Cochrane · systematic review · CD008333
Anti‐cytokine targeted therapies for ANCA‐associated vasculitis
Bala, MM, Malecka-Massalska, TJ, Koperny, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
MusculoskeletalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
23
current version
GRADE rated
20
No studies
3
Included studies
NR
No studies 3 · 13%Ungraded 0 · 0%Very low 5 · 21.7%Low 13 · 56.5%Moderate 2 · 8.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Mepolizumab compared to placebo for adults with EGPA ANCA‐associated vasculitis
Population: adults (age 18 years and older) with EGPA ANCA‐associated vasculitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Mepolizumab vs placebo | Peto OR 7.39 [0.15, 372.38] | NR | Low Downgraded: imprecision |
Remission for at least 24 weeks Mepolizumab vs placebo | RR 9.5 [2.3, 39.21] | NR | Low Downgraded: imprecision |
Durable remission within the first 24 weeks sustained until week 52 Mepolizumab vs placebo | RR 13 [1.75, 96.33] | NR | Low Downgraded: imprecision |
Disease relapse Mepolizumab vs placebo | RR 0.68 [0.53, 0.86] | NR | Moderate Downgraded: imprecision |
Disease flares Mepolizumab vs placebo | no estimate extracted | NR | No studies |
Any adverse event Mepolizumab vs placebo | RR 1.03 [0.96, 1.11] | NR | Low Downgraded: imprecision |
Any serious adverse event Mepolizumab vs placebo | RR 0.67 [0.35, 1.28] | NR | Low Downgraded: imprecision |
Any withdrawals due to AEs Mepolizumab vs placebo | RR 2 [0.19, 21.54] | NR | Low Downgraded: imprecision |
Active drug (etanercept or belimumab) with standard therapy compared to standard therapy with placebo for adults with GPA ANCA‐associated vasculitis
Population: adults (age 18 years and older) with GPA ANCA‐associated vasculitis or microscopic polyangiitis (only a subset of patients in one study, i.e. 7.7% of total population and not analysed separately)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
MortalityNumber of participants: 285(2 RCTs) WGET 2005 Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | Peto OR 2.45 [0.55, 10.97] | NR | Low Downgraded: imprecision |
Remission (number of patients with remission) Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 0.97 [0.89, 1.07] | NR | Low Downgraded: risk of bias, imprecision |
Durable remission Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 0.93 [0.77, 1.11] | NR | Low Downgraded: imprecision |
Major relapse Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 2.94 [0.12, 70.67] | NR | Low Downgraded: imprecision |
Disease flare Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 0.98 [0.76, 1.27] | NR | Moderate Downgraded: risk of bias, imprecision |
Any adverse event Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 1.12 [0.97, 1.29] | NR | Low Downgraded: imprecision |
Any severe or serious AE (grade 3, 4 or 5) Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 1 [0.8, 1.27] | NR | Low Downgraded: risk of bias, imprecision |
Any withdrawals due to AE Active drug (etanercept or belimumab) with standard therapy vs standard therapy with placebo | RR 2.66 [1.07, 6.59] | NR | Low Downgraded: risk of bias, imprecision |
Infliximab compared to rituximab for adults with refractory GPA ANCA‐associated vasculitis
Population: adults (age 18 years and older) with refractory GPA ANCA‐associated vasculitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Infliximab vs rituximab | Peto OR 0.88 [0.05, 15.51] | NR | Very low Downgraded: risk of bias |
Remission Infliximab vs rituximab | RR 0.44 [0.11, 1.81] | NR | Very low Downgraded: risk of bias |
Durable remission during additional Infliximab vs rituximab | RR 0.22 [0.03, 1.6] | NR | Very low Downgraded: risk of bias |
Disease flare/relapse Infliximab vs rituximab | no estimate extracted | NR | No studies |
Any adverse event Infliximab vs rituximab | no estimate extracted | NR | No studies |
Any severe AEs Infliximab vs rituximab | RR 1.78 [0.2, 16.1] | NR | Very low Downgraded: risk of bias |
Any withdrawals due to AEs Infliximab vs rituximab | RR 2.7 [0.13, 58.24] | NR | Very low Downgraded: risk of bias |