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干扰素相关内分泌不良事件的系统评价和荟萃分析。

A systematic review and meta-analysis of endocrine-related adverse events associated with interferon.

机构信息

Medicine School of Nankai University, Tianjin, China.

Department of Endocrinology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Aug 5;13:949003. doi: 10.3389/fendo.2022.949003. eCollection 2022.

Abstract

OBJECTIVES

To perform a systematic review and meta-analysis of interferon and endocrine side effects, including their incidence, evaluation, and management.

METHODS

PubMed was searched through March 7th, 2021, by 2 authors independently (LH Wang and H Zhao). Early phase I/II, phase III experimental trials, prospective and retrospective observational studies were included. Stata 16.0 (StataCorp LLC, 16.0) was the main statistical software for meta-analysis. The weighted incidence and risk ratio were estimated for primary thyroid disease and diabetes mellitus.

RESULTS

A total of 108 studies involving 46265 patients were included. Hypothyroidism was the most common thyroid disorder, followed by hyperthyroidism. IFN α+RBV treated patients experienced hypothyroidism in 7.8% (95%CI, 5.9-9.9), which was higher than IFN α (5.2%; 95%CI, 3.7-6.8) and IFN β (7.0%; 95%CI, 0.06-23.92). IFN α+RBV treated patients experienced hyperthyroidism in 5.0% (95%CI, 3.6-6.5), which was higher than IFN α (3.5%; 95%CI, 2.5-4.8) and IFN β (3.4%; 95%CI, 0.9-7.5). The summary estimated incidence of painless thyroiditis was 5.8% (95%CI, 2.8-9.8) for IFN α, and 3.5% (95%CI,1.9-5.5) for IFN α+RBV. The summary estimated incidence of diabetes was 1.4% (95%CI, 0.3-3.1) for IFN, 0.55% (95%CI, 0.05-1.57) for IFN α, 3.3% (95%CI,1.1-6.6) for IFN α+RBV.

CONCLUSIONS

Our meta-analysis shows a high incidence of endocrine adverse events provoked by IFN, further reinforced by combined RBV treatment.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42022334131.

摘要

目的

对干扰素和内分泌副作用进行系统回顾和荟萃分析,包括其发生率、评估和管理。

方法

由 2 位作者(LH 王和 H 赵)于 2021 年 3 月 7 日之前独立检索 PubMed。纳入早期 I/II 期、III 期实验性试验、前瞻性和回顾性观察性研究。Stata 16.0(StataCorp LLC,16.0)是主要的荟萃分析统计软件。对原发性甲状腺疾病和糖尿病的发生率和风险比进行了加权估计。

结果

共纳入 108 项研究,涉及 46265 例患者。甲状腺功能减退症是最常见的甲状腺疾病,其次是甲状腺功能亢进症。IFN α+RBV 治疗患者的甲状腺功能减退症发生率为 7.8%(95%CI,5.9-9.9),高于 IFN α(5.2%;95%CI,3.7-6.8)和 IFN β(7.0%;95%CI,0.06-23.92)。IFN α+RBV 治疗患者的甲状腺功能亢进症发生率为 5.0%(95%CI,3.6-6.5),高于 IFN α(3.5%;95%CI,2.5-4.8)和 IFN β(3.4%;95%CI,0.9-7.5)。IFN α 汇总估计的无痛性甲状腺炎发生率为 5.8%(95%CI,2.8-9.8),IFN α+RBV 为 3.5%(95%CI,1.9-5.5)。IFN 汇总估计的糖尿病发生率为 1.4%(95%CI,0.3-3.1),IFN α 为 0.55%(95%CI,0.05-1.57),IFN α+RBV 为 3.3%(95%CI,1.1-6.6)。

结论

我们的荟萃分析表明,干扰素引起的内分泌不良事件发生率较高,联合 RBV 治疗进一步加强了这一结果。

系统评价注册

https://www.crd.york.ac.uk/prospero/,标识符 CRD42022334131。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ee/9388759/18326e651a17/fendo-13-949003-g001.jpg

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