PMID- 31470986
OWN - NLM
STAT- MEDLINE
DCOM- 20200611
LR  - 20200611
IS  - 1879-114X (Electronic)
IS  - 0149-2918 (Linking)
VI  - 41
IP  - 9
DP  - 2019 Sep
TI  - Evaluation of the Effect of Intravenous Immunoglobulin Dosing on Mortality in 
      Patients with Sepsis: A Network Meta-analysis.
PG  - 1823-1838.e4
LID - S0149-2918(19)30337-6 [pii]
LID - 10.1016/j.clinthera.2019.06.010 [doi]
AB  - PURPOSE: Intravenous immunoglobulin (IVIG) has been proposed as an adjunctive 
      therapy for sepsis. Related systematic reviews and meta-analyses of IVIG in 
      sepsis indicate that IVIG can reduce the mortality of sepsis in adults. However, 
      the effective dose of IVIG has not been clearly determined to date. We aimed to 
      conduct an updated meta-analysis and use a network meta-analysis to elucidate the 
      efficacy of IVIG dosing regimens in sepsis treatment. METHODS: We searched 
      PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE 
      for articles published on or before February 14, 2019. We performed a direct 
      meta-analysis to update a previous meta-analysis of the effects of IVIG therapy 
      on mortality in adult patients with septic shock and a network meta-analysis to 
      evaluate the efficacy of IVIG dosing regimens in sepsis treatment. FINDINGS: 
      Compared with the control treatment, the IVIG treatment reduced the all-cause 
      mortality of patients with sepsis (odds ratio = 0.61; 95% CI, 0.41-0.92; 
      P = 0.018), but significant heterogeneity was found across the studies 
      (I(2) = 45.0%; P = 0.04). Regarding the IVIG dosage regimens, the highest total 
      dose range (1.5-2 g/kg) was the optimal dose of administration (surface under the 
      cumulative ranking curve = 84.7%). IMPLICATIONS: On the basis of the available 
      data, IVIG treatment is likely to reduce the all-cause mortality of patients with 
      sepsis, and the highest total dose range (1.5-2 g/kg) is likely the optimal dose 
      of administration.
CI  - Copyright (c) 2019. Published by Elsevier Inc.
FAU - Yang, Yi
AU  - Yang Y
AD  - Phase I Clinical Trial Center of the Second Affiliated Hospital of Chongqing 
      Medical University, Chongqing, China.
FAU - Yu, Xian
AU  - Yu X
AD  - Phase I Clinical Trial Center of the Second Affiliated Hospital of Chongqing 
      Medical University, Chongqing, China.
FAU - Zhang, Fan
AU  - Zhang F
AD  - School of Public Health and Management, Chongqing Medical University, Chongqing, 
      China.
FAU - Xia, Yifan
AU  - Xia Y
AD  - Department of Orthopaedics, Chongqing General Hospital, Chongqing, China. 
      Electronic address: xiayifan@yandex.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20190827
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Administration, Intravenous
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - Sepsis/drug therapy/*mortality
OTO - NOTNLM
OT  - intravenous immunoglobulin
OT  - network meta-analysis
OT  - optimal dose
OT  - review
OT  - sepsis
EDAT- 2019/09/01 06:00
MHDA- 2020/06/12 06:00
CRDT- 2019/09/01 06:00
PHST- 2018/12/11 00:00 [received]
PHST- 2019/06/02 00:00 [revised]
PHST- 2019/06/19 00:00 [accepted]
PHST- 2019/09/01 06:00 [pubmed]
PHST- 2020/06/12 06:00 [medline]
PHST- 2019/09/01 06:00 [entrez]
AID - S0149-2918(19)30337-6 [pii]
AID - 10.1016/j.clinthera.2019.06.010 [doi]
PST - ppublish
SO  - Clin Ther. 2019 Sep;41(9):1823-1838.e4. doi: 10.1016/j.clinthera.2019.06.010. 
      Epub 2019 Aug 27.