Efficacy, Safety, and Tolerability of Treatments for Systemic Sclerosis-Related Interstitial Lung Disease: A Systematic Review and Network Meta-Analysis
| Autor: | Marco Sebastiani, Angelo Zinellu, Maria Antonietta Fenu, Gian Luca Erre, Alberto Floris, Giuseppe Passiu, Richard J. Woodman, Arduino A. Mangoni, Elisabetta A. Renzoni, Lorenzo Cavagna, Andreina Teresa Manfredi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Vital capacity systemic sclerosis cyclophosphamide hematopoietic stem-cell transplantation interstitial lung disease mycophenolate mofetil network meta-analysis nintedanib pomalidomide randomized controlled trials rituximab lcsh:Medicine Review Placebo law.invention 03 medical and health sciences chemistry.chemical_compound FEV1/FVC ratio 0302 clinical medicine Randomized controlled trial DLCO law Internal medicine medicine 030212 general & internal medicine Adverse effect 030203 arthritis & rheumatology business.industry lcsh:R General Medicine respiratory system chemistry Tolerability Nintedanib business |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 2560, p 2560 (2020) Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Popis: | Background: There is a paucity of head-to-head comparisons of the efficacy and harms of pharmacological treatments for systemic sclerosis-related interstitial lung disease (SSc-ILD). Methods: We conducted a network meta-analysis (NMA) in order to compare the effects of different treatments with the placebo on change in forced vital capacity (FVC), change in diffusion lung capacity for CO (DLCO), serious adverse events (SAEs), discontinuation for adverse events and mortality in SSc-ILD. Standardized mean difference (SMD) and log odds ratio were estimated using NMA with fixed effects. Results: Nine randomized clinical trials (926 participants) comparing eight interventions and the placebo for an average follow-up of one year were included. Compared to the placebo, only rituximab significantly reduced FVC decline (SMD (95% CI) = 1.00 (0.39 to 1.61)). Suitable data on FVC outcome for nintedanib were not available for the analysis. No treatments influenced DLCO. Safety and mortality were also not different across treatments and the placebo, although there were few reported events. Cyclophosphamide and pomalidomide were less tolerated than the placebo, mycophenolate, and nintedanib. Conclusion: Only rituximab significantly reduced lung function decline compared to the placebo. However, direct head-to-head comparison studies are required to confirm these findings and to better determine the safety profile of various treatments. |
| Databáze: | OpenAIRE |
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