Faculty Opinions recommendation of Induction and maintenance treatment of proliferative lupus nephritis: a meta-analysis of randomized controlled trials.

2013 ◽  
Author(s):  
Jeremy Chapman
Keyword(s):  
Lupus Nephritis ◽  
Randomized Controlled Trials ◽  
Maintenance Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Proliferative Lupus Nephritis

Induction and Maintenance Treatment of Proliferative Lupus Nephritis: A Meta-analysis of Randomized Controlled Trials

2013 ◽  
Vol 61 (1) ◽  
pp. 74-87 ◽  
Author(s):  
Lorna K. Henderson ◽  
Philip Masson ◽  
Jonathan C. Craig ◽  
Matthew A. Roberts ◽  
Robert S. Flanc ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Randomized Controlled Trials ◽  
Maintenance Treatment ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Proliferative Lupus Nephritis

Treatment of diffuse proliferative lupus nephritis: a meta-analysis of randomized controlled trials

2004 ◽  
Vol 43 (2) ◽  
pp. 197-208 ◽  
Author(s):  
Robert S Flanc ◽  
Matthew A Roberts ◽  
Giovanni F.M Strippoli ◽  
Steven J Chadban ◽  
Peter G Kerr ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Proliferative Lupus Nephritis

Infectious complications in lupus nephritis treatment: a systematic review and meta-analysis

Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 334-346 ◽  
Author(s):  
K M Thong ◽  
T M Chan
Keyword(s):  
Lupus Nephritis ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Induction Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Serious Infections ◽  
Related Mortality

Objectives Infection is an important concern in lupus nephritis treatment, but few studies have focused on this complication. Available data suggest marked variation in occurrence and outcome. This meta-analysis and review aims to provide an overview of infective complications, focusing on the risk factors and outcomes. Methods Original articles on lupus nephritis Class III/IV/V published in the period January 1980 to December 2016 were identified from the Pubmed/Medline electronic database. Meta-analysis of randomized controlled trials was performed to investigate total and serious infections at different phases of treatment and their associated factors. A descriptive review that included all studies was also performed, providing details on the types of infection, infection-related mortality, and potential impact of different eras on infection rates. Results A total of 56 studies (32 randomized controlled trials) were included. The incidence rates of overall and serious infections were higher during the induction than maintenance phase of therapy, with serious infections occurring at 8.2–50 and 3.5 per 100 patient-years, respectively. Recent data, predominantly from Asia, suggested lower rates of overall infections with induction regimens that included tacrolimus compared with mycophenolate (risk ratio 0.50, 95% confidence interval 0.33–0.76, p = 0.001). Mycophenolate as induction treatment was associated with lower overall infection risks than cyclophosphamide in non-Asians (risk ratio 0.60, 95% confidence interval 0.48–0.75, p < 0.001). The rates of serious infections were 4.1–25% in Asian and 4.4–8.5% in non-Asian countries; with infection-related mortality rates of 0–6.7% in Asian, compared to 0–2.1% in non-Asian locations. Conclusions Infection remains a serious complication during treatment of lupus nephritis, but the reported rates and outcomes varied markedly. Mycophenolate was associated with lower infection risk than cyclophosphamide in non-Asians. Infection-related deaths appeared more common in Asian patients.

scholarly journals Efficacy and toxicities of combination maintenance therapy in the treatment of advanced colorectal cancer: a meta-analysis of randomized controlled trials

2018 ◽  
Author(s):  
Fanzhong Lin ◽  
Hongyun Li ◽  
Jianzhu Wang ◽  
Fang Wang
Keyword(s):  
Colorectal Cancer ◽  
Maintenance Therapy ◽  
Randomized Controlled Trials ◽  
Maintenance Treatment ◽  
Advanced Colorectal Cancer ◽  
Meta Analysis ◽  
Single Agent ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Grade 3

Purpose: We performed a systematic review and meta-analysis to investigate the efficacy and toxicities of combination maintenance therapy for the treatment of advanced colorectal cancer (CRC). Methods: Relevant trials were identified by searching electronic databases and conference meetings. Prospective randomized controlled trials (RCTs) assessing combination maintenance therapy in advanced CRC patients were included. Outcomes of interest included overall survival (OS), progression-free survival (PFS) and grade 3-4 toxicities. Results: A total of 3,174 advanced CRC patients received combination maintenance treatment from 6 RCTs were included for analysis. The use of combination maintenance therapy did not significantly improved PFS (HR 0.95, 95%CI: 0.75-1.20, p=0.67) and OS (HR 1.05, 95%CI: 0.93-1.17, p=0.45) in comparison with single bevacizumab maintenance therapy for the treatment of advanced CRC, similar results were observed in sub-group analysis according to treatment regimens. In addition, combination maintenance therapy significantly improved PFS (HR 0.57, 95%CI: 0.41-0.80, p=0.001), but not for OS (HR 0.93, 95%CI: 0.76-1.14, p=0.47) in comparison with observation. Additionally, more incidences of any grade 3-4 toxicities (diarrhea, fatigue and hand-foot skin reaction) were observed in the combination maintenance therapy. Conclusions: The findings of this study show that the efficacy of combination maintenance therapy is comparable to that of bevacizumab alone in terms of PFS and OS for advanced CRC patients, but at the cost of increased grade 3-4 toxicities. Thus single agent bevacizumab remains the recommended maintenance treatment for advanced CRC patients.

Comparison of Different Uses of Cyclophosphamide in Lupus Nephritis: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 20 (5) ◽  
pp. 687-702
Author(s):  
Yebei Li ◽  
Shizhang Xu ◽  
Gaosi Xu
Keyword(s):  
Lupus Nephritis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Short Interval ◽  
Cochrane Library ◽  
Lower Probability ◽  
Controlled Trials ◽  
High Dose ◽  
Dose Regime ◽  
Randomized Controlled

Background: The present study aims to compare the relative efficacy and safety of different uses of cyclophosphamide (CYC) in lupus nephritis (LN). Methods: We searched the Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed for articles from the database till June 2018. Results: 12 randomized controlled trials with 994 participants were included. The meta-analysis indicated that the short-interval lower-dose intravenous CYC regime remarkably reduced 24-hour proteinuria [mean difference (MD) -0.45; 95% confidence interval (CI) -0.62 to -0.27; I2 0%], incidence of major infections [odds ratio (OR) 0.62, 95% CI 0.40 to 0.95; I2 42%], gonadal toxicity (OR 0.41, 95% CI 0.27 to 0.62; I2 0%), and leukopenia (OR 0.55, 95% CI 0.33 to 0.94, I2 0%), while high-dose regime had an obvious lower probability of doubling of serum creatinine (Scr) level (OR 2.43; 95% CI 1.19 to 4.95; I2 0%). However, the difference in the complete and total remission rates between the two regimens was not observed. Conclusion: The result suggested that the short-interval lower-dose CYC regime remarkably reduced 24-hour proteinuria and the incidence of adverse events, while the long-course high-dose regime played a significant role in reducing the rate of doubling Scr level.

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