SynthesisEpilepsia2022
Second-line immunotherapy and functional outcomes in autoimmune encephalitis: A systematic review and individual patient data meta-analysis.
Synthesis in Epilepsia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Recurrence of Autoimmune Encephalitis.Annals of clinical and translational neurology · 2026Pooled it
- Efficacy of immunotherapy and prognosis in anti-LGI1 encephalitis patients: A meta-analysis.Annals of clinical and translational neurology · 2023Pooled it
- Second-line immunotherapy and functional outcomes in autoimmune encephalitis: A systematic review and individual patient data meta-analysis.Epilepsia · 2022Pooled it
- Th1/Th17-linked transcription factors TBX21 and RORC were associated with clinical response to rituximab in treatment-resistant schizophrenia.Brain, behavior, & immunity - health · 2026Article
- Neuroinflammation and Mental Health in Multiple Sclerosis and Autoimmune Encephalitis: Bridging Biological Mechanisms and Psychosocial Factors.Archives of internal medicine research · 2026Article
- Autoimmune inflammatory diseases of the central nervous system: advances in clinical trials and immunotherapeutic strategies.Reumatologia · 2026Review
- Efgartigimod-rituximab sequential therapy in Anti-NMDAR encephalitis: real-world evidence for a novel salvage-maintenance strategy.Journal of neurology · 2025Article
- Immunotherapy for autoimmune encephalitis.Cell death discovery · 2025Review
- Intravenous immunoglobulin as first-line acute treatment in adults with autoimmune encephalitis caused by antibodies to NMDAR, LGI1 and CASPR2.Journal of neurology · 2025Article
- Long-term neurological outcome in patients presenting with encephalitis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Late relapse of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis: a case report.Journal of medical case reports · 2024Article
- Study on clinical features and factors related to long-term outcomes of antibody-negative autoimmune encephalitis.Annals of clinical and translational neurology · 2024Article
- Seizure burden and neuropsychological outcomes of new-onset refractory status epilepticus: Systematic review.Frontiers in neurology · 2023Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Autoimmune encephalitis (AE) is a neurological disorder caused by autoimmune attack on cerebral proteins. Experts currently recommend staged immunotherapeutic management, with first-line immunotherapy followed by second-line immunotherapy if response to first-line therapy is inadequate. Meta-analysis of the evidence base may provide higher quality evidence to support this recommendation. We undertook a systematic review of observational cohort studies reporting AE patients treated with either second-line immunotherapy or first-line immunotherapy alone, and outcomes reported using the modified Rankin Scale (mRS; search date: April 22, 2020). We performed several one-stage multilevel individual patient data (IPD) meta-analyses to examine the association between second-line immunotherapy and final mRS scores (PROSPERO ID CRD42020181805). IPD were obtained for 356 patients from 25 studies. Most studies were rated as moderate to high risk of bias. Seventy-one patients (71/356, 19%) were treated with second-line immunotherapy. We did not find a statistically significant association between treatment with second-line immunotherapy and final mRS score for the cohort overall (odds ratio [OR] = 1.74, 95% confidence interval [CI] = .98-3.08, p = .057), or subgroups with anti-N-methyl-D-aspartate receptor encephalitis (OR = 1.03, 95% CI = .45-2.38, p = .944) or severe AE (maximum mRS score > 2; OR = 1.673, 95% CI = .93-3.00, p = .085). Treatment with second-line immunotherapy was associated with higher final mRS scores in subgroups with anti-leucine-rich glioma-inactivated 1 AE (OR = 6.70, 95% CI = 1.28-35.1, p = .024) and long-term (at least 12 months) follow-up (OR = 3.94, 95% CI = 1.67-9.27, p = .002). We did not observe an association between treatment with second-line immunotherapy and lower final mRS scores in patients with AE. This result should be interpreted with caution, given the risk of bias, limited adjustment for disease severity, and insensitivity of the mRS in estimating psychiatric and cognitive disability.
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