Porcine antilymphocyte globulin versus rabbit antithymocyte globulin for intensive immunosuppressive therapy of acquired aplastic anemia: A meta-analysis and systematic review

Objective: Several studies have reported that porcine antilymphocyte globulin (pALG) has a significant effect on aplastic anemia (AA), but their conclusions are inconsistent. To objectively evaluate its efficacy and safety, a meta-analysis was conducted. Materials and methods: We sys-tematically searched the relevant literature on pALG vs. rabbit antithymocyte globulin (rATG) as the first-line treatment in AA pa-tients until August 31, 2022, in electronic da-tabases: PubMed, Cochrane Library, Web of Science, etc. Two researchers independently extracted data and evaluated the quality of the study. Stata 14.0 was used for statistical analysis. Results: 50 studies were included in the analysis. The overall responses at 3, 6, and 12 months between the pALG group and rATG group were equivalent. We ana-lyzed early mortality, total mortality, relapse rates, and 5-year survival after the adminis-tration of pALG or rATG, and there was no significant difference between the pALG and rATG groups. In our study, the incidence of infection in the pALG group was better than that in the rATG group, OR = 0.63, 95% CI (0.44 - 0.88), p = 0.008, which showed a sta-tistically significant difference. Conclusion: The efficacy of pALG in AA patients is equiv-alent to that of rATG. rATG was associated with a significantly higher incidence rate of infection than pALG.

Automated summary

The meta-analysis conducted in this study showed that porcine antilymphocyte globulin (pALG) is as effective as rabbit antithymocyte globulin (rATG) in treating aplastic anemia (AA) patients, while rATG is associated with a significantly higher incidence rate of infection.