Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Translational Medicine Research Center, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Eur J Clin Pharmacol. 2023 Oct;79(10):1303-1314. doi: 10.1007/s00228-023-03542-z. Epub 2023 Aug 14.
The incidence of linezolid-induced thrombocytopenia (LIT) has been reported to vary widely across studies. We performed a meta-analysis to identify the risk factors for thrombocytopenia among patients who received linezolid treatment.
The PubMed, Embase and Cochrane Library databases were searched from inception to November 2022 to identify eligible studies. Data on the potential predictors of incidence in LIT were pooled using a random effects model. Sensitivity analyses were performed to determine the robustness of the results when significant heterogeneity was observed.
Forty observational studies involving 6454 patients treated with linezolid were included in the analysis. LIT was estimated to occur in 37% of patients. The following important factors were associated with the incidence of LIT: advanced age, body mass index, concurrent renal impairment or liver disease, abnormal laboratory parameters (including white blood cell count, serum creatinine, baseline platelet count, albumin, creatinine clearance rate, and estimated glomerular filtration rate), treatment duration and renal replacement therapy.
A variety of risk factors related to the occurrence of LIT were revealed in our analysis. Early identification of these factors could help patients improve clinical outcomes.
已有研究报道利奈唑胺诱导的血小板减少症（LIT）的发生率差异很大。我们进行了一项荟萃分析，以确定接受利奈唑胺治疗的患者发生血小板减少症的危险因素。
从建库到 2022 年 11 月，我们检索了 PubMed、Embase 和 Cochrane Library 数据库，以确定符合条件的研究。使用随机效应模型汇总与 LIT 发生率相关的潜在预测因素的数据。当观察到显著异质性时，进行敏感性分析以确定结果的稳健性。
分析纳入了 40 项涉及 6454 例接受利奈唑胺治疗的患者的观察性研究。估计有 37%的患者发生了 LIT。以下重要因素与 LIT 的发生有关：年龄较大、体重指数、同时存在肾功能损害或肝脏疾病、实验室参数异常（包括白细胞计数、血清肌酐、血小板计数、白蛋白、肌酐清除率和估计肾小球滤过率）、治疗持续时间和肾脏替代治疗。
我们的分析揭示了与 LIT 发生相关的多种危险因素。早期识别这些因素可能有助于改善患者的临床结局。
