Efficacy of eculizumab discontinuation in atypical hemolytic uremic syndrome: a systematic review and meta-analysis.

Although effective, these therapies are costly, and increase susceptibility to infections, notably meningococcal disease, raising concerns about long-term use.

尽管这些疗法有效，但它们成本高昂，并增加了感染的风险，尤其是脑膜炎球菌疾病，这引发了对长期使用这些疗法的担忧。

The optimal duration of complement inhibition remains unclear, prompting efforts to explore the possibility of treatment discontinuation.

补体抑制的最佳持续时间尚不明确，这促使人们努力探索停药的可能性。

We conducted a systematic reviewand meta-analysisto evaluate the benefits and risks of stopping terminal complement inhibitor therapy in aHUS.

我们进行了一项系统评价和荟萃分析，以评估在aHUS中停止终末补体抑制剂治疗的益处和风险。

We searched PubMed, Scopus, and CINAHL for studies of continuing vs stopping anticomplement treatment in aHUS.

我们在PubMed、Scopus和CINAHL中检索了关于在aHUS中继续使用与停止抗补体治疗的研究。

Of 3303 identified studies, 13 observational studies (3 case control and 10 cohort) comprising 584 patients were included.

在识别的3303项研究中，包括了13项观察性研究（3项病例对照研究和10项队列研究），共涵盖584名患者。

Overall, continuing treatment was associated with an ∼76% reduction in the odds of relapse (odds ratio [OR], 0.24; 95% confidence interval[CI], 0.09-0.62; P = .01).

总体而言，继续治疗与复发几率降低约76%相关（比值比[OR]，0.24；95%置信区间[CI]，0.09-0.62；P = .01）。

Study design influenced results: cohort studies showed a more modest effect (OR, 0.40 [95% CI, 0.15-1.09]), whereas case-control studies reported inflated estimates (OR, 0.04; 95% CI, 0.02-0.08; subgroup interaction P = .03).

研究设计影响了结果：队列研究显示了较为温和的效果（OR，0.40 [95% CI，0.15-1.09]），而病例对照研究报告了夸大的估计值（OR，0.04；95% CI，0.02-0.08；亚组交互作用P = .03）。

When the analysis was restricted to cohort studies, the effects became uncertain (statistically nonsignificant with large CIs, indicating the possibility that outcomes with continued treatment could be either superior or inferior to those observed after treatment withdrawal, or that there may be no true difference in relapse rates between the 2 therapies).

当分析仅限于队列研究时，效果变得不确定（统计学上不显著，置信区间大，表明持续治疗的结果可能优于或劣于停药后的观察结果，或者两种疗法的复发率之间可能没有真正的差异）。

Although current evidence is insufficient to provide personalized guidance on which patients with aHUS can safely discontinue anticomplement therapy, findings from higher-quality studies, which show no statistical difference between continued and discontinued treatment, suggest that discontinuation may be possible for at least some patients.

尽管目前的证据不足以提供关于哪些aHUS患者可以安全停用抗补体治疗的个性化指导，但来自质量较高的研究的发现表明，持续治疗和停药之间没有统计学差异，这表明至少对某些患者来说，停药可能是可能的。