A systematic review of the efficacy and safety of the immunomodulator thymic polypeptides as adjuvant treatment for severe pneumonia
Objective To evaluate the effectiveness and safety for thymic polypeptides as adjunctive treatment of severe pneumonia and explore the rationality for application.Methods A systematic searching was conducted in six Chinese and English databases to identify randomized controlled trials on the use of thymic polypeptides for severe pneumonia.After screening,the included studies were subjected to quality assessment and data synthesis.Results A total of 28 randomized controlled trials involving 2 228 participants were included.Results showed that the thymic polypeptide group had lower mortality rate(RR=0.51,95％CI:0.32-0.83,P=0.006),higher effectiveness rate(RR=1.24,95％CI:1.19-1.30,P＜0.001),shorter ICU stay(MD=-3.03,95％CI:-3.79--2.26,P＜0.001),shorter mechanical ventilation time(MD=-61.34,95％CI:-65.55--57.12,P＜0.001),and better blood gas and inflammatory indicators compared to the control group,with no significant difference in adverse event rate(P＞0.05).Subgroup analyses revealed a trend for reduced ICU stay for patients over 60.The quality of evidence was generally low,with high heterogeneity in some indicators.Conclusions Based on the available evidence,thymic polypeptides show certain advantages as adjuvant treatment for severe pneumonia.However,there are limitations in the current evidence that do not justify the widespread use of them in China,There is a need for more RCTs to be conducted in the future,along with in-depth research into the safety and economic benefits of these medications.
Severe pneumoniaThymosinThymopentinSystematic reviewImmunomodulatory
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NSTL
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