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Meta-analysis on the efficacy and safety of immunoadsorption for systemic lupus erythematosus among Chinese population

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Abstract

To systematically evaluate the efficacy and safety of immunoadsorption (IAS) versus non-IAS for systemic lupus erythematosus (SLE) among Chinese population. A meta-analysis was performed by all the literatures germane to estimate the SLE patients treated with IAS and non-IAS from published randomized controlled trials (RCTs) from 1990 to February 2020. Mean differences (MDs), relative ratios (RRs), and 95% confidence intervals (CIs) were calculated, and the meta-analysis was conducted with Stata 12.0 software. A total of 18 RCTs involving 457 patients were included. The results of meta-analysis demonstrated that the IgG, Scr, Bun, ANA, 24-h urine protein, leptin, and TNF-α of IAS combined with a drug therapy group were lower than that of non-IAS, and the levels of C3 and C4 were higher than that of non-IAS after treatment in terms of laboratory parameters. In terms of adverse reactions, the incidence of fever or chills, low blood pressure, or bleeding risk was higher in the treatment group. However, there was no difference in the incidence of puncture point bleeding, thrombocytopenia, mild rash, death due to severe infection, tightness, palpitation, or chest tightness between the two groups. However, most of the adverse effects could be considered as tolerable after timely treatment. Our results indicate that IAS may be superior to non-IAS in treating SLE patients. However, due to the lower quality of included studies, high quality of multicenter, large sample size, randomized, and double-blind controlled trials are needed to validate the results.

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References

  1. Durcan L, O'Dwyer T, Petri M (2019) Management strategies and future directions for systemic lupus erythematosus in adults. Lancet 393:2332–2343

    Article  PubMed  Google Scholar 

  2. Zhang X, Tian Y, Li J, Zhao X (2016) Effect of targeted nursing applied to SLE patients. Exp Ther Med 11:2209–2212

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tektonidou MG, Lewandowski LB, Hu J, Dasgupta A, Ward MM (2017) Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016. Ann Rheum Dis 76:2009–2016

    Article  PubMed  Google Scholar 

  4. Thamer M, Hernán MA, Zhang Y, Cotter D, Petri M (2009) Prednisone, lupus activity, and permanent organ damage. J Rheumatol 36:560–564

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Huang J, Song G, Yin Z, He W, Zhang L, Kong W, Ye Z (2016) Rapid reduction of antibodies and improvement of disease activity by immunoadsorption in Chinese patients with severe systemic lupus erythematosus. Clin Rheumatol 35:2211–2218

    Article  PubMed  Google Scholar 

  6. Stummvoll G (2011) Immunoadsorption (IAS) for systemic lupus erythematosus. Lupus 20:115–119

    Article  CAS  PubMed  Google Scholar 

  7. Kronbichler A, Brezina B, Quintana LF, Jayne DR (2016) Efficacy of plasma exchange and immunoadsorption in systemic lupus erythematosus and antiphospholipid syndrome: a systematic review. Autoimmun Rev 15:38–49

    Article  PubMed  Google Scholar 

  8. YunBo C, Ying W, HaiYan Y, HongMei Y, YanHui J (2011) Clinical evaluation of DNA immunoabsorption for systemic lupus erythematosus. J Harbin Med Univ 45:93–94,98

    Google Scholar 

  9. JinYing H (2016) The clinical efficacy of DNA immunoadsorption treatment for severe systemic lupus erythematosus. Women's Health Res 24:204–205

    Google Scholar 

  10. Ying J (2018) Observation on the effect of DNA immunoadsorption hemoperfusion on lupus nephritis. Chin J Mod Drug Appl 12:20–22

    Google Scholar 

  11. DeYuan L, HuHui H, LiQun Y (1999) Therapeutic and protective effects of extracorporeal immunoadsorption on lupus nephritis. Chin J Nephrol 15:28–31

    Google Scholar 

  12. Qin L, YuXiong Z, Pan T, BiHua L (2013) Analysis of anti-double-strand DNA antibody-positive systemic lupus erythematosus with immunoadsorption therapy. Med J Chin People's Health 25:36–38

    Google Scholar 

  13. Zhen L, YongZhi Z, Jie W, Li S, ShaoMin W, YanJuan Z, YouBo Y (2009) Study of double pulse therapy combined with DNA immune absorb post on lupus nephritis. Mod J Integr Tradit Chin West Med 18:4192–4193

    Google Scholar 

  14. JingSong L, WenLin S, Yan W (2017) Efficacy and safety of DNA immunoadsorption for systemic lupus erythematosus. Chin J Control Endem Dis 32:102–106

    Google Scholar 

  15. JinCheng L, XianHu T (2012) Clinical study of immunoadsorption in the treatment of severe lupus nephritis. Med Inf 25:109

    Google Scholar 

  16. Jie L, Tao W, ChangLiang Z (2018) Effect of Western medicine combined with immunosorbent therapy on systemic lupus erythematosus nephritis and its effect on inflammatory cytokines and immune function. China Med Herald 15:63–66

