Abstract: Objective To systematically evaluate the efficacy and safety of Ixazomib in the treatment of multiple myeloma (MM). Methods Web of science, PubMed, Embase, The Cochrane Library, ClinicalTrials.gov were searched. Data was extracted between their inception and June 2022 and all the documents were manually retrieved. After literature selection, evaluation quality and data extraction according to inclusion and exclusion criteria, meta-analysis was performed using RevMan5.4 software. Results Seven RCTs involving a total of 3 094 patients were included. Meta-analysis showed that Ixazomib reduced the risk of disease progression in MM patients (HR=0.75, 95%CI：0.68~0.83, P<0.00001) and reduced the risk of disease progression in high-risk cytogenetic patients (HR=0.73,95%CI：0.57~0.94, P=0.01), but did not significantly reduce the risk of death (HR=0.94, 95%CI：0.82~1.08, P=0.37). Ixazomib had an increased risk of any grade ≥ 3 adverse events (RR=1.18, 95%CI：1.11~1.25, P<0.000 01). The main increased adverse events were thrombocytopenia, diarrhea, rash and peripheral neuropathy. Conclusion Ixazomib has significant progression-free survival (PFS) benefit in patients with MM, and can significantly reduce the risk of disease progression in high-risk cytogenetic patients. With limited toxicity and convenient oral therapy, it is an important treatment choice for patients with multiple myeloma.

Key words: Multiple myeloma, Ixazomib, Efficacy, Safety, Meta-analysis