A systematic review 1 including 4 studies with a total of 5 916 subjects was abstracted in DARE. Bolus pexelizumab plus infusion was associated with a significant reduction in mortality at 30 days compared with placebo (2.9% versus 4.2%; RR 0.70, 95% CI 0.52 to 0.95; n = 2476). Reductions in mortality were similar for patients with myocardial infarction and patients undergoing coronary artery bypass graft surgery. Any pexelizumab (bolus plus infusion or bolus only) was associated with a reduction in mortality at 30 days compared with placebo, but the reduction was not statistically significant (3.5% versus 4.2%; RR 0.85, 95% CI 0.66 to 1.0975). There was no overall reduction in 30-day mortality between pexelizumab bolus alone and placebo (5.2% versus 5.4%; RR 0.96, 95% CI 0.66 to 1.41). Pexelizumab bolus plus infusion was associated with a significant reduction in mortality at 180 days compared with placebo (Kaplan-Meir survival curve, p=0.05; 3 studies).
Comment: The quality of evidence is downgraded by limitations in the review quality (incomplete reporting of review methods).
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