Effectiveness Of Nilotinib、Imatinibfor Chronic Myeloid Leukemia:a Meta-Analysis

Obiective:To systematically evaluate the effectiveness of nilotinib in doses of 300 mg twice daily、nilotinib in doses of 400 mg twice daily and imatinib in doses of 400 mg once dailyfor adults within 6 months of confirmed diagnosis of Ph+CML-CP. And to systematically evaluate the effectiveness of nilotinib in doses of 300 mg twice daily、nilotinib in doses of 400 mg twice daily for adults within 6 months of confirmed diagnosis of Ph+CML-CP.Methods:Databases including TheCochrane Library(Issue 9,2014), MEDLINE, EMbase, PubMed, Ovid, CBM, CNKI, VIP and WanFang Data, at the same time, including some-concerned data in library, to search the treatment of nilotinib and imatinib for within 6 months of diagnosis of Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase of RCT, the time is from inception to November 1,2014.Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the quality of included studies. Then, meta-analysis and sensitivity-analysis ware performed using RevMan 5.2. StataSE12.0software.Results:A total of four studies involving and 2617 patients were included. Results of meta-analyses showed that in the long-term treatment of Ph+CML-CP, significant difference was found between nilotinib 300mg twice daily vs imatinib 400mg once daily in the major molecular response, [RR=1.76,95%Cl(1.54,2.01), P=0.22], complete molecular response, [RR=2.02,95%Cl(1.68,2.41), P=0.51]; significant difference was found between nilotinib 400mg twice daily vs imatinib 400mg once daily in the major molecular response, [[RR=1.68,95%Cl(1.47,1.92), P=0.18],complete molecular response, [RR= 1.75,95%Cl(1.45,2.10), P=0.34]; no significant difference was found between nilotinib 300mg twice daily vs nilotinib 400mg twice daily in the major molecular response, [RR=0.89,95%Cl(0.86,1.05), P=0.90], complete molecular response[RR=0.87,95%Cl(0.76,1.00), P= 1.00].Conclusion:In the effectiveness of nilotinib 300/400mg twice daily vsimatinib400mg once daily for adults within 6 months of confirmed diagnosis of Ph+CML-CP is significant, well the effectiveness of nilotinib 300mg twice daily and nilotinib 400mg twice daily are no significant difference.