.001) and a lower rate of concomitant carcinoma in situ (OR, 0.25; 95% CI, 0.09–0.72; p = 0.010). The other clinicopathological variables were similar between SV-UCB and C-UCB. With unadjusted data, patients with SV-UCB had a significant inferior OS (HR, 1.24; 95% CI, 1.07–1.44; p = 0.004) and CSS (HR, 2.08; 95% CI, 1.63–2.66; p < 0.001). However, after adjusted, SV-UCB had worse OS (HR, 1.41; 95% CI, 0.95–2.08; p = 0.090) and CSS (HR, 1.54; 95% CI, 0.95–2.52; p = 0.080) approaching the borderline of significance. For SV-UCB, NAC (HR, 0.73; 95% CI, 0.51–1.05; p = 0.090) and AC (HR, 0.88; 95% CI, 0.66–1.17; p = 0.370) seemed to have no benefit on OS. Conclusions Compared to C-UCB, SV-UCB was associated with more advanced disease and more inferior OS and CSS. NAC and AC had no survival benefit for SV-UCB.

Meta Analysis of Grade 3 and/or 4 Toxicities in Follicular (FL) and Mantle Cell (MCL) Non-Hodgkin Lymphoma (NHL) Patients Receiving Maintenance Rituximab (MR): Impact of Schedule, Histology, and Induction Regimen

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3654-3654
Author(s):  
Chadi Nabhan ◽  
Dana Villines ◽  
Brian C-H Chiu ◽  
Nicholas J. Ollberding ◽  
Tina V. Valdez ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Research Funding ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Induction Phase ◽  
Low Grade ◽  
Front Line ◽  
Grade 3 ◽  
The Impact

Abstract Abstract 3654 Background: MR has improved the outcome and progression-free survival (PFS) of patients (pts) with FL and MCL. However, maintenance schedules have been empirically designed with no consensus on the optimal regimen. While toxicities are usually predictable, the impact of MR schedule on toxicities has not been previously reported and could influence selection of maintenance regimens. We analyzed grade 3 and/or 4 adverse events (AE) in FL and MCL pts enrolled in prospective MR trials in order to compare AEs by MR schedule, histology, and setting (front-line and relapsed). Methods: A systematic search of the Medline (Pub-Med, Google Scholar, Cochrane Library) electronic database was performed to identify prospective clinical trials employing MR in FL and MCL. The following search terms were used: “MR, maintenance immunotherapy, maintenance therapy, low-grade lymphoma, NHL, MCL, and FL”. Abstracts and studies using MR after autologous stem cell transplantation or radioimmunotherapy were excluded. The number of AE reported was considered as the unit of analysis. Data for overall Grade 3 and/or Grade 4 toxicity (AE reported at any phase of treatment) were further categorized as an AE occurring during the induction phase or the maintenance phase. The incidence, severity, and type of toxicity were analyzed by type of induction (R vs. R+chemotherapy), histology (FL, MCL and FL plus other low-grade histologies), setting (front-line vs. relapsed), and MR schedule (one dose every 2 months vs. one dose every 3 months vs. 4 weekly doses every 6 months; all given for 2 years) and analysis was performed using t-tests or one-way ANOVA weighted means by either the total sample or the MR phase sample. Means were calculated using both fixed-effect and random-effect models Results: Thirteen clinical trials met criteria, including six trials which were randomized controlled in the MR phase. Of the total 3,100 pts, 1,263 received MR. The mean percentage of Grade 3/4 toxicities during any phase of treatment was 26% (95% CI = 0.12–51.88) but in the MR phase, it was only 12.88% (95% CI = 6.50–19.26). The overall mean number of grade 3/4 toxicities during any phase of treatment was 173.85 (95% CI = 167.76–179.95) and it was 60.5 (95% CI 58–63) in the MR phase. Toxicities were significantly different between induction therapy regimens, front-line and the relapsed settings and histologies (all P < 0.001). Pts receiving MR every 2 months encountered more grade 3 and 4 toxicities (mean percentage = 33%, mean = 97.46, 95% CI = 94.15–100.77) compared to 3 months (mean percentage = 21%, mean = 29.24, 95% CI = 27.92 –30.57) and 6 months (mean percentage = 13%, mean = 11.62, 95% CI = 10.70–12.54) schedules (P < 0.001). Pts receiving R+ chemo induction had more AEs compared to those receiving R induction [(mean=73.9 (95% CI 70.8–77.0) vs. 7.5 (95% CI 6.4–8.5), P<0.001]. Pts receiving MR in front-line had more AEs compared to those receiving MR in relapsed disease [mean= 73.1 (95% CI 69.9–76.6) vs. 43.3 (95% CI 41.3–45.3), P<0.001]. Pts with FL had more AEs compared to those with MCL [mean=72.9 (95% CI 69.8–75.9) vs. 15.3 (95% CI 13.2–17.3), P<0.001] Neutropenia and infections were the most common reported individual toxicities. Conclusions: Approximately 13% of patients receiving MR experience grade 3 and/or 4 toxicities, mainly neutropenia and infections. MR given every 6 months appears to cause fewer toxicities. Importantly, this meta-analysis did not compare relative efficacy amongst the three most commonly used MR schedules, but may be helpful in advising patients of relative risks amongst the three schedules. Disclosures: Nabhan: Genentech: Research Funding, Speakers Bureau. Ghielmini:Roche: Honoraria, Research Funding. Smith:Genentech/Roche: Data Safety Monitoring Board and advisory Board attendance Other.

