TY - JOUR
T1 - Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia
AU - Hayakawa, Jin
AU - Kanda, Junya
AU - Akahoshi, Yu
AU - Harada, Naonori
AU - Kameda, Kazuaki
AU - Ugai, Tomotaka
AU - Wada, Hidenori
AU - Ishihara, Yuko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Ashizawa, Masahiro
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Kimura, Shun ichi
AU - Kikuchi, Misato
AU - Yamazaki, Rie
AU - Kako, Shinichi
AU - Kanda, Yoshinobu
N1 - Publisher Copyright:
© 2017, The Japanese Society of Hematology.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Aplastic anemia patients who received rabbit antithymocyte globulin exhibited response and survival rates inferior to those who received horse antithymocyte globulin in several studies. Therefore, we conducted a meta-analysis to compare rabbit and horse antithymocyte globulin as immunosuppressive therapy for aplastic anemia. We searched online databases for studies that compared antithymocyte globulin regimens as first-line treatment for aplastic anemia, including both randomized and non-randomized controlled trials. The early mortality rate at 3 months and overall response rate at 6 months were evaluated. Thirteen studies were included in the analysis. The risk ratio (RR) of early mortality for rabbit vs. horse antithymocyte globulin was 1.33 [95% confidence interval (CI) 0.69–2.57; P = 0.39], with significant heterogeneity. A sensitivity analysis suggested higher early mortality rate in patients who received rabbit antithymocyte globulin. The overall response rate was significantly higher in patients who received horse antithymocyte globulin (RR 1.27; 95% CI 1.05–1.54; P = 0.015). In conclusion, in aplastic anemia patients treated with ATG, early mortality rate was not significantly different in patients receiving horse or rabbit ATG, although a sensitivity analysis showed higher early mortality in the rabbit ATG group. Horse ATG was associated with significantly higher response rate than rabbit ATG.
AB - Aplastic anemia patients who received rabbit antithymocyte globulin exhibited response and survival rates inferior to those who received horse antithymocyte globulin in several studies. Therefore, we conducted a meta-analysis to compare rabbit and horse antithymocyte globulin as immunosuppressive therapy for aplastic anemia. We searched online databases for studies that compared antithymocyte globulin regimens as first-line treatment for aplastic anemia, including both randomized and non-randomized controlled trials. The early mortality rate at 3 months and overall response rate at 6 months were evaluated. Thirteen studies were included in the analysis. The risk ratio (RR) of early mortality for rabbit vs. horse antithymocyte globulin was 1.33 [95% confidence interval (CI) 0.69–2.57; P = 0.39], with significant heterogeneity. A sensitivity analysis suggested higher early mortality rate in patients who received rabbit antithymocyte globulin. The overall response rate was significantly higher in patients who received horse antithymocyte globulin (RR 1.27; 95% CI 1.05–1.54; P = 0.015). In conclusion, in aplastic anemia patients treated with ATG, early mortality rate was not significantly different in patients receiving horse or rabbit ATG, although a sensitivity analysis showed higher early mortality in the rabbit ATG group. Horse ATG was associated with significantly higher response rate than rabbit ATG.
KW - Aplastic anemia
KW - Bone marrow failure
KW - Immunosuppressive therapy
KW - Meta-analysis
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U2 - 10.1007/s12185-017-2179-3
DO - 10.1007/s12185-017-2179-3
M3 - Article
C2 - 28078653
AN - SCOPUS:85009250667
SN - 0925-5710
VL - 105
SP - 578
EP - 586
JO - International Journal of Hematology
JF - International Journal of Hematology
IS - 5
ER -