The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis
The therapeutic effect of plasma exchange (PLEX) combined with conventional treatment in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) remains controversial. We searched PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure for randomize...
Gespeichert in:
| Veröffentlicht in: | Clinical nephrology 2021-06, Vol.95 (6), p.312-322 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 322 |
|---|---|
| container_issue | 6 |
| container_start_page | 312 |
| container_title | Clinical nephrology |
| container_volume | 95 |
| creator | Zhu, Yan Rao, Jinlan Liu, Liu Ou, Jihong Li, Wei Xue, Chao |
| description | The therapeutic effect of plasma exchange (PLEX) combined with conventional treatment in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) remains controversial.
We searched PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure for randomized controlled trials (RCTs) and cohort studies that compared PLEX added to conventional therapy with conventional therapy only in active AAV.
19 studies were included for the meta-analysis. Compared with the conventional therapy group, the PLEX group had a significantly reduced risk of end-stage renal disease (ESRD) at 3 months (odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.16 - 0.66, p = 0.002, I2 = 0%), and the ANCA titerwas also decreased (OR = 40.99, 95% Cl = 23.56 - 58.43, p |
| doi_str_mv | 10.5414/CN110410 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2503669977</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2503669977</sourcerecordid><originalsourceid>FETCH-LOGICAL-c367t-bafa8f9f6fbe5c5e697d6737a060c408bd6f3c2a52d29233890065fcdaf68d2b3</originalsourceid><addsrcrecordid>eNqF0cFL3EAUBvA5WNytCv4FZcBLL2nfzMvMZLwti9aCrBcFb-Fl8sbNkmzWTCL1v3elWqGH9vRdfnx88AlxquCbyVX-fblSCnIFB2IOCCqDHGEmPqe0AdBQYHEoZogu96bAubi_XbMc1zzQjqexCZJj5DDKPspdS6kjyb_CmrYPLPutXKyWi4xS6kNDI9fyiVKY2mZs0rlcyI5HymhL7XNq0rH4FKlNfPKWR-Lu8uJ2eZVd3_z4uVxcZwGtG7OKIhXRRxsrNsGw9a62Dh2BhZBDUdU2YtBkdK29Riw8gDUx1BRtUesKj8TX3727oX-cOI1l16TAbUtb7qdUagNorffO7enZX3TTT8N-717ZHFWOTtt_K0TUzpn_KAVGee_Nx7gw9CkNHMvd0HQ0PJcKyte3yve39vTLW-FUdVz_ge9X4QtkQI4K</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2610519995</pqid></control><display><type>article</type><title>The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis</title><source>Alma/SFX Local Collection</source><creator>Zhu, Yan ; Rao, Jinlan ; Liu, Liu ; Ou, Jihong ; Li, Wei ; Xue, Chao</creator><creatorcontrib>Zhu, Yan ; Rao, Jinlan ; Liu, Liu ; Ou, Jihong ; Li, Wei ; Xue, Chao</creatorcontrib><description>The therapeutic effect of plasma exchange (PLEX) combined with conventional treatment in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) remains controversial.
We searched PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure for randomized controlled trials (RCTs) and cohort studies that compared PLEX added to conventional therapy with conventional therapy only in active AAV.
19 studies were included for the meta-analysis. Compared with the conventional therapy group, the PLEX group had a significantly reduced risk of end-stage renal disease (ESRD) at 3 months (odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.16 - 0.66, p = 0.002, I2 = 0%), and the ANCA titerwas also decreased (OR = 40.99, 95% Cl = 23.56 - 58.43, p < 0.00001, I2 = 42%). The plasma and non-plasma exchange groups had no substantial differences in terms of short- and long-term outcomes, including all-cause mortality, ESRD risk at 12 months and 5 years, remission rate, serum creatine levels, or serious adverse events.
