Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis

Abstract Background Currently, there is no standard therapy for idiopathic retroperitoneal fibrosis, so a systematic review was undertaken to assess the effectiveness of different treatment approaches. Methods A comprehensive search of English and German literature from 1980 to 2021 was conducted us...

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Main Authors: Annik Steimer, Mike O. Becker
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Rheumatology
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Online Access:https://doi.org/10.1186/s41927-024-00445-z
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author Annik Steimer
Mike O. Becker
author_facet Annik Steimer
Mike O. Becker
author_sort Annik Steimer
collection DOAJ
description Abstract Background Currently, there is no standard therapy for idiopathic retroperitoneal fibrosis, so a systematic review was undertaken to assess the effectiveness of different treatment approaches. Methods A comprehensive search of English and German literature from 1980 to 2021 was conducted using PubMed, Embase, and PreMedline. To be included, studies must have had a minimum of two patients employing the same treatment approach and reporting relevant treatment outcomes. A meta-analysis with a subgroup analysis was conducted for the primary outcomes “regression of fibrosis,” “freedom from ureteric stents” and “relapse rate,” and the secondary outcome “clinical improvement.” The lack of homogeneous data prevented a subgroup analysis for the primary outcome “improvement in renal function.” Results The search resulted in a total of 3818 articles, of which 108 were selected for qualitative analysis involving a total of 1408 patients. For the meta-analysis 83 studies were included involving 1044 patients. The summary effect size of the outcomes “regression of fibrosis,” “freedom from ureteric stent” and “clinical improvement” was high with values between 80–97.9%. The summary relapse rate across studies was 18.1%. Subgroup analysis revealed no statistically significant differences in the effectiveness of treatment approaches for the outcomes “regression of fibrosis” (QM = 2.72, p = 0.74), “freedom from ureteric stent” (QM = 7.21, p = 0.13), “relapse rate” (QM = 11.34, p = 0.08) and “clinical improvement” (QM = 9.54, p = 0.15). Conclusions Considering the lack of clear evidence indicating that one drug is more effective than the other, the treatment choice should depend on factors such as the potential side effects of different drug therapies, patient comorbidities, and clinician expertise. The review protocol is registered on PROSPERO under the identification number CRD42019115744.
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spelling doaj-art-7c13e66814044170b795fa6abf799cf72025-02-09T12:59:25ZengBMCBMC Rheumatology2520-10262025-02-019111610.1186/s41927-024-00445-zTreatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysisAnnik Steimer0Mike O. Becker1Department of Rheumatology, University Hospital ZurichDepartment of Rheumatology, University Hospital ZurichAbstract Background Currently, there is no standard therapy for idiopathic retroperitoneal fibrosis, so a systematic review was undertaken to assess the effectiveness of different treatment approaches. Methods A comprehensive search of English and German literature from 1980 to 2021 was conducted using PubMed, Embase, and PreMedline. To be included, studies must have had a minimum of two patients employing the same treatment approach and reporting relevant treatment outcomes. A meta-analysis with a subgroup analysis was conducted for the primary outcomes “regression of fibrosis,” “freedom from ureteric stents” and “relapse rate,” and the secondary outcome “clinical improvement.” The lack of homogeneous data prevented a subgroup analysis for the primary outcome “improvement in renal function.” Results The search resulted in a total of 3818 articles, of which 108 were selected for qualitative analysis involving a total of 1408 patients. For the meta-analysis 83 studies were included involving 1044 patients. The summary effect size of the outcomes “regression of fibrosis,” “freedom from ureteric stent” and “clinical improvement” was high with values between 80–97.9%. The summary relapse rate across studies was 18.1%. Subgroup analysis revealed no statistically significant differences in the effectiveness of treatment approaches for the outcomes “regression of fibrosis” (QM = 2.72, p = 0.74), “freedom from ureteric stent” (QM = 7.21, p = 0.13), “relapse rate” (QM = 11.34, p = 0.08) and “clinical improvement” (QM = 9.54, p = 0.15). Conclusions Considering the lack of clear evidence indicating that one drug is more effective than the other, the treatment choice should depend on factors such as the potential side effects of different drug therapies, patient comorbidities, and clinician expertise. The review protocol is registered on PROSPERO under the identification number CRD42019115744.https://doi.org/10.1186/s41927-024-00445-zIdiopathic retroperitoneal fibrosisSystematic reviewMeta-analysisTreatment
spellingShingle Annik Steimer
Mike O. Becker
Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
BMC Rheumatology
Idiopathic retroperitoneal fibrosis
Systematic review
Meta-analysis
Treatment
title Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
title_full Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
title_fullStr Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
title_full_unstemmed Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
title_short Treatment approaches for idiopathic retroperitoneal fibrosis: a systematic review with meta-analysis
title_sort treatment approaches for idiopathic retroperitoneal fibrosis a systematic review with meta analysis
topic Idiopathic retroperitoneal fibrosis
Systematic review
Meta-analysis
Treatment
url https://doi.org/10.1186/s41927-024-00445-z
work_keys_str_mv AT anniksteimer treatmentapproachesforidiopathicretroperitonealfibrosisasystematicreviewwithmetaanalysis
AT mikeobecker treatmentapproachesforidiopathicretroperitonealfibrosisasystematicreviewwithmetaanalysis