Adverse effects of intravenous LNP-mediated mRNA therapy in clinical trials: a systematic review and meta-analysis.

Wenhan Wu, Ziwei Wang
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Abstract

Introduction: Intravenous LNP-mediated mRNA therapy holds promise for treating various diseases, yet its safety, particularly regarding adverse events, remains a critical concern. This review systematically evaluates the adverse effects associated with this therapeutic approach.

Methods: A comprehensive search of PubMed was conducted for clinical trials on intravenous LNP-mediated mRNA therapies. Data extraction focused on study design, participant demographics, and adverse events. Meta-analysis was performed to assess the incidence of treatment-emergent adverse events (TEAEs) and common manifestations. The risk of bias was assessed using the ROBINS-I tool.

Results: A total of six phase 1/2 clinical trials on intravenous LNP-mediated mRNA therapies were included, with sample sizes ranging from 6 to 38 participants. The pooled incidence of TEAEs was 92.2% (95% CI: 77.7%-99.4%). Sensitivity analysis indicated that excluding one study with a single smaller dose reduced heterogeneity to 6.8%. The incidence of severe TEAEs was 9.2% (95% CI: 0%-38.1%) and showed substantial heterogeneity (I2 = 89.87%), which was likely influenced by factors such as higher doses, multiple administrations, and patient-specific conditions like comorbidities.

Conclusion: While low-dose, single-dose intravenous LNP-mediated mRNA therapies generally have a manageable safety profile, higher doses or repeated administrations may increase the risk of severe adverse events.

Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42025643741.

临床试验中静脉lnp介导的mRNA治疗的不良反应:系统回顾和荟萃分析。
静脉lnp介导的mRNA治疗有望治疗多种疾病,但其安全性,特别是不良事件,仍然是一个关键问题。这篇综述系统地评估了与这种治疗方法相关的不良反应。方法:综合PubMed检索静脉lnp介导mRNA治疗的临床试验。数据提取侧重于研究设计、参与者人口统计和不良事件。进行荟萃分析以评估治疗后出现的不良事件(teae)和常见表现的发生率。使用ROBINS-I工具评估偏倚风险。结果:共纳入6项静脉lnp介导的mRNA治疗的1/2期临床试验,样本量从6到38名参与者不等。teae的总发生率为92.2% (95% CI: 77.7%-99.4%)。敏感性分析表明,排除一个较小剂量的研究将异质性降低到6.8%。严重teae的发生率为9.2% (95% CI: 0%-38.1%),并显示出很大的异质性(I2 = 89.87%),这可能受到较高剂量、多次给药以及合并症等患者特异性条件等因素的影响。结论:虽然低剂量、单剂量静脉lnp介导的mRNA治疗通常具有可控的安全性,但高剂量或重复给药可能会增加严重不良事件的风险。协议注册:www.crd.york.ac.uk/prospero标识为CRD42025643741。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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