PMID- 36511097
OWN - NLM
STAT- MEDLINE
DCOM- 20221223
LR  - 20221223
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 47
IP  - 12
DP  - 2022 Dec
TI  - Tumour necrosis factor inhibitor combined with intravenous immunoglobulin and 
      heparin for treatment of recurrent spontaneous abortion: A two-centre, 
      retrospective, cohort study.
PG  - 2320-2324
LID - 10.1111/jcpt.13771 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: Immune disorder is a key trigger of recurrent 
      spontaneous abortion (RSA); meanwhile, tumour necrosis factor inhibitor (TNFi) is 
      a fundamental therapeutic for multiple immune and inflammatory diseases. Hence, 
      this real-world study aimed to explore the efficacy and safety of TNFi combined 
      with intravenous immunoglobin (IVIG) and heparin therapy in RSA patients. 
      METHODS: A total of 105 RSA patients who received TNFi+IVIG+Heparin (enoxaparin) 
      (n = 48) or IVIG+Heparin (enoxaparin) (n = 57) were retrospectively included in 
      this two-centre cohort study. RESULTS AND DISCUSSION: The live birth rate of RSA 
      patients in the TNFi+IVIG+heparin group was 72.9% (95% confidence interval [CI]: 
      69.6%-85.9%). Besides, the live birth rate in the IVIG+heparin group was 52.6% 
      (95% CI: 42.8%-62.4%). By comparison, the live birth rate was higher in the 
      TNFi+IVIG+heparin group compared to the IVIG+heparin group (p = 0.033). After 
      adjustment by the multivariate logistic regression model using the enter method, 
      TNFi+IVIG+Heparin was also superior to IVIG+Heparin regarding increased live 
      birth rate (odds ratio [OR] = 2.941, p = 0.015). Moreover, TNFi+IVIG+Heparin (vs. 
      IVIG+Heparin) also served as an independent factor for increased live birth rate 
      (OR = 2.423, p = 0.035) by the forward stepwise method in the multivariate 
      analysis. Gestational weeks at delivery (38.3 +/- 1.3 vs. 37.7 +/- 2.0 weeks, 
      p = 0.155), newborn weight (3123.9 +/- 332.1 vs. 3056.6 +/- 287.4 g, p = 0.390), 
      Apgar score of newborns (9.8 +/- 0.5 vs. 9.7 +/- 0.7, p = 0.271) were of no 
      difference between TNFi+IVIG+Heparin and IVIG+Heparin groups. In terms of safety 
      profile, the adverse events were of no difference between the TNFi+IVIG+Heparin 
      and the IVIG+Heparin groups (all p > 0.05), either. WHAT IS NEW AND CONCLUSION: 
      TNFi combined with IVIG and heparin therapy improves the live birth rate but does 
      not elevate the adverse events compared to IVIG and heparin therapy in RSA 
      patients.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Jiang, Yi
AU  - Jiang Y
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
FAU - Zou, Qinghua
AU  - Zou Q
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
FAU - Zhang, Nian
AU  - Zhang N
AUID- ORCID: 0000-0002-0474-2656
AD  - Department of Traditional Chinese Medicine, The Second Hospital Affiliated to 
      Army Medical University, Chongqing, China.
FAU - Chen, Jingjing
AU  - Chen J
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
FAU - Chen, Xuemeng
AU  - Chen X
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
FAU - You, Qingxia
AU  - You Q
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
FAU - Wu, Hong
AU  - Wu H
AD  - Department of Rheumatology and Immunology, The First Hospital Affiliated to Army 
      Medical University, Chongqing, China.
LA  - eng
PT  - Journal Article
DEP - 20221213
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 9005-49-6 (Heparin)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Tumor Necrosis Factor Inhibitors)
RN  - 0 (Enoxaparin)
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Pregnancy
MH  - Female
MH  - Infant, Newborn
MH  - Humans
MH  - *Heparin/adverse effects
MH  - Immunoglobulins, Intravenous/adverse effects
MH  - Retrospective Studies
MH  - Tumor Necrosis Factor Inhibitors/therapeutic use
MH  - Cohort Studies
MH  - Enoxaparin/therapeutic use
MH  - Anticoagulants/adverse effects
MH  - *Abortion, Habitual/drug therapy
OTO - NOTNLM
OT  - TNF inhibitor
OT  - intravenous immunoglobin and heparin
OT  - live birth rate
OT  - recurrent spontaneous abortion
OT  - safety profile
EDAT- 2022/12/14 06:00
MHDA- 2022/12/24 06:00
CRDT- 2022/12/13 04:33
PHST- 2022/08/18 00:00 [revised]
PHST- 2022/08/03 00:00 [received]
PHST- 2022/08/24 00:00 [accepted]
PHST- 2022/12/14 06:00 [pubmed]
PHST- 2022/12/24 06:00 [medline]
PHST- 2022/12/13 04:33 [entrez]
AID - 10.1111/jcpt.13771 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2022 Dec;47(12):2320-2324. doi: 10.1111/jcpt.13771. Epub 2022 
      Dec 13.