兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Comparative efficacies of different immunotherapy regimens in recurrent implantation failure: A systematic review and network meta-analysis

Yongxiu Yang; Kehu Yang
2021-09-28
For patients with recurrent implantation failure (RIF), immune system imbalances have become the focus of research. The effects of different classes of immunotherapies on improving pregnancy outcomes have not been fully established. This network meta-analysis was performed to assess the impact of popular immunotherapies in women with RIF. We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of Science databases as well as clinical trial registration websites. Randomized controlled trials comparing immunotherapeutic outcomes were included. We performed the random-effects network metaanalysis to compare efficacy measures. A total of 21 trials involving 2277 participants and 8 immunotherapies were eligible for this study. Patients that had been administered with PBMCs, G-CSF, PRP, and sirolimus exhibited higher CPR than those administered with the placebo (2.63, 1.71-4.06; 2.03, 1.35-3.05; 1.98, 1.02-3.84; 2.55, 1.36-4.79; and 3.95, 1.33-11.72, respectively). For IR, only PBMCs and G-CSF were significantly more effective than the placebo (2.92, 1.39-6.12; 2.66, 1.16-6.06, respectively). In terms of LBR, PBMCs (2.96, 1.67-5.27) and sirolimus (3.55, 1.18-10.64) were effective. However, r-hLIF (0.25, 0.10-0.62) had a reduced risk of LBR. No therapeutic regimen was found to have significantly decreased MR, but PBMCs exhibited the lowest rank among all interventions (0.28, 0.06-1.44). To improve clinical pregnancy while reducing miscarriage outcomes, PBMCs might be a beneficent therapeutic option for RIF in the future.
Journal of Reproductive Immunology
卷号:148
ISSN:0165-0378|收录类别:SCIE
DOI
10.1016/j.jri.2021.103429
EISSN
1872-7603
出版日期
2021-09-28
相关链接
https://www.sciencedirect.com/science/article/pii/S0165037821001595
语种
英文
国家
中国
学科领域
循证医学
被引频次(WOS)
3
来源机构
Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
研究类型
Meta分析
关键词
Recurrent implantation failure Immunotherapy Efficacy Network meta-analysis
WOS学科分类
Immunology Reproductive Biology