Luspatercept for patients with lower-risk myelodysplastic syndromes/neoplasms: a systematic review and meta-analysis.

This systematic reviewand meta-analysisaimed to evaluate the efficacy and safety of luspatercept in TD LR-MDS.

本系统评价和荟萃分析旨在评估 luspatercept 在依赖输血的低危骨髓增生异常综合征（LR-MDS）中的疗效和安全性。

Six databases were searched through March 2025 to find relevant material. Studies were screened and extracted by 2 independent authors.

通过六个数据库检索至2025年3月以寻找相关资料。研究由两位独立作者进行筛选和提取。

A total of 20 studies encompassing 3455 patients were included in the analysis.

分析共纳入了20项研究，涵盖3455名患者。

The pooled 8-week transfusion independence (TI) rate was 51.2% (95% confidence interval[CI], 39.9-60.4; I2 = 94.9%), with higher rates observed among ring sideroblast-positive (RS+) patients (57.8%; 95% CI, 47.4-67.7; I2 = 86%) and those with low transfusion burden (LTB; 72.9%; 95% CI, 60.4-82.6; I2 = 0%).

综合分析显示，8周输血独立（TI）率为51.2%（95%置信区间[CI]，39.9-60.4；I2 = 94.9%），其中环形铁粒幼细胞阳性（RS+）患者的TI率更高（57.8%；95% CI, 47.4-67.7；I2 = 86%），以及输血负担低（LTB）的患者TI率更高（72.9%；95% CI, 60.4-82.6；I2 = 0%）。

The 12-week and 24-week TI rates were 57.0% (95% CI, 48.1-65.5; I2 = 90%) and 35.8% (95% CI, 28.7-43.6; I2 = 82.1%), respectively.

12周和24周的TI率分别为57.0%（95% CI, 48.1-65.5；I2 = 90%）和35.8%（95% CI, 28.7-43.6；I2 = 82.1%）。

Hematologic improvement-erythroid was achieved in 51.3% of patients (95% CI, 41.3%-61.2%; I2 = 93%).

51.3%的患者实现了血液学改善-红细胞生成（95% CI，41.3%-61.2%；I2 = 93%）

The most frequent adverse events were peripheral edema (17.8%; 95% CI, 11.4-26.8), diarrhea (15.6%; 95% CI, 8.2-27.7), and fatigue (11.4%; 95% CI, 5.4-22.6).

最常见的不良事件是外周水肿（17.8%；95% CI，11.4-26.8），腹泻（15.6%；95% CI，8.2-27.7）和疲劳（11.4%；95% CI，5.4-22.6）

Serious adverse events occurred in 28.0% of patients (95% CI, 12.8-50.7; I2 = 97.2%).

28.0%的患者出现了严重不良事件（95%置信区间，12.8-50.7；I2 = 97.2%）。

Luspatercept is an effective and well-tolerated treatment for anemia in TD LR-MDS, especially in patients with RS+ and LTB.

Luspatercept是治疗TD LR-MDS贫血的有效且耐受性良好的治疗方式，尤其适用于RS+和LTB的患者。

Its favorable safety profile and high TI rates, particularly in erythropoiesis-stimulating agent-naïve populations, support its use in the frontline setting.

其良好的安全性和高转铁率，特别是在未使用促红细胞生成素的患者中，支持其作为一线治疗的使用。