American journal of hematology
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Review Meta Analysis
Thalidomide versus bortezomib based regimens as first-line therapy for patients with multiple myeloma: a systematic review.
Thalidomide (T) or bortezomib (B) in combination with melphalan plus prednisone (MP) is superior to MP as first line therapy for previously untreated myeloma. However, direct head-to-head comparison of Melphalan, Prednisone plus Bortezomib (MPB) versus Melphalan, Prednisone plus Thalidomide (MPT) is lacking. We performed an indirect meta-analysis to assess the treatment effects of MPB versus MPT via common comparator MP using the systematic review and meta-analytical techniques. ⋯ The indirect comparison of MPB versus MPT showed no difference between MPB versus MPT for all outcomes but a significant benefit for complete response (RR 2.34, 95% CI 1.12-4.90), and grade III/IV adverse events (RR 0.53, 95% CI 0.38-0.73) favoring MPB. There is an uncertainty about definitive superiority of one type of regimen over the other. Therefore, direct head-to-head comparison between these competing regimens is warranted.