Effect and safety of cyclosporine A treatment for aplastic anemia:A systematic review

Objective:To assess the effect of CsA for treating aplastic anemia(AA).Method:Randomized controlled trials(RCTs)were identified from MEDLINE(1996.1-2006.5),EMBASE(1984.1-2006.5),Cochrane Controlled Trials Register(Issue 2,2006),Chinese Cochrane Centre Database(Issue 2,2006)and CBMdisc(1978.1-2006.5).Related published and unpublished data and their references were handsearched.Data were extracted and evaluated by two reviewers independently with designed extraction form.RevMan4.2.7 software was used for data analysis.Result:Seven RCTs involving 513 patients were included.All the results of meta-analysis were listed as the following:①Mortality:Compared with decaris,1 study showed that patients with AA treated with CsA had statistical difference [RR 0.52,95%CI(0.25,1.05)].Compared with ATG,1 study showed that patients with AA treated with CsA had statistical difference[RR 0.14,95%CI(0.03,0.61)].②Total effective rate:Compared with decaris,2 studies showed that CsA had statistical difference[RR2.24,95 %CI(1.55,3.23)].Compared with no CsA,3 studies showed statistical difference with [RR1.70,95 %CI(1.35,2.14 ].Compared with ATG,2 studies showed statistical difference[RR1.77,95 %CI(1.03,3.03)].③Adverse effect:CsA had lower adverse effect significantly than others.Conclusion:CsA can decrease morbidity and increase total effective rate of AA and decrease adverse effects.More high quality trials are required.