Meta-analysis of controlled clinical trials studying the efficacy of rHuEPO in reducing blood transfusions in the anemia of prematurity

摘要: BACKGROUND: Recombinant human EPO (rHuEPO) has not gained broad acceptance in the treatment of anemia prematurity, because its efficacy diminishing RBC transfusions is questionable. Meta-analysis was used to investigate extent and reasons for variation results published clinical trials. STUDY DESIGN AND METHODS: Prospective controlled trials from 1990 through 1999 were retrieved; 21 met criteria meta-analysis. Calculated across these studies summary OR transfusion treated neonates as compared with controls mean difference between volume RBCs transfused number per infant. Twelve study descriptors examined possible results. RESULTS: Results eligible varied widely (p<0.001 Q test statistic), this persisted most analyses when stratified by individual descriptors. When outcome measure, modest four highly desired characteristics (i.e., high blindness design quality scores, “conservative” criteria, majority weighing <1 kg at birth), rHuEPO reduced an average 11.0 mL (p<0.001). CONCLUSION: Benefit detected high-quality using conservative criteria. However, there extreme overall findings available trials, and—until accounted for—it premature recommend standard prematurity.