PLEX therapy was not associated with favorable long-term outcomes, although the results showed benefits in the incidence of ESRD rate at 3 months and ANCA titers in patients with AAV. No advantage of PLEX added to conventional therapy on mortality and complete remission was observed in patients with diffuse alveolar hemorrhage. Further high-quality multicenter RCTs with a high number of participants are required to assess the potential efficacy of PLEX in active AAV.</description><identifier>ISSN: 0301-0430</identifier><identifier>DOI: 10.5414/CN110410</identifier><identifier>PMID: 33749583</identifier><language>eng</language><publisher>Germany: Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG</publisher><subject>Antibodies ; Apheresis ; Confidence intervals ; Hemorrhage ; Hospitals ; Kidney diseases ; Meta-analysis ; Mortality ; Nephrology ; Neutrophils ; Plasma ; Remission (Medicine)</subject><ispartof>Clinical nephrology, 2021-06, Vol.95 (6), p.312-322</ispartof><rights>Copyright Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG Jun 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c367t-bafa8f9f6fbe5c5e697d6737a060c408bd6f3c2a52d29233890065fcdaf68d2b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33749583$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Yan</creatorcontrib><creatorcontrib>Rao, Jinlan</creatorcontrib><creatorcontrib>Liu, Liu</creatorcontrib><creatorcontrib>Ou, Jihong</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><creatorcontrib>Xue, Chao</creatorcontrib><title>The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis</title><title>Clinical nephrology</title><addtitle>Clin Nephrol</addtitle><description>The therapeutic effect of plasma exchange (PLEX) combined with conventional treatment in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) remains controversial.
We searched PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure for randomized controlled trials (RCTs) and cohort studies that compared PLEX added to conventional therapy with conventional therapy only in active AAV.
19 studies were included for the meta-analysis. Compared with the conventional therapy group, the PLEX group had a significantly reduced risk of end-stage renal disease (ESRD) at 3 months (odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.16 - 0.66, p = 0.002, I2 = 0%), and the ANCA titerwas also decreased (OR = 40.99, 95% Cl = 23.56 - 58.43, p < 0.00001, I2 = 42%). The plasma and non-plasma exchange groups had no substantial differences in terms of short- and long-term outcomes, including all-cause mortality, ESRD risk at 12 months and 5 years, remission rate, serum creatine levels, or serious adverse events.
PLEX therapy was not associated with favorable long-term outcomes, although the results showed benefits in the incidence of ESRD rate at 3 months and ANCA titers in patients with AAV. No advantage of PLEX added to conventional therapy on mortality and complete remission was observed in patients with diffuse alveolar hemorrhage. Further high-quality multicenter RCTs with a high number of participants are required to assess the potential efficacy of PLEX in active AAV.</description><subject>Antibodies</subject><subject>Apheresis</subject><subject>Confidence intervals</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Kidney diseases</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Nephrology</subject><subject>Neutrophils</subject><subject>Plasma</subject><subject>Remission (Medicine)</subject><issn>0301-0430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqF0cFL3EAUBvA5WNytCv4FZcBLL2nfzMvMZLwti9aCrBcFb-Fl8sbNkmzWTCL1v3elWqGH9vRdfnx88AlxquCbyVX-fblSCnIFB2IOCCqDHGEmPqe0AdBQYHEoZogu96bAubi_XbMc1zzQjqexCZJj5DDKPspdS6kjyb_CmrYPLPutXKyWi4xS6kNDI9fyiVKY2mZs0rlcyI5HymhL7XNq0rH4FKlNfPKWR-Lu8uJ2eZVd3_z4uVxcZwGtG7OKIhXRRxsrNsGw9a62Dh2BhZBDUdU2YtBkdK29Riw8gDUx1BRtUesKj8TX3727oX-cOI1l16TAbUtb7qdUagNorffO7enZX3TTT8N-717ZHFWOTtt_K0TUzpn_KAVGee_Nx7gw9CkNHMvd0HQ0PJcKyte3yve39vTLW-FUdVz_ge9X4QtkQI4K</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Zhu, Yan</creator><creator>Rao, Jinlan</creator><creator>Liu, Liu</creator><creator>Ou, Jihong</creator><creator>Li, Wei</creator><creator>Xue, Chao</creator><general>Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210601</creationdate><title>The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis</title><author>Zhu, Yan ; Rao, Jinlan ; Liu, Liu ; Ou, Jihong ; Li, Wei ; Xue, Chao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-bafa8f9f6fbe5c5e697d6737a060c408bd6f3c2a52d29233890065fcdaf68d2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibodies</topic><topic>Apheresis</topic><topic>Confidence intervals</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Kidney diseases</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Nephrology</topic><topic>Neutrophils</topic><topic>Plasma</topic><topic>Remission (Medicine)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Yan</creatorcontrib><creatorcontrib>Rao, Jinlan</creatorcontrib><creatorcontrib>Liu, Liu</creatorcontrib><creatorcontrib>Ou, Jihong</creatorcontrib><creatorcontrib>Li, Wei</creatorcontrib><creatorcontrib>Xue, Chao</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</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 Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</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>Clinical nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Yan</au><au>Rao, Jinlan</au><au>Liu, Liu</au><au>Ou, Jihong</au><au>Li, Wei</au><au>Xue, Chao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis</atitle><jtitle>Clinical nephrology</jtitle><addtitle>Clin Nephrol</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>95</volume><issue>6</issue><spage>312</spage><epage>322</epage><pages>312-322</pages><issn>0301-0430</issn><abstract>The therapeutic effect of plasma exchange (PLEX) combined with conventional treatment in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) remains controversial.
We searched PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure for randomized controlled trials (RCTs) and cohort studies that compared PLEX added to conventional therapy with conventional therapy only in active AAV.
19 studies were included for the meta-analysis. Compared with the conventional therapy group, the PLEX group had a significantly reduced risk of end-stage renal disease (ESRD) at 3 months (odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.16 - 0.66, p = 0.002, I2 = 0%), and the ANCA titerwas also decreased (OR = 40.99, 95% Cl = 23.56 - 58.43, p < 0.00001, I2 = 42%). The plasma and non-plasma exchange groups had no substantial differences in terms of short- and long-term outcomes, including all-cause mortality, ESRD risk at 12 months and 5 years, remission rate, serum creatine levels, or serious adverse events.
PLEX therapy was not associated with favorable long-term outcomes, although the results showed benefits in the incidence of ESRD rate at 3 months and ANCA titers in patients with AAV. No advantage of PLEX added to conventional therapy on mortality and complete remission was observed in patients with diffuse alveolar hemorrhage. Further high-quality multicenter RCTs with a high number of participants are required to assess the potential efficacy of PLEX in active AAV.</abstract><cop>Germany</cop><pub>Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG</pub><pmid>33749583</pmid><doi>10.5414/CN110410</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-0430 |
| ispartof | Clinical nephrology, 2021-06, Vol.95 (6), p.312-322 |
| issn | 0301-0430 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2503669977 |
| source | Alma/SFX Local Collection |
| subjects | Antibodies Apheresis Confidence intervals Hemorrhage Hospitals Kidney diseases Meta-analysis Mortality Nephrology Neutrophils Plasma Remission (Medicine) |
| title | The therapeutic effect of plasma exchange on ANCA-associated vasculitis: A meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T03%3A09%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20therapeutic%20effect%20of%20plasma%20exchange%20on%20ANCA-associated%20vasculitis:%20A%20meta-analysis&rft.jtitle=Clinical%20nephrology&rft.au=Zhu,%20Yan&rft.date=2021-06-01&rft.volume=95&rft.issue=6&rft.spage=312&rft.epage=322&rft.pages=312-322&rft.issn=0301-0430&rft_id=info:doi/10.5414/CN110410&rft_dat=%3Cproquest_cross%3E2503669977%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2610519995&rft_id=info:pmid/33749583&rfr_iscdi=true |