Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background and Aims: Granulocyte colony-stimulating factor (G-CSF) has been proposed as a therapeutic option for patients with acute-on-chronic liver failure (ACLF). However, its clinical efficacy remains debatable. This study aimed to synthesize available evidence on the efficacy of G-CSF in ALCF.M...

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Autores principales:	Xiaoxue Hou, Yuwen Li, Hui Yuan, Jinyuan Cai, Rui Liu, Jun Li, Chuanlong Zhu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	granulocyte colony-stimulating factor acute-on-chronic liver failure end stage liver disease hepatic insufficiency randomized controlled trial Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/468fc793a97f4dd1a9f42e1f0205d313
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spelling	oai:doaj.org-article:468fc793a97f4dd1a9f42e1f0205d3132021-11-16T06:17:14ZTherapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials2296-858X10.3389/fmed.2021.784240https://doaj.org/article/468fc793a97f4dd1a9f42e1f0205d3132021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.784240/fullhttps://doaj.org/toc/2296-858XBackground and Aims: Granulocyte colony-stimulating factor (G-CSF) has been proposed as a therapeutic option for patients with acute-on-chronic liver failure (ACLF). However, its clinical efficacy remains debatable. This study aimed to synthesize available evidence on the efficacy of G-CSF in ALCF.Methods: The Cochrane Library, CNKI, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched from inception until September 2021. After qualitative evaluation of the included literature, the included studies were analyzed.Results: Seven studies were included in this meta-analysis. Overall, G-CSF therapy was not associated with a reduced risk of death (30-day survival, OR = 1.55, 95% CI: 1.00, 2.38, P = 0.05; 60-day survival, OR = 1.50, 95% CI: 0.95, 2.36, P = 0.08; 90-day survival, OR = 1.61, 95% CI: 0.99, 2.62, P = 0.05) or complication including occurrence of infections infection (OR = 0.66, 95% CI: 0.41, 1.05, P = 0.08), bleeding (OR = 1.50, 95% CI: 0.58, 3.89, P = 0.41), and hepatorenal syndrome (OR = 0.56, 95% CI: 0.25, 1.24, P = 0.15). Moreover, it had no obvious beneficial effects on the model of end-stage liver disease score (30-day SMD = −3.31, 95%CI: −7.42, 0.81, P = 0.12; 60-day SMD = −1.23, 95% CI: −5.21, 2.75, P = 0.54; 90-day SMD = −2.29, 95%CI: −4.94, 0.37, P = 0.09). Sensitivity analyses showed that patients in Asia had improved survival (30-day OR = 2.76, 95%CI: 1.43, 5.35, P = 0.003; 60-day OR = 2.83, 95% CI: 1.39, 5.73, P = 0.004; 90-day OR = 2.92, 95% CI: 1.34, 6.36, P = 0.007).Conclusions: Our findings suggest that, currently, G-CSF cannot be recommended for the treatment of ACLF.Xiaoxue HouYuwen LiHui YuanJinyuan CaiRui LiuJun LiChuanlong ZhuChuanlong ZhuFrontiers Media S.A.articlegranulocyte colony-stimulating factoracute-on-chronic liver failureend stage liver diseasehepatic insufficiencyrandomized controlled trialMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	granulocyte colony-stimulating factor acute-on-chronic liver failure end stage liver disease hepatic insufficiency randomized controlled trial Medicine (General) R5-920
spellingShingle	granulocyte colony-stimulating factor acute-on-chronic liver failure end stage liver disease hepatic insufficiency randomized controlled trial Medicine (General) R5-920 Xiaoxue Hou Yuwen Li Hui Yuan Jinyuan Cai Rui Liu Jun Li Chuanlong Zhu Chuanlong Zhu Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
description	Background and Aims: Granulocyte colony-stimulating factor (G-CSF) has been proposed as a therapeutic option for patients with acute-on-chronic liver failure (ACLF). However, its clinical efficacy remains debatable. This study aimed to synthesize available evidence on the efficacy of G-CSF in ALCF.Methods: The Cochrane Library, CNKI, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched from inception until September 2021. After qualitative evaluation of the included literature, the included studies were analyzed.Results: Seven studies were included in this meta-analysis. Overall, G-CSF therapy was not associated with a reduced risk of death (30-day survival, OR = 1.55, 95% CI: 1.00, 2.38, P = 0.05; 60-day survival, OR = 1.50, 95% CI: 0.95, 2.36, P = 0.08; 90-day survival, OR = 1.61, 95% CI: 0.99, 2.62, P = 0.05) or complication including occurrence of infections infection (OR = 0.66, 95% CI: 0.41, 1.05, P = 0.08), bleeding (OR = 1.50, 95% CI: 0.58, 3.89, P = 0.41), and hepatorenal syndrome (OR = 0.56, 95% CI: 0.25, 1.24, P = 0.15). Moreover, it had no obvious beneficial effects on the model of end-stage liver disease score (30-day SMD = −3.31, 95%CI: −7.42, 0.81, P = 0.12; 60-day SMD = −1.23, 95% CI: −5.21, 2.75, P = 0.54; 90-day SMD = −2.29, 95%CI: −4.94, 0.37, P = 0.09). Sensitivity analyses showed that patients in Asia had improved survival (30-day OR = 2.76, 95%CI: 1.43, 5.35, P = 0.003; 60-day OR = 2.83, 95% CI: 1.39, 5.73, P = 0.004; 90-day OR = 2.92, 95% CI: 1.34, 6.36, P = 0.007).Conclusions: Our findings suggest that, currently, G-CSF cannot be recommended for the treatment of ACLF.
format	article
author	Xiaoxue Hou Yuwen Li Hui Yuan Jinyuan Cai Rui Liu Jun Li Chuanlong Zhu Chuanlong Zhu
author_facet	Xiaoxue Hou Yuwen Li Hui Yuan Jinyuan Cai Rui Liu Jun Li Chuanlong Zhu Chuanlong Zhu
author_sort	Xiaoxue Hou
title	Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short	Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full	Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr	Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed	Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort	therapeutic effect and safety of granulocyte colony-stimulating factor therapy for acute-on-chronic liver failure: a systematic review and meta-analysis of randomized controlled trials
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/468fc793a97f4dd1a9f42e1f0205d313
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Therapeutic Effect and Safety of Granulocyte Colony-Stimulating Factor Therapy for Acute-On-Chronic Liver Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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