Timmermans, P and Barradas-Pires, A and Ali, O and Henkens, M and Heymans, S and Negishi, K, Prednisone and azathioprine in patients with inflammatory cardiomyopathy: systematic review and meta-analysis, ESC Heart Failure pp. 1-19. ISSN 2055-5822 (2020) [Refereed Article]
© 2020 The Authors. Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/
Methods and results: All trials with using IPA vs. OMT in this syndrome were searched using OVID Medline and ClinicalTrials. gov, following the PRISMA guidelines. Missing data were retrieved after contacting the corresponding authors. All data was reviewed and analysed using and standard meta-analysis methods. A random effect model was used to pool the effect sizes. A total of four trials (three randomised controlled trials and one propensity-matched retrospective registry) including 369 patients were identified. IPA on top of OMT did not improve LVEF [mean difference 9.9% (95% confidence interval -1.8, 21.7)] with significant heterogeneity. When we limited our pooled estimate to the published studies only, significant LVEF improvement by IPA was observed [14% (1.4, 26.6)]. No cardiovascular mortality benefit was observed with the intervention [risk ratio 0.34 (0.08, 1.51)].
Conclusions: At the moment, there is insufficient evidence supporting functional and prognostic benefits of IPA added to OMT in virus negative inflammatory positive cardiomyopathy. Further adequate-powered well-designed prospective RCTs should be warranted to explore the potential effects of adding immunosuppressive therapy to OMT.
|Item Type:||Refereed Article|
|Keywords:||myocarditis, immunosuppression, prednisolone, azathioprine, failure, cardiomyopathy|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Negishi, K (Dr Kazuaki Negishi)|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||9 View Download Statistics|
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