Systematic Review and Meta-Analysis on Efficacy and Safety of PEG-rhG-CSF and rhG-CSF in the Prevention of Chemotherapy-Related Neutropenia
OBJECTIVE:To compare the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)and rhG-CSF in the prevention of chemotherapy-related neutropenia.METHODS:PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data and VIP databases were retrieved to collect randomized controlled trials of PEG-rhG-CSF and rhG-CSF in the prevention of chemotherapy-related neutropenia(intervention measures were PEG-rhG-CSF,control measures were rhG-CSF)until May 2023.Literature screening,information extraction and bias risk assessment were carried out by two researchers independently.Meta-analysis was performed by RevMan 5.3 statistical software.RESULTS:A total of 41 studies were included.Meta-analysis showed that compared with rhG-CSF,PEG-rhG-CSF could significantly reduce the incidence of neutropenia with fever(FN)after chemotherapy(OR=0.64,95%CI=0.51-0.81,P=0.0002)and the incidence of grade Ⅲ/Ⅳ neutropenia(OR=0.49,95%CI=0.35-0.69,P<0.0001),the differences were statistically significant;however,differences in the duration of grade Ⅲ/Ⅳ neutropenia(MD=-0.33,95%CI=-0.68-0.01,P=0.06),the recovery time of neutropenia(MD=-0.11,95%CI=-0.32-0.09,P=0.27),the incidence of bone pain or skeletal muscle pain(OR=0.81,95%CI=0.66-1.00,P=0.05)were not statistically significant.CONCLUSIONS:The efficacy of PEG-rhG-CSF in the prevention of FN and grade Ⅲ/Ⅳ neutropenia after chemotherapy is significantly better than that of rhG-CSF,and PEG-rhG-CSF is feasible as primary prevention.
Pegylated recombinant human granulocyte colony-stimulating factorRecombinant human granulocyte colony-stimulating factorNeutropeniaMeta-analysis
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