Nebulised granulocyte-macrophage colony-stimulating factor (GM-CSF) in autoimmune pulmonary alveolar proteinosis: a systematic review and meta-analysis.

"Conflict of interest: All authors have nothing to disclose."

"We performed a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines [], using a protocol prospectively registered with PROSPERO (CRD42021231328). Methods:: We conducted a systematic review and meta-analysis searching Embase, CINAHL, MEDLINE and Cochrane Collaborative databases (1946–1 April 2022). Studies included patients aged >18 years with aPAP receiving nebulised GM-CSF treatment and a comparator cohort. Exclusion criteria included secondary or congenital pulmonary alveolar proteinosis, GM–CSF allergy, active infection or other serious medical conditions. The protocol was prospectively registered with PROSPERO (CRD42021231328). Outcomes assessed were St George's Respiratory Questionnaire (SGRQ), 6-min walk test (6MWT), gas exchange (diffusing capacity of the lung for carbon monoxide (DLCO) % predicted) and arterial–alveolar oxygen gradient."