The Efficacy And Safety Of DNA Immunoadsorption Therapy For Systemic Lupus Erythematosus:A Meta-Analysis Of Random Control Trial

Objective: To systematically evaluate the efficacy and safety of DNA immunoadsorption(IAS)combined with drugs therapy for systemic lupus erythematosus(SLE).Methods: Databases including PubMed,EMbase,Cochrane Library,China Biomedical Literature Database(CBM),VIP Database,Wanfang Data and China Knowledge Network(CNKI)were searched from inception to March 2019 to collect the randomized controlled trials(RCT)on DNA immunoadsorption combined with drug therapy VS medication alone therapy for SLE.According to the inclusion and exclusion criteria,the data were extracted and the methodological quality was evaluated.The RevMan 5.3 software was used to perform a meta-analysis..Results: A total of 9 RCTs were included.The Meta-analysis suggested that the decline of anti ds-DNA antibody,IgG,serum creatinine,urea,24 h urine protein,and SLEDAI scores were more significant in the immunoadsorption combined with drug treated group.Simultaneously,the higher level of C3 was observed in the IAS treatment group.While prolong the observation time,thelevel of anti ds-DNA antibody in the IAS treatment group remained lower than the control group.In terms of adverse reactions,the incidence of fever,allergies,chills,hemorrhage,and hypotension was higher in the treatment group.The risk of infection was not statistically different between the two treatment regimens.Conclusion: IAS combined with drug therapy is more effective than drug alone therapy in the short term,but the incidence of adverse reactions is higher,and patients can be tolerated after timely treatment.In addition,IAS treatment may show a relatively long-term effectiveness.The above conclusions need to be confirmed by more high quality,large sample RCTs.