Meta-Analysis and Bayesian Meta-Analysis for Myeloma and Stroke Xiaoping Liu1,*, Jing Tian1,**, Yuncen A. He#, Liang Shao2,*, Shangqin Liu2,*, Colin K. He2,## 1 The first Authors * Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P. R. China ** Xiang Yang NO.1 People’s Hospital, Affiliated Hospital of Hubei University of Medicine, Hubei, China # School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA ## Orient Health Care, NY, USA 2 Corresponding Author Key words: Bayesian Meta-Analysis, Meta-Analysis; multiple myeloma, autologous stem-cell transplantation; stroke, cerebral ischemia, clopidogrel

Meta-analysis and Bayesian meta-analysis were carried out for myeloma and stroke therapy. Phase ? studies were analyzed to evaluate the efficacy and safety of bortezomib-based versus non-bortezomib-based post-transplantation therapy in patients with multiple myeloma (MM). The outcome measures included response rate, progression-free survival (PFS), overall survival (OS), and adverse events (AEs). Three RCTs containing 1518 participants were included in myeloma study. Response rates in terms of ORR (overall response rate) and CR/nCR (completes response and near complete response) were significantly higher in bortezomib-based group (ORR:93.4% versus 89.4%, odds ratio (OR) = 1.85, 95% CI: 1.29-2.64; CR/nCR:53.0% versus 40%, OR = 1.75, 95% CI: 1.42-2.15) than those in non-bortezomib-based group. Pooled hazard ratio (HR) for PFS favored bortezomib-based therapy over non-bortezomib-based therapy (HR = 0.73, 95% CI: 0.67-0.81), while no statistically significant difference could be found between the two groups regarding the pooled HR for 3-year OS. We also compared the safety and efficacy of adding clopidogrel(Clop) to aspirin(ASA) versus aspirin alone in patients with transient ischemic attack(TIA)/minor stroke attack. The major outcome is recurrent stroke, the secondary outcomes are myocardial infarction (MI) and vascular mortalities, and safety outcome is major hemorrhagic events. At last five RCTs studies involving 9527 patients were included. In comparison to ASA, Clop+ASA significantly reduced the incidence of recurrent stroke (RR=0.76, 95% CI, 0.67-0.87), and did not increase the incidence of MI and vascular mortalities (RR=1.08, 95% CI, 0.83-1.41) or major hemorrhagic events (RR=1.55, 95% CI, 0.72-3.36). Thus Clop+ASA appear to be safe and effective in reducing stroke recurrence. It is also associated with an insignificant trend of increasing MI, vascular mortalities, and major hemorrhagic events. The results were validated by Bayesian meta-analysis when studies were a few or confidence interval on margin.