Efficacy and safety of immunosuppressive therapy in connective tissue disease-related immune thrombocytopenia: a systematic review and meta-analysis.

IF 3.1 3区医学 Q2 HEMATOLOGY

Therapeutic Advances in Hematology Pub Date : 2026-02-28 eCollection Date: 2026-01-01 DOI:10.1177/20406207261422963

Yupei Zhang, Xiaxiao Yan, Alyssa A Grimshaw, Yanhong Wang, Mengtao Li, Xiaofeng Zeng, Evelyn Hsieh, Nan Jiang

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引用次数: 0

Abstract

Background: Connective tissue diseases (CTDs) are a group of autoimmune disorders in which immune thrombocytopenia (ITP) represents a common and important manifestation. Current CTD-ITP management mainly relies on glucocorticoids and immunosuppressive agents.

Objectives: This systematic review and meta-analysis aims to evaluate the efficacy and safety of immunosuppressive agents in patients with CTD-ITP.

Design: Systematic review and meta-analysis.

Methods: This study was conducted using eight databases up to July 22, 2024. Observational studies and experimental trials with relevant efficacy and safety data were included. Methodological quality were evaluated using the Newcastle-Ottawa Scale and the ROBINS-I tool. The Mantel-Haenszel formula with a random effect model was employed to estimate the overall effect size. Subgroup analyses were performed based on the study characteristics, clinical features, and treatment regimen.

Results: Through integrating 24 studies (1 single-arm clinical trial, 1 case-control, and 22 cohort studies) involving 775 CTD-ITP patients, the pooled estimates of the optimal overall and complete response rate for immunosuppressive therapy were 82% (95% CI: 75-88) and 64% (95% CI: 56-72), with stable results after sensitivity analysis. The combined side-effect incidence was 31% (95% CI: 24-39). The pooled relapse rate was 30% (95% CI: 18-43) among 403 immunosuppressive therapy responders.

Conclusion: Immunosuppressive treatments exhibited favorable efficacy and safety in CTD-ITP patients. Future larger-scale multicenter studies are needed.

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免疫抑制治疗结缔组织病相关免疫性血小板减少症的疗效和安全性：系统回顾和荟萃分析

背景：结缔组织疾病（CTDs）是一组自身免疫性疾病，其中免疫性血小板减少症（ITP）是一种常见且重要的表现。目前CTD-ITP的治疗主要依靠糖皮质激素和免疫抑制剂。目的：本系统综述和荟萃分析旨在评估免疫抑制剂在CTD-ITP患者中的有效性和安全性。设计：系统回顾和荟萃分析。方法：本研究使用8个数据库，截止到2024年7月22日。纳入了具有相关疗效和安全性数据的观察性研究和实验试验。采用纽卡斯尔-渥太华量表和ROBINS-I工具评估方法学质量。采用随机效应模型的Mantel-Haenszel公式估计总体效应大小。根据研究特点、临床特征和治疗方案进行亚组分析。结果：通过整合24项研究（1项单组临床试验，1项病例对照，22项队列研究），共纳入775例CTD-ITP患者，免疫抑制治疗的最佳总体缓解率和完全缓解率汇总估计为82% （95% CI: 75-88）和64% (95% CI: 56-72)，经敏感性分析结果稳定。联合副作用发生率为31% （95% CI: 24-39）。403例免疫抑制治疗应答者的总复发率为30% （95% CI: 18-43）。结论：免疫抑制治疗对CTD-ITP患者具有良好的疗效和安全性。未来需要更大规模的多中心研究。

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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来源期刊

Therapeutic Advances in Hematology HEMATOLOGY-

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.