Comparative efficacy and safety of antibody induction therapy for the treatment of kidney: a network meta-analysis.
Shao M, Tian T, et al.Oncotarget 2017; 8(39): 66426-66437.
Aims
To conduct a systematic review and meta-analysis to evaluate the efficacy and safety of antibody induction therapies in kidney transplantation.
Interventions
The databases Pubmed, Embase and Cochrane library were searched up until August 2016, and the websites of Current Controlled Trials, ClinicalTrials.gov and The World Health Organization International Clinical Trials Registry were manually searched. English randomized controlled studies which included kidney transplant recipients with at least two of the eligible inductions of alemtuzumab, interleukin-2 receptor antibodies & antibody antithymocyte globulin, and containing the main or adverse outcomes were independently screened for inclusion by two researchers.
Participants
23 studies were included in the systemetic review and 18 were included in the meta-analysis.
Outcomes
Measured outcomes included biopsy-proven acute rejection, patient death, renal function, delayed graft function, cytomegalovirus infection, new-onset diabetes mellitus after transplantation, malignancy and graft loss.
Follow-up
1 year
CET Conclusions
This systematic review has included 18 studies in a network meta-analysis of antibody induction therapy in renal transplantation. All studies had at least 12 months follow up. Heterogeneity in statistical testing, publication bias-testing results were all low. Multiple sources were searched and duplicate assessment of papers was undertaken. The authors present the results of numerous traditional and network meta-analysis comparing the different antibodies and for different outcomes, without presenting any p-values for these analyses. Whilst the reader can see which Confidence Intervals do not cross the line of equality, it is usual to present the associated p-values alongside these results. Alemtuzumab showed reduced 1-year acute rejection and a significantly lower risk of cytomegalovirus infection when compared with interleukin-2 receptor antibodies and anti-thymocyte globulin.
Quality notes
Quality assessment not appropriate
Trial registration
None