%0 Generic %A Lanznaster, Débora %A Bejan-Angoulvant, Theodora %A Patin, Franck %A Andres, Christian R. %A Vourc’h, Patrick %A Corcia, Phillipe %A Blasco, HÉlÉne %D 2020 %T Plasma creatinine and amyotrophic lateral sclerosis prognosis: a systematic review and meta-analysis %U https://tandf.figshare.com/articles/dataset/Plasma_creatinine_and_amyotrophic_lateral_sclerosis_prognosis_a_systematic_review_and_meta-analysis/7969715 %R 10.6084/m9.figshare.7969715.v2 %2 https://tandf.figshare.com/ndownloader/files/14837897 %2 https://tandf.figshare.com/ndownloader/files/14837900 %K ALS %K biomarkers %K plasma creatinine %K prognosis %K systematic review %X

Background: Plasma creatinine has been described as a prognostic biomarker for Amyotrophic Lateral Sclerosis (ALS), but with conflicting results in the literature. We performed a systematic review followed by a meta-analysis to address this question. Methods: We performed a systematic review of Pubmed, Embase and Cochrane databases and retrieved 14 distinct cohorts (19 studies) reporting results regarding the relationship between plasma creatinine and a clinical marker for ALS progression, notably ALSFRS (ALS Functional Rating Scale) and survival. Results: For baseline plasma creatinine, mortality risk was 28% lower when creatinine was higher than 88.4 µmol/L (hazard ratio (HR): 0.72; 95% confidence interval (CI): 0.58 to 0.88; p = 0.0003) and was 25% lower if creatinine was above versus below the median (HR: 0.75; 95% CI: 0.63 to 0.89; p = 0.0008). We found a significant positive correlation between plasma creatinine at baseline and functional score, and between creatinine decline and functional score decline (p < 0.0001 for both); but a negative correlation between plasma creatinine and functional score decline (p = 0.033). The overall quality of the studies was low mainly due to potential attrition bias, and several studies did not report analyzable results raising concern regarding a potential reporting bias. Conclusions: Plasma creatinine seems to be a promising prognostic biomarker for ALS. However, new studies with sound methodology and standardized criteria for the evaluation of ALS progression should be conducted to validate plasma creatinine as a clinical biomarker for ALS prognosis.

%I Taylor & Francis