对于复发性/耐药性多发性骨髓瘤的网络元分析中的效果修改:系统性审查和元分析
Christopher James Rose1,2, Ingrid Kristine Ohm3, Liv Giske3
1Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway ChristopherJames.Rose@fhi.no.
BMJ open
|August 29, 2023
概括
在复发性/耐药性多发性骨髓瘤 (RRMM) 治疗中,效果的改变是最小的. 对总生存率 (OS) 和无进展生存率 (PFS) 的网络元分析 (NMA) 是可靠的,因为小效应大小不会显著影响结果.
科学领域:
- 血液学 血液学 血液学
- 临床试验 临床试验
- 生物统计学 生物统计学
背景情况:
- 复发性/耐药性多发性骨髓瘤 (RRMM) 提出了治疗方面的挑战.
- 网络元分析 (NMA) 对于比较治疗至关重要,但假设效果修改最小.
- 了解效果修改是验证NMA结果的关键.
研究的目的:
- 系统地审查和分析RRMM中耐火性状态和治疗线路对效果修改的证据.
- 评估效果修改是否会使假设微不足道修改的NMA无效.
主要方法:
- 随机对照试验的系统文献搜索和元分析 (第二/三阶段).
- 对总生存期 (OS) 和无进展生存期 (PFS) 的相对危险比率 (RHRs) 的估计.
- 模拟以量化效果修改对NMA结果的影响.
主要成果:
- 在42个出版物和8364名患者中,对效果修改的证据很弱.
- 在PFS中耐火状态的最大RHR为1.32 (95%CI为1.18-1.49).
- 模拟表明<5%的NMA估计将因效果修改而显著不同.
结论:
- 在RRMM中效果修改通常很小,在NMA中可以忽略.
- 在RRMM中对OS和PFS的NMA可能是可靠的.
- 结果支持NMA在RRMM中的治疗比较的有效性.
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