Potential therapeutics for antiphospholipid antibody associated thrombocytopenia: A systematic review and meta-analysis.

Abstract:

:Objectives: Thrombocytopenia is frequently observed in antiphospholipid antibody (aPL) carriers. Due to the paradoxical risks of thrombosis and hemorrhage, the management of aPL-associated thrombocytopenia (APAT) is often deductive. We aimed to investigate the efficacy and safety of therapeutic approaches for APAT through a systematic review.Methods: Four therapeutic approaches for APAT, including antiplatelet agents, glucocorticoids, splenectomy and thrombopoietin receptor agonists, were selected. Clinical trials evaluating therapeutic outcomes including the remission, complications, mortality and relapse, were searched in MEDLINE, EMBASE and CENTRAL from the inception dates to 28 November 2016. A meta-analysis was performed to calculate risk ratios (RRs) and 95% confidence intervals (CIs) using random-effects models.Results: Out of 1407 papers, eight controlled clinical trials were included. In patients with APAT, the remission rates were higher in patients on glucocorticoids (RR 8.33 [95% CI 3.07-22.6]) or splenectomy (RR 8.37 [95% CI 1.61-43.7]) than in patients without those treatments. There was no significant association between glucocorticoids and thrombosis (RR 1.57 [95% CI, 0.17-14.9]) or between splenectomy and hemorrhage (RR 0.17 [95% CI 0.02-1.28]). The extracted data of mortality and relapse rate were not available for synthesis.Conclusion: Glucocorticoids or splenectomy seemed suitable therapeutic approaches for APAT.

journal_name

Mod Rheumatol

journal_title

Modern rheumatology

authors

Abe N,Oku K,Amengual O,Fujieda Y,Kato M,Bohgaki T,Yasuda S,Mori R,Morishita E,Suzuki-Inoue K,Atsumi T

doi

10.1080/14397595.2018.1558934

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

116-124

issue

1

eissn

1439-7595

issn

1439-7609

journal_volume

30

pub_type

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