scholarly journals The Impact of Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy on Oncological Outcomes in Patients with Upper Tract Urothelial Carcinoma: A Comprehensive Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4197
Author(s):  
Łukasz Nowak ◽  
Wojciech Krajewski ◽  
Joanna Chorbińska ◽  
Paweł Kiełb ◽  
Michał Sut ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Tract Urothelial Carcinoma ◽  
Cochrane Library ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Upper Tract ◽  
Oncological Outcomes ◽  
The Impact

Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It was suggested that preoperative diagnostic ureteroscopy (URS) could increase the IVR rate after RNU. However, the available data are often conflicting. Thus, in this systematic review and meta-analysis we sought to synthesize available data for the impact of pre-RNU URS for UTUC on IVR and other oncological outcomes. Materials and methods: A systematic literature search of the PubMed, Embase, and Cochrane Library databases was performed in June 2021. Cumulative analyses of hazard ratios (HRs) and their corresponding 95% confidence intervals (CI) were conducted. The primary endpoint was intravesical recurrence-free survival (IVRFS), with the secondary endpoints being cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS). Results: Among a total of 5489 patients included in the sixteen selected papers, 2387 (43.4%) underwent diagnostic URS before RNU and 3102 (56.6%) did not. Pre-RNU diagnostic URS was significantly associated with worse IVRFS after RNU (HR = 1.44, 95% CI: 1.29–1.61, p < 0.001) than RNU alone. However, subgroup analysis including patients without biopsy during URS revealed no significant impact of diagnostic URS on IVRFS (HR = 1.28, 95% CI: 0.90–1.80, p = 0.16). The results of other analyses showed no significant differences in CSS (HR = 0.94, p = 0.63), OS (HR: 0.94, p = 0.56), and MFS (HR: 0.91, p = 0.37) between patients who underwent URS before RNU and those who did not. Conclusions: The results of this meta-analysis confirm that diagnostic URS prior to RNU is significantly associated with worse IVRFS, albeit with no concurrent impact on the other long-term survival outcomes. Our results indicate that URS has a negative impact on IVRFS only when combined with endoscopic biopsy. Future studies are warranted to assess the role of immediate postoperative intravesical chemotherapy in patients undergoing biopsy during URS for suspected UTUC.

scholarly journals Clinicopathological and prognostic significance of speckle-type POZ protein in cancers: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan He ◽  
Jun Chen ◽  
Xingchen Peng ◽  
Yanli Xia ◽  
Yonglin Su
Keyword(s):  
Meta Analysis ◽  
Clinical Stage ◽  
Prognostic Significance ◽  
Clinicopathological Features ◽  
Cochrane Library ◽  
Cancer Tissue ◽  
Prognostic Stratification ◽  
The Cochrane Library ◽  
Cancer Tissues ◽  
The Impact

Abstract Background Controversial findings have been reported in the impact of speckle-type POZ protein (SPOP) on clinicopathological features and prognosis in diverse cancers. We conducted this meta-analysis to confirm whether SPOP was an effective biomarker to predict clinical stage, cancer differentiation and survival. Methods We searched studies published before June 2021 through Medline, Embase, the Cochrane library register of controlled trials and Wanfang databases. The corrections of SPOP expression with expression disparity, tumor differentiation, clinical stage and survival were analyzed. Results Our meta-analysis found that higher expression of SPOP was significantly associated with earlier clinical stage, well differentiation and better overall survival. Subgroup analysis showed that the SPOP expression of adjacent tissue was significantly higher than that in cancer tissues of prostate and liver. However, renal cancer presented improved expression of SPOP in cancer tissue. Conclusions SPOP has the potential function to act as a novel and effective biomarker for cancer diagnosis and prognostic stratification.

scholarly journals Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Oswald D. Kothgassner ◽  
Andreas Goreis ◽  
Kealagh Robinson ◽  
Mercedes M. Huscsava ◽  
Christian Schmahl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Suicidal Ideation ◽  
Dialectical Behavior Therapy ◽  
Meta Analysis ◽  
Adolescent Psychopathology ◽  
Cochrane Library ◽  
Behaviour Therapy ◽  
Clinical Consequences ◽  
Self Harm

Abstract Background Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7. Results Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63). Conclusions DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.

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