tetano
Editor, Senior Moderator
J Infect Dis. 2014 Jul 16. pii: jiu396. [Epub ahead of print]
The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral aetiology: a systematic review and exploratory meta-analysis.
Mair-Jenkins J1, Saavedra-Campos M2, Baillie K3, Cleary P4, Khaw FM1, Lim WS5, Makki S1, Rooney KD6; Convalescent Plasma Study Group, Nguyen-Van-Tam JS7, Beck CR7.
Collaborators (12)
Author information
Abstract
BACKGROUND:
Administration of convalescent plasma, serum or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARI) of viral aetiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence.
METHODS:
Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria using a three stage process. Data extraction and risk of bias assessments were undertaken.
RESULTS:
We identified 32 studies of SARS-CoV and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment compared to placebo or no therapy (odds ratio 0∙25; 95% confidence interval 0∙14 to 0∙45; I2=0%). Studies were commonly of low or very low quality, lacked control groups and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified.
CONCLUSIONS:
Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of MERS-CoV.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.
PMID:
25030060
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25030060
The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral aetiology: a systematic review and exploratory meta-analysis.
Mair-Jenkins J1, Saavedra-Campos M2, Baillie K3, Cleary P4, Khaw FM1, Lim WS5, Makki S1, Rooney KD6; Convalescent Plasma Study Group, Nguyen-Van-Tam JS7, Beck CR7.
Collaborators (12)
Author information
Abstract
BACKGROUND:
Administration of convalescent plasma, serum or hyperimmune immunoglobulin may be of clinical benefit for treatment of severe acute respiratory infections (SARI) of viral aetiology. We conducted a systematic review and exploratory meta-analysis to assess the overall evidence.
METHODS:
Healthcare databases and sources of grey literature were searched in July 2013. All records were screened against the protocol eligibility criteria using a three stage process. Data extraction and risk of bias assessments were undertaken.
RESULTS:
We identified 32 studies of SARS-CoV and severe influenza. Narrative analyses revealed consistent evidence for a reduction in mortality, especially when convalescent plasma is administered early after symptom onset. Exploratory post hoc meta-analysis showed a statistically significant reduction in the pooled odds of mortality following treatment compared to placebo or no therapy (odds ratio 0∙25; 95% confidence interval 0∙14 to 0∙45; I2=0%). Studies were commonly of low or very low quality, lacked control groups and at moderate or high risk of bias. Sources of clinical and methodological heterogeneity were identified.
CONCLUSIONS:
Convalescent plasma may reduce mortality and appears safe. This therapy should be studied within the context of a well-designed clinical trial or other formal evaluation, including for treatment of MERS-CoV.
? The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.
PMID:
25030060
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25030060