Drug Therapies for Patients with IgA Nephropathy: A Network Meta-analysis of Randomized Clinical Trials.

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology Pub Date : 2020-01-01 DOI:10.2174/1574884715666191223103914

Kannan Sridharan, Gowri Sivaramakrishnan

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引用次数: 1

Abstract

Background: Several drugs are used for treating IgA nephropathy (IgAN). We carried out a network meta-analysis evaluating these drugs.

Methods: Electronic databases were searched for appropriate randomized clinical trials carried out in patients with IgAN. The primary outcome was proteinuria remission rates and there were several other secondary outcome measures. The risk of bias was assessed. Mixed treatment comparison estimates were modelled from direct and indirect comparison estimates. Grading of the evidence for key comparisons was carried out.

Results: Fifty-seven clinical trials were included in the systematic review and 51 in the metaanalysis. Polyunsaturated fatty acids, corticosteroids/angiotensin receptor blockers (ARB), ARB, angiotensin converting enzyme inhibitors (ACEI), ARB/ACEI, corticosteroids/ACEI and hypolipidemics/ ARB were observed with significantly higher rates of proteinuria remission than the standard of care. Several benefits were observed with other drugs on the secondary outcome measures. A very low grade was observed for the interventions.

Conclusion: We observed a few interventions to perform better in the management of IgAN. The results of this study will aid in further evaluation of such drugs that may assist in saving the resources and time. However, the readers should interpret the findings with great caution as the results might change with the advent of future head-to-head clinical trials.

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IgA肾病患者的药物治疗:随机临床试验的网络荟萃分析

背景:有几种药物用于治疗IgA肾病(IgAN)。我们对这些药物进行了网络荟萃分析。方法:在电子数据库中检索适合IgAN患者的随机临床试验。主要结果是蛋白尿缓解率，还有其他几个次要结果测量。评估偏倚风险。混合处理比较估计值由直接和间接比较估计值建模。对关键比较的证据进行分级。结果:系统评价纳入了57项临床试验，荟萃分析纳入了51项临床试验。多不饱和脂肪酸、皮质类固醇/血管紧张素受体阻滞剂(ARB)、ARB、血管紧张素转换酶抑制剂(ACEI)、ARB/ACEI、皮质类固醇/ACEI和低血脂/ ARB组的蛋白尿缓解率明显高于标准护理组。其他药物在次要结局指标上也有一些益处。观察到干预的评分很低。结论:我们观察到一些干预措施可以更好地治疗IgAN。本研究的结果将有助于进一步评价这类药物，从而有助于节省资源和时间。然而，读者应该非常谨慎地解释这些发现，因为结果可能会随着未来正面临床试验的到来而改变。

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

Current clinical pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

3.60

自引率

0.00%

发文量

期刊介绍： Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.