Open AccessEffectiveness of granulocyte colony-stimulating factor for patients with acute-on-chronic liver failure: a meta-analysis
Author(s) -
Wei Huang,
Yuanji Ma,
Lingyao Du,
Shengwei Kang,
Changhai Liu,
Lan Bai,
Lei Xin,
Hong Tang
Publication year - 2021
Publication title -
annals of saudi medicine/annals of saudi medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.373
H-Index - 44
eISSN - 0975-4466
pISSN - 0256-4947
DOI - 10.5144/0256-4947.2021.383
Subject(s) - medicine , meta analysis , granulocyte colony stimulating factor , cochrane library , confidence interval , gastroenterology , relative risk , liver failure , chemotherapy
BACKGROUND: The safety and efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute-on-chronic liver failure (ACLF) remain uncertain. Therefore, we conducted a meta-analysis to draw a firmer conclusion. METHODS: We searched the Cochrane library, PubMed, Embase, and China Biology Medicine disc to identify relevant RCTs performed before January 2020. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were calculated using a random effects model. MAIN OUTCOME MEASURES: RRs (95% CI) for 1-, 2-, and 3-month survival rates. SAMPLE SIZE: Six RCTs, including three open-label studies. RESULTS: The six studies included 246 subjects (121 in a G-CSF group and 125 in a control group). G-CSF administration significantly improved the 1-, 2-, and 3-month survival rates in patients with ACLF. The pooled RRs (95% CI, P) were 0.43 (0.27–0.69,P =.0004), 0.44 (0.32–0.62,P <.00001), and 0.39 (0.22–0.68,P =.0009), respectively.CONCLUSION: G-CSF may be beneficial and effective in the treatment of ACLF, but further studies are needed to verify this conclusion. LIMITATIONS: The sample size was small, and studies were restricted to countries in Asia. PROSPERO REGISTRATION NUMBER: CRD42021225681 CONFLICT OF INTEREST: None.