1.
Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials
Bohlius J, Schmidlin K, Brillant C, Schwarzer G, Trelle S, Seidenfeld J, Zwahlen M, Clarke M, Weingart O, Kluge S, et al
Lancet. 2009;373((9674):):1532-42.
2.
Erythropoietin or darbepoetin for patients with cancer - meta-analysis based on individual patient data
Bohlius J, Schmidlin K, Brillant C, Schwarzer G, Trelle S, Seidenfeld J, Zwahlen M, Clarke MJ, Weingart O, Kluge S, et al
Cochrane Database of Systematic Reviews. 2009;((3):):CD007303.
3.
Recombinant human erythropoiesis stimulating agents in cancer patients: individual patient data meta-analysis on behalf of the EPO IPD Meta-Analysis Collaborative Group
Bohlius J, Brillant C, Clarke M, Kluge S, Napoli M, Piper M, Rades Dirk, Ray-Coquard I, Schmidlin K, Schumacher M, et al
Blood. 2008;112((11):): Abstract No. 6 & Abstract No. 4675
4.
Use of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock
Kreymann KG, De Heer G, Nierhaus A, Kluge S
Critical Care Medicine. 2007;35((12):):2677-2685.
Abstract
OBJECTIVE There is ongoing debate about the efficacy of polyvalent immunoglobulins as adjunctive therapy for sepsis or septic shock. Two meta-analyses by the Cochrane collaboration calculated a significant reduction in mortality. However, data of the largest study were missing in one, and a subset of four high-quality studies failed to show an effect in the other. To broaden the database, we performed a meta-analysis of all randomized controlled studies published so far. DATA SOURCE MEDLINE, EMBASE, Cochrane Library of randomized trials, and personal files. STUDY SELECTION Meta-analysis of all published randomized controlled studies published on polyvalent immunoglobulins (Ig) for treatment of sepsis or septic shock in adults, children, or neonates. DATA EXTRACTION Twenty-seven trials with a total of 2,202 patients fulfilled the inclusion criteria. DATA SYNTHESIS As the immunologic state of neonates is different than that of adults or older children, data were evaluated separately for each group. Fifteen trials on 1,492 adults could be included. The pooled effect on mortality was a relative risk of death (RR) of 0.79 (95% confidence interval (CI) 0.69-0.90, p (less-than or equal to) .0003). There was a strong trend in favor of an immunoglobulin preparation enriched with IgA and IgM (IgGAM) (RR = 0.66, 95% CI 0.51-0.84, p (less-than or equal to) .0009) compared with preparations containing only IgG (RR = 0.85, 95% CI 0.73-0.99, p (less-than or equal to) .04). In 12 trials on 710 neonates, the pooled effect on mortality was 0.56 (95% CI 0.42-0.74, p (less-than or equal to) .0001). There was also a positive although less pronounced trend favoring the effect of IgGAM (RR = 0.50, 95% CI 0.34-0.73, p (less-than or equal to) .0003) compared with IgG (RR = 0.63, 95% CI 0.42-0.96, p (less-than or equal to) .03). A sensitivity analysis selecting eight trials in adults and ten in neonates of highest methodological quality confirmed these results. CONCLUSIONS Polyvalent immunoglobulins exert a significant effect on mortality in sepsis and septic shock, with a trend in favor of IgGAM. 2007 Lippincott Williams & Wilkins, Inc.
