Meta And Network Meta-analysis Of Drug Therapies For Purpura Nephritis

Objective:At present the effect and prognosis of all kinds of drug treatments for Henoch-Schonlein purpura nephritis(HSPN)had been evaluated and reported by many literature researches.But most reports were single center studies.In this study,meta-analysis and network meta-analysis were used to evaluate the efficacy of various drugs on HSPN that providing more accurate basis for the selection of clinical treatment programs and the researchers who attempt to conduct such a study.Methods:After literature retrieval in major databases,meta-analysis and network meta-analysis were used to evaluate the efficacy of various drugs on HSPN.Literature quality assessment,heterogeneity,subgroup analysis,meta-regression,sensitivity and bias were used to evaluate the reliability of meta-analysis results.Results:Through searching domestic and foreign literature databases,22 HSPN randomized controlled trials were selected.The results of meta-analysis showed that the cure rate and remission rate of glucocorticoid combined with immunosuppressant(without differentiating immunosuppressant types)for HSPN were higher than that of glucocorticoid alone,and the 24-hour urine protein decreased significantly with statistically significant differences.The results of the network meta-analysis showed that cyclosporine A combined with glucocorticoid was the most significant in the efficacy evaluation of various treatments,but the result was limited due to its single included in the study.Conclusion:Glucocorticoid combined with immunosuppressant therapy for HSPN can significantly improve the prognosis of patients compared with glucocorticoid alone in terms of cure rate,remission rate and 24-hour urine protein.Cyclosporine A combined with glucocorticoid may be the most significant in the efficacy evaluation of various treatments.