Table 5.6GRADE profile: Is primary prophylaxis with pegfilgrastim more effective than primary prophylaxis with filgrastim at improving outcomes for patients at risk of neutropenic sepsis

Quality assessmentNo of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsPegfilgrastimFilgrastimRelative
(95% CI)		Absolute
Mortality - not reported
0-----none----
Febrile neutropenia
5randomised trialsserious1no serious inconsistencyno serious indirectnessserious2,3none35/315
(11.1%)		51/291
(17.5%)		RR 0.66 (0.44 to 0.98)60 fewer per 1000 (from 4 fewer to 98 fewer)LOW
Antibiotic resistance - not reported
0-----none----
length of hospital stay - not reported
0-----none----
Quality of life - not reported
0-----none----
1

2/5 trials had double blinding, 2/5 were open label. 3/5 trials were phase II studies

2

Low number of events

3

95% confidence interval around the pooled estimate of effect includes both no effect and appreciable benefit or appreciable harm.

From: 5, Reducing the risk of septic complications of anticancer treatment

Cover of Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients
Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients.
NICE Clinical Guidelines, No. 151.
National Collaborating Centre for Cancer (UK).
Copyright © National Collaborating Centre for Cancer, 2012.

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