دورية أكاديمية
أعرض في EDS

Calcineurin inhibitors in the management of recurrent miscarriage and recurrent implantation failure: Systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: Calcineurin inhibitors in the management of recurrent miscarriage and recurrent implantation failure: Systematic review and meta-analysis.
المؤلفون: Cavalcante MB; Postgraduate Program in Medical Sciences, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil; CONCEPTUS - Reproductive Medicine, Fortaleza, CE 60.170-240, Brazil; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil. Electronic address: marcelocavalcante.med@gmail.com., Tavares ACM; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., Rocha CA; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., de Souza GF; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., Lima EM; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., Simões JML; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., de Souza LC; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., Martins MYM; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., de Araújo NO; Medical Course, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil., Barini R; Department of Obstetrics and Gynecology, Campinas University (UNICAMP), Campinas, SP 13.083-887, Brazil.
المصدر: Journal of reproductive immunology [J Reprod Immunol] 2023 Dec; Vol. 160, pp. 104157. Date of Electronic Publication: 2023 Sep 30.
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Ireland NLM ID: 8001906 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7603 (Electronic) Linking ISSN: 01650378 NLM ISO Abbreviation: J Reprod Immunol Subsets: MEDLINE
أسماء مطبوعة: Publication: Limerick : Elsevier/North-Holland Biomedical Press
Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
مواضيع طبية MeSH: Calcineurin Inhibitors*/therapeutic use , Abortion, Habitual*, Pregnancy ; Infant, Newborn ; Female ; Humans ; Pregnancy Rate ; Immunosuppressive Agents/therapeutic use ; Birth Rate ; Tacrolimus/therapeutic use
مستخلص: Recurrent miscarriage (RM) affects up to 2.5% of couples of reproductive age. Up to 10% of couples using assisted reproductive technology experience recurrent implantation failure (RIF). Immunosuppressive drugs, such as calcineurin inhibitors (CNIs), has been proposed for RM and RIF management. This systematic review and meta-analysis (SRMA) aimed to evaluate the efficacy and safety of CNIs in RM and RIF treatment. We searched in the three databases. Review Manager 5.4.1 was used for statistical analysis. This review included 8 studies involving 1042 women (485 women in the CNIs group and 557 women in the control group). CNI treatment (cyclosporine [CsA] and tacrolimus [TAC]) increases live birth rate (LBR, odds ratio [OR]: 2.52; 95% confidence interval [CI]: 1.93-3.28, p < 0.00001) and clinical pregnancy rate (OR: 2.25; 95% CI: 1.54-4.40, p < 0.0001) and decreases miscarriage rate (OR: 0.45 95% CI: 0.32-0.63, p < 0.00001) when compared to the control. Side effects and obstetric and neonatal complications was similar in both groups. In conclusion, CNIs increased LBR in women with RM and RIF but there is a moderate risk of bias. Subgroup analysis revealed that CNIs improved LBR in women with RM with a low risk of bias. However, in women with RIF, with moderate to high risk of bias. The use of CsA and TAC, in low doses and for a short period, for managing reproductive failures in women seems to be safe, not causing serious side effects nor increasing the risk of obstetric and neonatal complications.
Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
فهرسة مساهمة: Keywords: Cyclosporine; Habitual abortion; Immunotherapy; Recurrent implantation failure; Tacrolimus
المشرفين على المادة: 0 (Calcineurin Inhibitors)
0 (Immunosuppressive Agents)
WM0HAQ4WNM (Tacrolimus)
تواريخ الأحداث: Date Created: 20231009 Date Completed: 20231205 Latest Revision: 20231228
رمز التحديث: 20231228
DOI: 10.1016/j.jri.2023.104157
PMID: 37813069
قاعدة البيانات: MEDLINE
الوصف
تدمد:1872-7603
DOI:10.1016/j.jri.2023.104157