Evidence map›Paper›PMID 37981614›Full record

SynthesisClinical rheumatology2024

Efficacy and safety of mycophenolate mofetil in patients with immune thrombocytopenic purpura: a systematic review and meta-analysis.

Omar Ahmed Abdelwahab, Ahmed Mechi, Shereen Gahlan, Fatima-Elzahraa Hamadein, Hallas Kadhim, Doaa Ismail, Youssef Soliman, Mohamed El-Samahy

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Omar Ahmed AbdelwahabFaculty of Medicine, Al-Azhar University, Cairo, 11884, Egypt. omarabdelwahab.216@azhar.edu.eg.ORCID http://orcid.org/0000-0001-8266-0245
Ahmed MechiMedical Research Group of Egypt, Cairo, Egypt.ORCID http://orcid.org/0000-0003-4682-1392
Shereen GahlanFaculty of Medicine, Al-Azhar University, Cairo, 11884, Egypt.
Fatima-Elzahraa HamadeinFaculty of Medicine, University of Gezira, Wad Madani, Sudan.
Hallas KadhimMedical Research Group of Egypt, Cairo, Egypt.
Doaa IsmailMedical Research Group of Egypt, Cairo, Egypt.ORCID http://orcid.org/0009-0008-0203-4008
Youssef SolimanMedical Research Group of Egypt, Cairo, Egypt.
Mohamed El-SamahyMedical Research Group of Egypt, Cairo, Egypt.
Scientific Research Group in Egypt · EGAl-Azhar University · EGUniversity of Gezira · SDZagazig University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune thrombocytopenic purpura (ITP) is a challenging disease in its presentation and management as it may cause life-threatening hemorrhaging in vital organs and may resist several lines of treatment. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of mycophenolate mofetil (MMF) in treating patients with ITP.

methodsWe systematically searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) from inception until 10 October 2022. We included all clinical trials, either controlled or single arm, and prospective and retrospective observational studies that evaluate the efficacy and safety of MMF in patients with ITP. We assessed the risk of bias using three tools (ROBINS-I, Cochrane ROB-2, and NIH), each for eligible study design.

resultsNine studies were included in this meta-analysis, with a total of 411 patients with ITP. We found that MMF demonstrated an overall response rate of (62.09%; 95% CI = [43.29 to 77.84]) and the complete response rate was (46.75%; 95% CI = [24.84 to 69.99]). The overall proportion of adverse events was (12%; 95% CI = [6 to 24]). After the sensitivity analysis, the overall response rate became 50%; 95% CI = [38 to 63]) and the complete response rate became (32%; 95% CI = [24 to 42]). However, MMF did not appear to affect white blood cell counts or hemoglobin levels significantly.

conclusionThis systematic review and meta-analysis demonstrate that MMF appears to be an effective and relatively safe treatment option for patients with ITP when combined with steroids and even in those who have not responded to standard therapies (steroid-resistant cases). Further research with well-designed studies is warranted to better understand the factors influencing treatment response and to refine the use of MMF in the management of ITP. An interactive version of our analysis can be accessed from here: https://databoard.shinyapps.io/mycophenolate_meta/.

Indexed as

Mycophenolic AcidPurpura, Thrombocytopenic, IdiopathicHumansImmunosuppressive AgentsProspective StudiesRetrospective StudiesSteroidsImmunosuppressive AgentsMycophenolic AcidSteroidsImmune thrombocytopenic purpuraITPMMFMycophenolate mofetilSystematic review

Identifiers

PMID37981614
PMCPMC10834632
OpenAlexW4388814171

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.