    Google Scholar 

  17. Feng S, HuiWen Y, YuSheng L, QiuPing Y, XingWen Y, XueFei L, HaiQing Y, Yue Y (2019) Effects of CRRT combined with immunoadsorption on immune function regulation in patients with severe systemic lupus erythematosus. Jiangxi Med J 54:1167–1170

    Google Scholar 

  18. ShenWei W (2016) Clinical analysis of DNA immunoabsorption for systemic lupus erythematosus. Clin J Chin Med 8:124–125

    Google Scholar 

  19. Bing W, Ning Z, Jing M, XiaoLian Z, Bin X (2012) Effects of DNA immunoabsorption therapy on cytokines and clinical efficacy in patients with systemic lupus erythematosus. Chin J Med Guide 14:149–150

    Google Scholar 

  20. Jing X, Shan L, Dong L, XiaoXue Z, XiaoYang Z, DongYi H, ZhanZheng Z (2015) Clinical observation of DNA immunoadsorption for severe systemic lupus erythematosus. J Zhenzhou Univ (Med Sci) 50:98–101

    Google Scholar 

  21. XiaoYan X, Zi'An L, AiCheng Y (2014) Therapeutic effect of immunoadsorption combined with hormone and mycophenolate mofetil on severe lupus nephritis. Guangxi Med J 36:380–381,387

    Google Scholar 

  22. GangLian Y, QinDi C, LiQun M, XingYing Z (2002) The treatment with immunoadsorption for lupus nephritis. J Xi'an Med Univ 23:206–207

    Google Scholar 

  23. ShuZhen Z, GuangZhen L, ShiRong W, DeQian L (2009) Clinical observation of DNA immunoabsorption for lupus nephritis. Chin J Blood Purif 8:541–544

    Google Scholar 

  24. Qing Z, LiMing Z, Yu H, Ling Z, ShuQiang C (2015) Effects of DNA immunoadsorption combined with glucocorticoid and cyclophosphamide on immune function and renal function in elderly patients with systemic lupus erythematosus nephritis. Chin J Gerontol 35:6882–6884

    Google Scholar 

  25. XingHua Z, WeiXiong L, Lu C, BaoZhen Q, DongXia H (2017) Plasma adsorption improves immunity function and prognosis in patients with severe lupus nephritis and renal impairment, a prospective controlled study. Guangdong Med J 38:713–716

    Google Scholar 

  26. Meyersburg D, Schmidt E, Kasperkiewicz M, Zillikens D (2012) Immunoadsorption in dermatology. Ther Apher Dial 16:311–320

    Article  CAS  PubMed  Google Scholar 

  27. Zhang G, Zhang X, Chai Y, Zang S, Shi Y, Wu H (2020) Rapid induction of clinical remission by immunoadsorption for refractory lupus retinopathy complicated with life-threatening neuropsychiatric lupus. Ann Rheum Dis 79:302–304

    Article  PubMed  Google Scholar 

  28. Stummvoll GH, Schmaldienst S, Smolen JS, Derfler K, Biesenbach P (2012) Lupus nephritis: prolonged immunoadsorption (IAS) reduces proteinuria and stabilizes global disease activity. Nephrol Dial Transplant 27:618–626

    Article  CAS  PubMed  Google Scholar 

  29. Aragón CC, Posso-Osorio I, Puerta G et al (2020) Prevalence of anti-DFS70 autoantibodies in a Latin American cohort of patients with systemic lupus erythematosus and without autoimmune diseases. Clin Rheumatol. https://doi.org/10.1007/s10067-020-04990-z

  30. Nguyen G, Delarue F, Burcklé C, Bouzhir L, Giller T, Sraer JD (2002) Pivotal role of the renin/prorenin receptor in angiotensin II production and cellular responses to renin. J Clin Invest 109:1417–1427

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Stummvoll GH, Aringer M, Jansen M, Smolen JS, Derfler K, Graninger WB (2004) Immunoadsorption (IAS) as a rescue therapy in SLE: considerations on safety and efficacy. Wien Klin Wochenschr 116:716–724

    Article  PubMed  Google Scholar 

Download references

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Author notes

  1. Meng Yang and Chifeng Liao contributed equally to this work.

Authors and Affiliations

  1. Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China

    Meng Yang, Qinghuan Zhu, Xiaoying Lin, Binbin Yang, Di Zhao & Danqi Deng

  2. Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, 13 Dancun Road, Nanning, 530031, Guangxi, China

    Meng Yang & Jianmin Li

  3. lnstitute of Dermatology and Department of Dermatology, No.1 Hospital, Anhui Medical University, Hefei, 230032, Anhui, China

    Chifeng Liao

  4. Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110000, Liaoning, China

    Wei Zhang

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  1. Meng Yang
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  2. Chifeng Liao
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  4. Xiaoying Lin
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  9. Wei Zhang
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Correspondence to Danqi Deng or Wei Zhang.

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Yang, M., Liao, C., Zhu, Q. et al. Meta-analysis on the efficacy and safety of immunoadsorption for systemic lupus erythematosus among Chinese population. Clin Rheumatol 39, 3581–3592 (2020). https://doi.org/10.1007/s10067-020-05156-7

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  • DOI: https://doi.org/10.1007/s10067-020-05156-7

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