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To synthesize the available clinical evidence to evaluate the efficacy and safety of lanadelumab,avoralstat, berotralstat, garadacimab, donidalorsen and plasma-derived C1-esterase inhibitor for preventing the acute attack of hereditary angioedema （HAE） using network meta-analysis.
PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for randomized controlled trials that evaluated the efficacy and safety of these six drugs in the prevention of the acute attack of HAE from the establishment of the library to January 2024. A network meta-analysis （NMA） was performed by Stata 17.0 and R 4.3.2.
A total of 10 randomized controlled trials fulfilling the inclusion criteria were retrieved, including 619 patients. NMA showed that five kinds of drugs were superior to placebo in reducing the number of acute HAE attacks every 4 weeks （P<0.05）. The surface under the cumulative ranking sorting results showed that garadacimab was the most efficacious （MD=2.59, 95%CI: 1.38 to 3.79）. For the comparison between placebo and these drugs, there were no significant differences in the incidence of adverse events and serious adverse events. The SUCRA indicated that lanadelumab had the lowest incidence of adverse events and donidalorsen had the lowest incidence of serious adverse events.
Garadacimab is the most effective drug of all these first-line agents used to prevent acute attacks of HAE, while lanadelumab has better safety.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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