Mortalité à un et trois ans des patients atteints de pemphigoïde bulleuse traités en première intention par corticothérapie locale intensive

Cantegrit, T.; Merklen, C.; Birckel, E.; Bottlaender, L.; Second, J.; Droy-Dupré, L.; Mahé, A.

doi:10.1016/j.annder.2019.09.215

Cited by 1 publication

(3 citation statements)

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“…Korman hypothesized that the study of Roujeau et al may have a selection bias, favoring the inclusion of severe generalized forms. Korman also hypothesized that ethnic differences could be the cause of higher death rates in France; we did not confirm this latter hypothesis, because most other French studies found much lower death rates …”

Section: Discussionmentioning

confidence: 66%

“…After screening, 77 full-text articles were read, and 56 were included in the analysis (Figure 1). Among the 56 unique articles (12 340 unique patients), individual patient data were available for 16 studies (n = 2122) . Characteristics of included studies, published from 1978 to April 2020, are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The meta-analysis included 36 studies (Figure 2) performed in Europe (n = 10 132), including 14 in France (n = 1733), 5 in the UK (n = 2922), 3 in Sweden (n = 381), and 1 in Denmark (n = 3281) . A total of 16 studies (n = 1903) were performed in Asia, including Turkey, Iran, Kuwait, Israel, Taiwan, China, Hong Kong, Singapore, Japan, Thailand, and South Korea.…”

Section: Resultsmentioning

confidence: 99%

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Mixed Individual-Aggregate Data on All-Cause Mortality in Bullous Pemphigoid

et al. 2021

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The 1-year standardized mortality ratio (SMR) of bullous pemphigoid (BP) has been reported as 2.15 to 7.56 and lower in the US than in Europe.OBJECTIVE To estimate the worldwide 1-year SMR of BP.DATA SOURCES PubMed, Embase, Cochrane Library, Google Scholar, Lissa, and gray literature (eg, medRxiv) were screened for studies of BP published from inception to June 10, 2020, with review of reference lists. STUDY SELECTIONRetrospective and prospective studies reporting 1-year all-cause mortality rate in patients with BP and providing age statistics (eg, mean [SD]).DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted the data. The 1-year SMR was computed in studies reporting 1-year mortality by combining information on age obtained from studies with aggregate data and individual data. Risk of representativity, misclassification, and attrition bias were assessed by a custom tool. MAIN OUTCOMES AND MEASURESThe primary end point was the worldwide 1-year SMR. Secondary analysis included comparison of 1-year SMRs between continents in a meta-regression.RESULTS Three studies were performed in the US (n = 260), 1 in South America (n = 45), 16 in Asia (n = 1903), and 36 in Europe (n = 10 132) for a total of 56 unique studies and 12 340 unique patients included in the meta-analysis (mean [SD] age, 77.3 [12.7] years; 55.9% women). The mean (SD) patient age in the United States was 75.6 (13.7) years; in Asia, 73.8 (13.6) years; and in Europe, 78.1 (12.3) years. The worldwide 1-year SMR was estimated at 2.93 (95% CI, 2.59-3.28; I 2 = 85.6%) for all 56 studies. The 1-year SMR in the US was 2.40 (95% CI, 0.89-3.90; I 2 = 86.3%) for 3 studies; in Asia, 3.53 (95% CI, 2.85-4.20; I 2 = 86.3%) for 16 studies; and in Europe, 2.77 (95% CI, 2.35-3.19; I 2 = 86.3%) for 36 studies. After adjustment on the expected 1-year mortality rate, the European 1-year SMR did not differ significantly from the 1-year SMR in the United States (−0.48 vs Europe; 95% CI, −2.09 to 1.14; P = .56) and Asia (0.51 vs Europe; 95% CI, −0.56 to 1.58; P = .35). Risk of attrition bias was high (>10% censorship) in 16 studies (28.6%), low in 16 (28.6%), and unclear in 24 (42.9%). Only 4 studies (7.1%) had a sampling method guaranteeing the representativity of BP cases in a population.CONCLUSIONS AND RELEVANCE Although heterogeneity was high and overall quality of follow-up was poor, this meta-analysis confirms the high mortality rate among patients with BP.

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Section: Discussionmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 99%