Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of prednisone combined with cyclophosphamide in the treatment of systemic lupus erythematosus.
METHODS CNKI, Wanfang, VIP, PubMed and Cochrane Library were searched by computer to collect randomized controlled trials of prednisone combined with cyclophospamide in the treatment of systemic lupus erythematosus from inception to September 2019. Literature screening and data extraction were independently conducted by two researchers. The included studies were evaluated according to the risk bias assessment tool in the Cochrane collaborative reviewers' manual, and meta analysis was performed in RevMan 5.3.
RESULTS A total of 7 randomized controlled trials were included, and meta-analysis showed that in the treatment of systemic lupus erythematosus, prednisone combined with cyclophospamide could improve the overall effective rate
RR=1.21, 95%
CI(1.13, 1.30),
P<0.000 01, reduce the level of immunoglobulinIgA:
MD=-0.68, 95%
CI(-0.91, -0.44),
P<0.000 01; IgG:
MD=-2.96, 95%
CI(-3.73, -2.19),
P<0.000 01; IgM:
MD=-0.48, 95%
CI(-0.53, -0.42),
P<0.000 01, improve the level of complementC3:
MD=0.23, 95%
CI(0.17, 0.29),
P<0.000 01; C4:
MD=0.11, 95%
CI(0.06, 0.16),
P<0.00 01, reduce the level of serum inflammatory cytokinesIL-6:
MD=-9.17, 95%
CI(-11.24, -7.10),
P<0.000 01; IL-10:
MD=-16.53, 95%
CI(-17.06, -16.00),
P<0.000 01; INF-α:
MD=-1.98, 95%
CI(-3.90, -0.06),
P=0.04, no significant difference in the incidence of adverse reactions
RR=0.92, 95%
CI(0.55, 1.52),
P=0.73.
CONCLUSION Prednisone combined with cyclophosphamide can improve the overall efficiency and immune function without serious adverse reactions. However, the number and quality of the included studies are not high, which still need to be further verified by high-quality, multi-center randomized controlled trials.
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