Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis

Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational...

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Detalles Bibliográficos
Autor Principal: Ortíz Salas, Paola
Otros Autores: Velez-van-Meerbeke, Alberto
Formato: Trabajo de grado (Bachelor Thesis)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2014
Materias:
Acceso en línea:http://repository.urosario.edu.co/handle/10336/5705
id ir-10336-5705
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects
Enfermedades
1. autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects
Neurología
Enfermedad autoinmune
Inmunología
Inmunoglobulina
spellingShingle autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects
Enfermedades
1. autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects
Neurología
Enfermedad autoinmune
Inmunología
Inmunoglobulina
Ortíz Salas, Paola
Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
description Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational studies of more than 10 cases, were reviewed. Cochrane Neuromuscular Disease Group trials, MEDLINE, EMBASE, HINARI Ovid, the Database of abstracts of reviews of effectiveness and the Economic evaluation Database were searched as data source. Reference lists were examined for further relevant articles. A random-effect model was used to derive a pooled risk ratio. Results: 725 articles were found and 27 met the criteria for a population studied of 4717 cases: 14 articles were about Guillain Barré syndrome, 10 of Myasthenia Gravis, one of Sydenham Chorea, one of Chronic inflammatory demyelinating polyneuropathy, and one of PANDAS. No evidence was found in favor of any of the two treatments as regards effectiveness (OR 0.94, IC 0.63 – 1.41, p= 0.77) or ventilator support time; IGIV had a significant better safety profile than plasmapheresis (OR 0.70, IC 0.51 – 0.96, p= 0.03) and patients needed less time of hospital stay (p=0.03). Conclusions: There is no evidence for superiority in the effectiveness of immunoglobulin or plasmapheresis in the management of autoimmune neurologic diseases. Nevertheless, patients treated with immunoglobulin have statistically significant less adverse effects, a shorter hospital stay and a tendency of less ventilator support time. These premises could lead to fewer costs for health services but an economic study should be done.
author2 Velez-van-Meerbeke, Alberto
author_facet Velez-van-Meerbeke, Alberto
Ortíz Salas, Paola
format Trabajo de grado (Bachelor Thesis)
author Ortíz Salas, Paola
author_sort Ortíz Salas, Paola
title Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
title_short Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
title_full Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
title_fullStr Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
title_full_unstemmed Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
title_sort plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis
publisher Universidad del Rosario
publishDate 2014
url http://repository.urosario.edu.co/handle/10336/5705
_version_ 1645142085083332608
spelling ir-10336-57052019-09-19T12:37:54Z Plasmapheresis vs. immunoglobulin in autoimmune neurologic diseases: a meta-analysis Ortíz Salas, Paola Velez-van-Meerbeke, Alberto autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects Enfermedades 1. autoimmune neurologic diseases; 2. Plasma Exchange; 3. Immunoglobulin; 4. Effectiveness; 5. Adverse Effects Neurología Enfermedad autoinmune Inmunología Inmunoglobulina Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational studies of more than 10 cases, were reviewed. Cochrane Neuromuscular Disease Group trials, MEDLINE, EMBASE, HINARI Ovid, the Database of abstracts of reviews of effectiveness and the Economic evaluation Database were searched as data source. Reference lists were examined for further relevant articles. A random-effect model was used to derive a pooled risk ratio. Results: 725 articles were found and 27 met the criteria for a population studied of 4717 cases: 14 articles were about Guillain Barré syndrome, 10 of Myasthenia Gravis, one of Sydenham Chorea, one of Chronic inflammatory demyelinating polyneuropathy, and one of PANDAS. No evidence was found in favor of any of the two treatments as regards effectiveness (OR 0.94, IC 0.63 – 1.41, p= 0.77) or ventilator support time; IGIV had a significant better safety profile than plasmapheresis (OR 0.70, IC 0.51 – 0.96, p= 0.03) and patients needed less time of hospital stay (p=0.03). Conclusions: There is no evidence for superiority in the effectiveness of immunoglobulin or plasmapheresis in the management of autoimmune neurologic diseases. Nevertheless, patients treated with immunoglobulin have statistically significant less adverse effects, a shorter hospital stay and a tendency of less ventilator support time. These premises could lead to fewer costs for health services but an economic study should be done. Objectives: to evaluate the efficacy and safety of human immunoglobulin versus plasmapheresis in the management of autoimmune neurologic diseases. Likewise, length of hospital stay and duration of ventilator support were compared. Methods: Randomized controlled trials and analytical observational studies of more than 10 cases, were reviewed. Cochrane Neuromuscular Disease Group trials, MEDLINE, EMBASE, HINARI Ovid, the Database of abstracts of reviews of effectiveness and the Economic evaluation Database were searched as data source. Reference lists were examined for further relevant articles. A random-effect model was used to derive a pooled risk ratio. Results: 725 articles were found and 27 met the criteria for a population studied of 4717 cases: 14 articles were about Guillain Barré syndrome, 10 of Myasthenia Gravis, one of Sydenham Chorea, one of Chronic inflammatory demyelinating polyneuropathy, and one of PANDAS. No evidence was found in favor of any of the two treatments as regards effectiveness (OR 0.94, IC 0.63 – 1.41, p= 0.77) or ventilator support time; IGIV had a significant better safety profile than plasmapheresis (OR 0.70, IC 0.51 – 0.96, p= 0.03) and patients needed less time of hospital stay (p=0.03). Conclusions: There is no evidence for superiority in the effectiveness of immunoglobulin or plasmapheresis in the management of autoimmune neurologic diseases. Nevertheless, patients treated with immunoglobulin have statistically significant less adverse effects, a shorter hospital stay and a tendency of less ventilator support time. These premises could lead to fewer costs for health services but an economic study should be done. 2014-06-05 2014-06-24T14:17:35Z info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion http://repository.urosario.edu.co/handle/10336/5705 spa http://creativecommons.org/publicdomain/zero/1.0/ info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Especialización en Neurología Facultad de Medicina instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Anaya J. Common mechanisms of autoimmune diseases (the autoimmune tautology). Autoimmun Rev. 2012;11:781–784.
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