Immunomodulatory and immunosuppressive drug protocols in the treatment of canine primary immune thrombocytopenia, a scoping review

Table 4 Synthesis of results of eligible studies reporting outcomes from immunomodulatory and immunosuppressive drug protocols in the treatment of canine primary ITP

Study	Bianco et al. [28]	Balog et al. [18]	Huang et al. [29]	Putsche and Kohn [8]	Kohn et al. [10]	Yau and Bianco [17]
Characteristics	Randomized, double-blinded, placebo-controlled, clinical trial	(Randomized), multicenter, blinded, clinical trial	Retrospective (case–control study)	Retrospective case series with a nested cohort study	Prospective case series	Prospective case series
Critical appraisal	LOE 1⁺⁺ Very small number of dogs in each group Strongly supportive enrollment Low statistical power and risk of confounding	LOE 1⁺ Small number of dogs in each group Uncertain enrollment Low statistical power and risk of confounding	LOE 3 Small to very small number of dogs in each group Uncertain enrollment	LOE 3 Small to very small number of dogs in each group Uncertain enrollment	LOE 3 Very small number of dogs in each group Uncertain enrollment	LOE 3 Very small number of dogs in each group Uncertain enrollment
Results of individual sources	Tx₁: CS + hIVIG C: CS Improvement^a(Tx₁): Platelet recovery Duration of hospitalization No improvement^b: Complete platelet recovery Survival 6-month	Tx₁: CS + hIVIG C: CS + Vinc No improvement^b: Platelet recovery Duration of hospitalization Survival to discharge Survival 6-month Survival 1-year	N/A	Tx₁: CS Tx₂: CS + Vinc Tx₃: CS + Aza Tx₄: CS + Cyclo C: Tx₂ + Tx₃ + Tx₄ No improvement^b: Mortality 1684-days Relapse 1684-days	N/A	N/A

Summary of the study characteristics, the level of evidence and methodological quality by critical appraisal, and the results of comparative studies
Synthesis of results of eligible studies reporting outcomes from immunomodulatory and immunosuppressive drug protocols in the treatment of canine primary ITP. Summary of the study characteristics, the level of evidence and methodological quality by critical appraisal, and the results of comparative studies
Aza, azathioprine; C, comparator; Cyclo, cyclosporine; CS, Corticosteroids; (case–control study), investigating association between recent vaccination and ITP but case series for the therapeutic intervention; hIVIG, human intravenous immunoglobulin; (randomized), study claimed to be randomized but procedure not described; LOE, level of evidence; Tx_1-4, Immunomodulatory and/or immunosuppressive treatment; Vinc, Vincristine
^aImprovement in outcome was defined when a significant difference in outcome measures between treatment and comparator was detected and if the treatment was superior to the comparator
^bNo improvement in outcome was defined when no significant difference in outcome measures between treatment and comparator was detected
N/A, Non-applicable, as these studies did not provide statistical information between groups

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