Abstract
Background: Chronic dialysis patients often fail to produce protective antibodies to hepatitis B virus surface antigen after vaccination towards hepatitis B virus (HBV). Several authors suggested a benefit for granulocyte macrophage-colony stimulating factor (GM-CSF) as an adjuvant to HBV vaccination in patients with end-stage renal disease (ESRD). However, consistent information is still lacking. Aims: To evaluate efficacy and safety of GM-CSF as adjuvant to hepatitis B vaccine in patients with ESRD by performing a systematic review with a meta-analysis of prospective controlled clinical trials (CCTs). Methods: Only trials comparing the seroresponse rate in study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients were included. We used the random effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titers at completion of HBV vaccine schedule in study versus control groups. Results: We identified seven studies involving 187 unique patients with ESRD. Only prospective CCTs were included. Pooling of study results showed a significant increase in response rates among study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients (pooled Odds Ratio, 4.63 [95% Confidence Intervals, 1.42; 15.14]). The P-value was 0.02 for our test of study heterogeneity. Conclusions: Our meta-analysis showed improved seroprotection rates with HBV vaccine after GM-CSF administration.
| Original language | English |
|---|---|
| Pages (from-to) | 789-796 |
| Number of pages | 8 |
| Journal | Alimentary Pharmacology and Therapeutics |
| Volume | 24 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2006 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Pharmacology (medical)
- Pharmacology, Toxicology and Pharmaceutics(all)
Cite this
Meta-analysis : The adjuvant role of granulocyte macrophage-colony stimulating factor on immunological response to hepatitis B virus vaccine in end-stage renal disease. / Fabrizi, F.; Ganeshan, S. V.; Dixit, V.; Martin, Paul.
In: Alimentary Pharmacology and Therapeutics, Vol. 24, No. 5, 01.09.2006, p. 789-796.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Meta-analysis
T2 - The adjuvant role of granulocyte macrophage-colony stimulating factor on immunological response to hepatitis B virus vaccine in end-stage renal disease
AU - Fabrizi, F.
AU - Ganeshan, S. V.
AU - Dixit, V.
AU - Martin, Paul
PY - 2006/9/1
Y1 - 2006/9/1
N2 - Background: Chronic dialysis patients often fail to produce protective antibodies to hepatitis B virus surface antigen after vaccination towards hepatitis B virus (HBV). Several authors suggested a benefit for granulocyte macrophage-colony stimulating factor (GM-CSF) as an adjuvant to HBV vaccination in patients with end-stage renal disease (ESRD). However, consistent information is still lacking. Aims: To evaluate efficacy and safety of GM-CSF as adjuvant to hepatitis B vaccine in patients with ESRD by performing a systematic review with a meta-analysis of prospective controlled clinical trials (CCTs). Methods: Only trials comparing the seroresponse rate in study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients were included. We used the random effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titers at completion of HBV vaccine schedule in study versus control groups. Results: We identified seven studies involving 187 unique patients with ESRD. Only prospective CCTs were included. Pooling of study results showed a significant increase in response rates among study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients (pooled Odds Ratio, 4.63 [95% Confidence Intervals, 1.42; 15.14]). The P-value was 0.02 for our test of study heterogeneity. Conclusions: Our meta-analysis showed improved seroprotection rates with HBV vaccine after GM-CSF administration.
AB - Background: Chronic dialysis patients often fail to produce protective antibodies to hepatitis B virus surface antigen after vaccination towards hepatitis B virus (HBV). Several authors suggested a benefit for granulocyte macrophage-colony stimulating factor (GM-CSF) as an adjuvant to HBV vaccination in patients with end-stage renal disease (ESRD). However, consistent information is still lacking. Aims: To evaluate efficacy and safety of GM-CSF as adjuvant to hepatitis B vaccine in patients with ESRD by performing a systematic review with a meta-analysis of prospective controlled clinical trials (CCTs). Methods: Only trials comparing the seroresponse rate in study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients were included. We used the random effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titers at completion of HBV vaccine schedule in study versus control groups. Results: We identified seven studies involving 187 unique patients with ESRD. Only prospective CCTs were included. Pooling of study results showed a significant increase in response rates among study (GM-CSF plus HBV vaccine) versus control (HBV vaccine alone) patients (pooled Odds Ratio, 4.63 [95% Confidence Intervals, 1.42; 15.14]). The P-value was 0.02 for our test of study heterogeneity. Conclusions: Our meta-analysis showed improved seroprotection rates with HBV vaccine after GM-CSF administration.
UR - http://www.scopus.com/inward/record.url?scp=33747346684&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747346684&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2036.2006.03035.x
DO - 10.1111/j.1365-2036.2006.03035.x
M3 - Article
C2 - 16918882
AN - SCOPUS:33747346684
VL - 24
SP - 789
EP - 796
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 5
ER -