• Wei Huang, Yuanji Ma, Lingyao Du, Shuang Kang, Chang-Hai Liu, Lang Bai, Xuezhong Lei, and Hong Tang.
• From the Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
• Ann Saudi Med. 2021 Nov 1; 41 (6): 383-391.

BackgroundThe safety and efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute-on-chronic liver failure (ACLF) remain uncertain. Therefore, we conducted a meta-analysis to draw a firmer conclusion.MethodsWe searched the Cochrane library, PubMed, Embase, and China Biology Medicine disc to identify relevant RCTs performed before January 2020. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were calculated using a random effects model.Main Outcome MeasuresRRs (95% CI) for 1-, 2-, and 3-month survival rates.Sample SizeSix RCTs, including three open-label studies.ResultsThe six studies included 246 subjects (121 in a G-CSF group and 125 in a control group). G-CSF administration significantly improved the 1-, 2-, and 3-month survival rates in patients with ACLF. The pooled RRs (95% CI, P) were 0.43 (0.27-0.69, P=.0004), 0.44 (0.32-0.62, P<.00001), and 0.39 (0.22-0.68, P=.0009), respectively.ConclusionG-CSF may be beneficial and effective in the treatment of ACLF, but further studies are needed to verify this conclusion.LimitationsThe sample size was small, and studies were restricted to countries in Asia.Prospero Registration NumberCRD42021225681 CONFLICT OF INTEREST: None.

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