{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:22:14Z","timestamp":1793467334974,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,5,22]],"date-time":"2012-05-22T00:00:00Z","timestamp":1337644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Primary immune thrombocytopenia (<jats:styled-content style=\"fixed-case\">ITP<\/jats:styled-content>) is an acquired immune\u2010mediated disorder with absence of any underlying cause. Corticosteroids are the standard initial treatment. Splenectomy is the main second\u2010line treatment. A trend to delay or avoid splenectomy has developed thanks to new agents like rituximab. Few studies have assessed the response rate to rituximab in chronic <jats:styled-content style=\"fixed-case\">ITP<\/jats:styled-content>. We performed the first meta\u2010analysis of randomized clinical trials and observational studies on rituximab as an effective splenectomy\u2010avoiding option in adult chronic <jats:styled-content style=\"fixed-case\">ITP<\/jats:styled-content>. Overall methods were adapted from published guidelines for meta\u2010analysis (meta\u2010analysis of observational studies in epidemiology and preferred reporting items for systematic reviews and meta\u2010analyses). Two haematologist investigators carried out study selection and data extraction independently, recording overall response rate (<jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content>) and complete response (<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>) as primary assessment criteria. Of 364 records were identified through electronic databases. Of 19 retrospective or prospective observational studies were retained after removing duplicate studies and full\u2010text analyses. The <jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content> was 57% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 48\u201365), for 368 non\u2010splenectomized patients after rituximab; <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> was 41% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b733\u20130\u00b751) for 346 patients. Results were stable for <jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> in all sub\u2010analyses. In univariate or multivariate mixed\u2010effect meta\u2010regression, age was the most relevant effect. According to our results, rituximab should be used in earlier in non\u2010splenectomized patients.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2012.09169.x","type":"journal-article","created":{"date-parts":[[2012,5,22]],"date-time":"2012-05-22T04:49:36Z","timestamp":1337662176000},"page":"386-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Rituximab before splenectomy in adults with primary idiopathic thrombocytopenic purpura: a meta\u2010analysis"],"prefix":"10.1111","volume":"158","author":[{"given":"Sophie","family":"Auger","sequence":"first","affiliation":[{"name":"Haematology Department University Hospital Saint\u2010Eloi  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohan","family":"Duny","sequence":"additional","affiliation":[{"name":"Biostatistical Unit University of Medicine Inserm EA 2415  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Fran\u00e7ois","family":"Rossi","sequence":"additional","affiliation":[{"name":"Haematology Department University Hospital Saint\u2010Eloi  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Quittet","sequence":"additional","affiliation":[{"name":"Haematology Department University Hospital Saint\u2010Eloi  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,5,22]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-008-0574-9"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-1-200701020-00006"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2009.11.008"},{"key":"e_1_2_5_5_1","first-page":"4681","article-title":"Efficacy of early use of rituximab in steroid refractory severe immune thrombocytopenic purpura in adult patients: single institution experience from Saudi Arabia","volume":"116","author":"Badar T.","year":"2010","journal-title":"Blood (ASH Annual Meeting Abstracts)"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4161\/mabs.1.6.9884"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190902779257"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-10-186999"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra010501"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2010.01561.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1130-6343(09)72973-3"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04889.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e3282c8ca50"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21029"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0317-3"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-01-131029"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21512"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-03-1168"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-010-0753-z"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1999.tb01750.x"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2008.01100.x"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_5_27_1","first-page":"1273","article-title":"Rituximab in the treatment of refractory autoimmune cytopenias in adults","volume":"90","author":"Narat S.","year":"2005","journal-title":"Haematologica"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-08-302984"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-005-0073-1"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.11709"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225565"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0902-4441.2003.00196.x"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-162503"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-007-8020-7"},{"issue":"12","key":"e_1_2_5_35_1","first-page":"99","article-title":"A pilot study of the anti\u2010CD20 monoclonal antibody rituximab in patients with refractory immune thrombocytopenia","volume":"27","author":"Saleh M.N.","year":"2000","journal-title":"Seminars in Oncology"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10253"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0335-1"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.4.952"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-02-0392"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-12-129262"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-010-1066-2"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_5_43_1","first-page":"72","article-title":"Efficacy and safety of splenectomy in immune thrombocytopenic purpura: long\u2010term results of 402 cases","volume":"90","author":"Vianelli N.","year":"2005","journal-title":"Haematologica"},{"key":"e_1_2_5_44_1","first-page":"538","article-title":"B\u2010cell compartment as the selective target for the treatment of immune thrombocytopenias","volume":"88","author":"Zaja F.","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-229815"},{"key":"e_1_2_5_46_1","first-page":"2514","article-title":"Interim analysis on a Dutch HOVON multicenter randomised open label phase II trial on 3 rituximab dosing schemes in chronic ITP patients","volume":"116","author":"Zwaginga J.","year":"2010","journal-title":"Blood (ASH) Annual Meeting Abstracts"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2141.2012.09169.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2141.2012.09169.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T05:07:15Z","timestamp":1700543235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2141.2012.09169.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,22]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1111\/j.1365-2141.2012.09169.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2141.2012.09169.x","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,22]]},"assertion":[{"value":"2012-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-04-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-05-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}