Journal of Immunology Research

Review Article

Monoclonal Antibodies versus Histone Deacetylase Inhibitors in Combination with Bortezomib or Lenalidomide plus Dexamethasone for the Treatment of Relapsed or Refractory Multiple Myeloma: An Indirect-Comparison Meta-Analysis of Randomized Controlled Trials

Table 6

Meta-analysis outcome of common at least grade 3 adverse events comparing monoclonal antibodies versus HDACis.


	Number of trials included	Risk ratio (95% CI)			Tests for publication bias
		MAb group versus control group	HDACi group versus control group	MAb group versus HDACi group (indirect comparison)	Egger’s test ( value)	Begg’s test ( value)

Hematological adverse events
Anemia	6 (trials 1, 2, 3, 4, 5, and 6)	0.81 (0.66–1.00)	1.07 (0.84–1.35)	0.79 (0.59–1.07)	0.95	1.00
Neutropenia	5 (trials 1, 2, 3, 5, and 6)	1.36 (0.77–2.41)	1.83 (0.70–4.81)	0.70 (0.51–0.96)	0.30	0.46
Thrombocytopenia	6 (trials 1, 2, 3, 4, 5, and 6)	1.02 (0.75–1.39)	2.05 (1.79–2.34)	0.35 (0.23–0.53)	0.03	0.26
Nonhematological adverse events
Nausea or vomiting	4 (trials 2, 4, 5, and 6)	2.57 (0.66–9.99)	3.43 (0.91–12.91)	0.28 (0–398.63)	0.76	1.00
Peripheral neuropathy	4 (trials 1, 4, 5, and 6)	0.71 (0.40–1.27)	1.16 (0.85–1.58)	0.63 (0.35–1.14)	0.14	1.00
Upper respiratory tract infection	4 (trials 1, 2, 5, and 6)	1.38 (0.44–4.32)	2.56 (1.08–6.07)	0.71 (0.04–11.47)	0.31	0.40
Pyrexia	6 (trials 1, 2, 3, 4, 5, and 6)	0.89 (0.46–1.70)	0.91 (0.39–2.12)	1.02 (0.32–3.22)	0.47	1.00
Fatigue	6 (trials 1, 2, 3, 4, 5, and 6)	1.39 (0.95–2.04)	2.29 (1.74–3.02)	0.37 (0.17–0.82)	0.97	1.00
Constipation	6 (trials 1, 2, 3, 4, 5, and 6)	1.49 (0.53–4.16)	1.43 (0.55–3.73)	0.70 (0.05–10.53)	0.78	0.71
Diarrhea	6 (trials 1, 2, 3, 4, 5, and 6)	1.63 (1.03–2.58)	2.56 (1.93–3.41)	0.42 (0.15–1.19)	0.47	1.00

MAb: monoclonal antibody; HDACi: histone deacetylase inhibitor. Trials included: trial 1 represents Palumbo et al. (2016); trial 2 represents Dimopoulos et al. (2016); trial 3 represents Lonial et al. (2015); trial 4 represents Jakubowiak et al. (2016); trial 5 represents San-Miguel et al. (2014); trial 6 represents Dimopoulos et al. (2013).