AUTHOR=Wang Yonghui , Li Xiaoying , Yang Qian , Wang Wei , Zhang Yanan , Liu Jun , Zheng Liang , Zha Bingbing 

TITLE=Granulocyte-Colony-Stimulating Factor Effectively Shortens Recovery Duration in Anti-Thyroid-Drug-Induced Agranulocytosis: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Endocrinology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00789

DOI=10.3389/fendo.2019.00789

ISSN=1664-2392

ABSTRACT=<p><bold>Background and aim:</bold> Granulocyte-colony-stimulating factor (G-CSF) is highly beneficial as a general treatment for anti-thyroid drug (ATD)-induced agranulocytosis. This meta-analysis aimed to assess the clinical effects of G-CSF and non-G-CSF on recovery duration in patients with ATD-induced agranulocytosis by analyzing the overall clinical outcomes.</p><p><bold>Methods:</bold> The PubMed, Embase, Ovid, Cochrane, Google Scholar, China National Knowledge Infrastructure (CNKI) databases were searched for published studies from 1900 to 2018. No language restriction was implemented.</p><p><bold>Results:</bold> This meta-analysis included 10 published retrospective studies and one prospective study. Data were obtained from 11 trials (474 patients: 247 with G-CSF and 227 with non-G-CSF treatment). Compared with the non-G-CSF group, the G-CSF group presented shorter recovery duration [weighted mean difference (WMD) = −3.04 days, 95% confidence interval (95% CI): −4.38 to −1.69 (<italic>Z</italic> = 4.43 <italic>P</italic> = 0.000)]. However, the recovery duration varied across regions and recovery criteria. Asian patients achieved significant clinical outcomes [WMD = −3.16 days (95% CI: −4.58 to −1.74, <italic>P</italic> = 0.000)] compared with European and South American patients [WMD = −2.19 days (95% CI: −7.38 to 3.01, <italic>P</italic> = 0.409)]. Also, according to various recovery criteria, a duration of granulocyte count increase of more than 1.5 or 1.0 × 10<sup>9</sup>/L [WMD = −3.50 days (95% CI: −4.82 to −2.18<italic>, P</italic> = 0.000)] revealed a better treatment effect.</p><p><bold>Conclusion:</bold> G-CSF can significantly shorten the recovery duration in patients with ATD-induced agranulocytosis.</p>