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Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia
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 th...
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| Published in: | International journal of hematology 2017-05, Vol.105 (5), p.578-586 |
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| cites | cdi_FETCH-LOGICAL-c429t-9893fecfde50714d4e13b9360e0d09ecdfbd9cedbce12007389ad73f34a226793 |
| container_end_page | 586 |
| container_issue | 5 |
| container_start_page | 578 |
| container_title | International journal of hematology |
| container_volume | 105 |
| creator | Hayakawa, Jin Kanda, Junya Akahoshi, Yu Harada, Naonori Kameda, Kazuaki Ugai, Tomotaka Wada, Hidenori Ishihara, Yuko Kawamura, Koji Sakamoto, Kana Ashizawa, Masahiro Sato, Miki Terasako-Saito, Kiriko Kimura, Shun-ichi Kikuchi, Misato Yamazaki, Rie Kako, Shinichi Kanda, Yoshinobu |
| description | 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. |
| doi_str_mv | 10.1007/s12185-017-2179-3 |
| format | article |
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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.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-017-2179-3</identifier><identifier>PMID: 28078653</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Anemia, Aplastic - drug therapy ; Anemia, Aplastic - mortality ; Animals ; Antilymphocyte Serum - administration & dosage ; Hematology ; Horses ; Humans ; Immunosuppressive Agents - administration & dosage ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Rabbits ; Survival Rate ; Treatment Outcome</subject><ispartof>International journal of hematology, 2017-05, Vol.105 (5), p.578-586</ispartof><rights>The Japanese Society of Hematology 2017</rights><rights>International Journal of Hematology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c429t-9893fecfde50714d4e13b9360e0d09ecdfbd9cedbce12007389ad73f34a226793</citedby><cites>FETCH-LOGICAL-c429t-9893fecfde50714d4e13b9360e0d09ecdfbd9cedbce12007389ad73f34a226793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28078653$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hayakawa, Jin</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Akahoshi, Yu</creatorcontrib><creatorcontrib>Harada, Naonori</creatorcontrib><creatorcontrib>Kameda, Kazuaki</creatorcontrib><creatorcontrib>Ugai, Tomotaka</creatorcontrib><creatorcontrib>Wada, Hidenori</creatorcontrib><creatorcontrib>Ishihara, Yuko</creatorcontrib><creatorcontrib>Kawamura, Koji</creatorcontrib><creatorcontrib>Sakamoto, Kana</creatorcontrib><creatorcontrib>Ashizawa, Masahiro</creatorcontrib><creatorcontrib>Sato, Miki</creatorcontrib><creatorcontrib>Terasako-Saito, Kiriko</creatorcontrib><creatorcontrib>Kimura, Shun-ichi</creatorcontrib><creatorcontrib>Kikuchi, Misato</creatorcontrib><creatorcontrib>Yamazaki, Rie</creatorcontrib><creatorcontrib>Kako, Shinichi</creatorcontrib><creatorcontrib>Kanda, Yoshinobu</creatorcontrib><title>Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>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.</description><subject>Anemia, Aplastic - drug therapy</subject><subject>Anemia, Aplastic - mortality</subject><subject>Animals</subject><subject>Antilymphocyte Serum - administration & dosage</subject><subject>Hematology</subject><subject>Horses</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Rabbits</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkU1r3DAQhkVp6G63_QG9FEEvvSgZfXhlHcvSL0jJJTn1IGRpnDjY1laSKfvvq82mpQQKPWmQnnlH876EvOFwzgH0ReaCtw0Drpng2jD5jKx5u22Y1Fo9J2swomGN5rAiL3O-hwqC0i_ISrSgKyfX5Ps3LI652Y2HPGQae1oSujLhXOjPodzR5LpuKNTNgd7FlLFWpd4fpugPBentGLtlHGbax0TdfnS5DL4yOA3uFTnr3Zjx9eO5ITefPl7vvrDLq89fdx8umVfCFGZaI3v0fcAGNFdBIZedkVtACGDQh74LxmPoPHJR15atcUHLXionxFYbuSHvT7r7FH8smIudhuxxHOs34pItb42WWmgF_4E2LQelpKrouyfofVxSNepBEAAaIZtK8RPlU8w5YW_3aZhcOlgO9hiSPYVkq_f2GJKVtefto_LSTRj-dPxOpQLiBOT6NN9i-mv0P1V_ARh6nKU</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Hayakawa, Jin</creator><creator>Kanda, Junya</creator><creator>Akahoshi, Yu</creator><creator>Harada, Naonori</creator><creator>Kameda, Kazuaki</creator><creator>Ugai, Tomotaka</creator><creator>Wada, Hidenori</creator><creator>Ishihara, Yuko</creator><creator>Kawamura, Koji</creator><creator>Sakamoto, Kana</creator><creator>Ashizawa, Masahiro</creator><creator>Sato, Miki</creator><creator>Terasako-Saito, Kiriko</creator><creator>Kimura, Shun-ichi</creator><creator>Kikuchi, Misato</creator><creator>Yamazaki, Rie</creator><creator>Kako, Shinichi</creator><creator>Kanda, Yoshinobu</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia</title><author>Hayakawa, Jin ; Kanda, Junya ; Akahoshi, Yu ; Harada, Naonori ; Kameda, Kazuaki ; Ugai, Tomotaka ; Wada, Hidenori ; Ishihara, Yuko ; Kawamura, Koji ; Sakamoto, Kana ; Ashizawa, Masahiro ; Sato, Miki ; Terasako-Saito, Kiriko ; Kimura, Shun-ichi ; Kikuchi, Misato ; Yamazaki, Rie ; Kako, Shinichi ; Kanda, Yoshinobu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c429t-9893fecfde50714d4e13b9360e0d09ecdfbd9cedbce12007389ad73f34a226793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anemia, Aplastic - drug therapy</topic><topic>Anemia, Aplastic - mortality</topic><topic>Animals</topic><topic>Antilymphocyte Serum - administration & dosage</topic><topic>Hematology</topic><topic>Horses</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Rabbits</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hayakawa, Jin</creatorcontrib><creatorcontrib>Kanda, Junya</creatorcontrib><creatorcontrib>Akahoshi, Yu</creatorcontrib><creatorcontrib>Harada, Naonori</creatorcontrib><creatorcontrib>Kameda, Kazuaki</creatorcontrib><creatorcontrib>Ugai, Tomotaka</creatorcontrib><creatorcontrib>Wada, Hidenori</creatorcontrib><creatorcontrib>Ishihara, Yuko</creatorcontrib><creatorcontrib>Kawamura, Koji</creatorcontrib><creatorcontrib>Sakamoto, Kana</creatorcontrib><creatorcontrib>Ashizawa, Masahiro</creatorcontrib><creatorcontrib>Sato, Miki</creatorcontrib><creatorcontrib>Terasako-Saito, Kiriko</creatorcontrib><creatorcontrib>Kimura, Shun-ichi</creatorcontrib><creatorcontrib>Kikuchi, Misato</creatorcontrib><creatorcontrib>Yamazaki, Rie</creatorcontrib><creatorcontrib>Kako, Shinichi</creatorcontrib><creatorcontrib>Kanda, Yoshinobu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hayakawa, Jin</au><au>Kanda, Junya</au><au>Akahoshi, Yu</au><au>Harada, Naonori</au><au>Kameda, Kazuaki</au><au>Ugai, Tomotaka</au><au>Wada, Hidenori</au><au>Ishihara, Yuko</au><au>Kawamura, Koji</au><au>Sakamoto, Kana</au><au>Ashizawa, Masahiro</au><au>Sato, Miki</au><au>Terasako-Saito, Kiriko</au><au>Kimura, Shun-ichi</au><au>Kikuchi, Misato</au><au>Yamazaki, Rie</au><au>Kako, Shinichi</au><au>Kanda, Yoshinobu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>105</volume><issue>5</issue><spage>578</spage><epage>586</epage><pages>578-586</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>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.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>28078653</pmid><doi>10.1007/s12185-017-2179-3</doi><tpages>9</tpages></addata></record> |
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| subjects | Anemia, Aplastic - drug therapy Anemia, Aplastic - mortality Animals Antilymphocyte Serum - administration & dosage Hematology Horses Humans Immunosuppressive Agents - administration & dosage Medicine Medicine & Public Health Oncology Original Article Rabbits Survival Rate Treatment Outcome |
| title | Meta-analysis of treatment with rabbit and horse antithymocyte globulin for aplastic anemia |
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