PMID- 29709100
OWN - NLM
STAT- MEDLINE
DCOM- 20190724
LR  - 20190724
IS  - 1600-0897 (Electronic)
IS  - 1046-7408 (Linking)
VI  - 80
IP  - 1
DP  - 2018 Jul
TI  - A comparison of effectiveness among frequent treatments of recurrent spontaneous 
      abortion: A Bayesian network meta-analysis.
PG  - e12856
LID - 10.1111/aji.12856 [doi]
AB  - OBJECTIVE: A comprehensive network meta-analysis was designed to clarify 
      contradictions and offer valuable clinical guidance in the treatment of recurrent 
      spontaneous abortion (RSA). METHOD: The included clinical trials were selected 
      from the relevant medical journal databases and screened. Treatments were ranked 
      by the surface under the cumulative ranking curve. Heat plots were constructed to 
      analyze the inconsistency between direct data and network results, and adjusted 
      funnel plots were constructed to assess publication bias. RESULTS: Forty-nine 
      randomized controlled trials involving a total of 8496 RSA patients were 
      selected. With placebo as control, corticosteroid plus low dose aspirin (LDA) 
      plus unfractionated heparin (UFH), granulocyte colony-stimulating factor (G-CSF) 
      alone, and LDA plus low molecular weight heparin (LMWH) all demonstrated 
      effectiveness in increasing successful live birth rates and reducing the 
      incidences of miscarriage. However, no treatment was demonstrably superior to 
      placebo in terms of pregnancy success. For all 3 endpoints (live birth, abortion 
      and success pregnancy), the adjusted funnel plots were symmetric to zero and 
      indicated no publication bias. In terms of live birth and abortion rates, no 
      treatment outperformed placebo in patients with antiphospholipid syndrome. 
      CONCLUSION: In consideration of live birth and abortion rates, corticosteroid 
      plus LDA plus UFH appeared to be the optimum treatment strategy; G-CSF was 
      second, followed by LDA with LMWH, LDA plus LMWH plus intravenous immunoglobulin, 
      corticosteroid with LDA and others. Subgroup analysis demonstrated no benefit of 
      antithrombotic therapy in patients with antiphospholipid syndrome.
CI  - (c) 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Lv, Sha
AU  - Lv S
AUID- ORCID: 0000-0002-8515-6877
AD  - Department of Gynaecology and Obstetrics, The Affiliated Hospital of Guizhou 
      Medical University, Guiyang, China.
FAU - Yu, Jing
AU  - Yu J
AD  - Department of Medical Imaging, The Affiliated Hospital of Guizhou Medical 
      University, Guiyang, China.
FAU - Xu, Xiaoxiao
AU  - Xu X
AD  - Department of Gynaecology and Obstetrics, The Affiliated Hospital of Guizhou 
      Medical University, Guiyang, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180430
PL  - Denmark
TA  - Am J Reprod Immunol
JT  - American journal of reproductive immunology (New York, N.Y. : 1989)
JID - 8912860
MH  - Abortion, Habitual/*drug therapy
MH  - Abortion, Spontaneous/*drug therapy
MH  - Bayes Theorem
MH  - Clinical Trials as Topic
MH  - Humans
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - antithrombotic therapy
OT  - hormonotherapy
OT  - immunotherapy
OT  - network meta-analysis
OT  - recurrent spontaneous abortion
EDAT- 2018/05/01 06:00
MHDA- 2019/07/25 06:00
CRDT- 2018/05/01 06:00
PHST- 2017/11/23 00:00 [received]
PHST- 2018/03/21 00:00 [accepted]
PHST- 2018/05/01 06:00 [pubmed]
PHST- 2019/07/25 06:00 [medline]
PHST- 2018/05/01 06:00 [entrez]
AID - 10.1111/aji.12856 [doi]
PST - ppublish
SO  - Am J Reprod Immunol. 2018 Jul;80(1):e12856. doi: 10.1111/aji.12856. Epub 2018 Apr 
      30.