scholarly journals Tocilizumab and Systemic Corticosteroids in the Management of COVID-19 Patients:A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Hadeel Alkofide ◽  
Abdullah Almohaizeie ◽  
Sara Almuhaini ◽  
Bashayer Alotaibi ◽  
Khalid M. Alkharfy
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Systemic Corticosteroids

scholarly journals Perioperative Systemic Corticosteroids in Orthognathic Surgery: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 75 (12) ◽  
pp. 2638-2649 ◽  
Author(s):  
Simon Jean ◽  
Pierre-Luc Dionne ◽  
Carl Bouchard ◽  
Luc Giasson ◽  
Alexis F. Turgeon
Keyword(s):  
Systematic Review ◽  
Orthognathic Surgery ◽  
Meta Analysis ◽  
Systemic Corticosteroids

scholarly journals Central nervous system infections in patients with systemic lupus erythematosus: a systematic review and meta-analysis

2022 ◽  
Vol 9 (1) ◽  
pp. e000560
Author(s):  
Kasra Molooghi ◽  
Fereshte Sheybani ◽  
Hamidreza Naderi ◽  
Zahra Mirfeizi ◽  
Negar Morovatdar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Diagnostic Tests ◽  
Activity Index ◽  
Meta Analysis ◽  
Cns Infection ◽  
Cns Infections ◽  
Systemic Corticosteroids

We aimed to conduct a systematic review and meta-analysis of studies on central nervous system (CNS) infections in patients with SLE, in order to describe their clinical and microbiological characteristics, and outcomes. A systematic search of PubMed/Medline and Embase electronic databases was performed (March 2021) to identify all published studies on CNS infections and their characteristics in patients with SLE. A random-effects model was adopted and findings were reported with 95% CI. Overall, 6 studies involving 17 751 patients with SLE and 209 SLE cases with CNS infection were included in our meta-analysis. The frequency rate of CNS infections in patients with SLE was 0.012 (95% CI: 0.008 to 0.018). Meningitis was the most common clinical syndrome (93.5%, n=109/114, 95% CI: 82.6% to 97.8%) and Cryptococcus neoformans (35.9%, n=55, 95% CI: 27.2% to 45.7%) and Mycobacterium tuberculosis (27.1%, n=43, 95% CI: 14.6% to 44.8%) were the most common causative pathogens. Our patient-pool showed a mean SLE Disease Activity Index (SLEDAI) score of 7.9 (95% CI: 6.1 to 9.6), while 92.4% (n=72/76, 95% CI: 83.0% to 96.8%) of cases were on oral systemic corticosteroids, with a prednisone equivalent mean daily dose of 30.9 mg/day (95% CI: 18.0 to 43.7). Our meta-analysis revealed a mortality rate of 29.0% (95% CI: 15.0% to 48.6%). Clinicians should maintain a high index of suspicion for cryptococcal and tuberculosis (TB) meningitis in patients with SLE with suspected CNS infection, particularly in those with higher SLEDAI and on higher doses of systemic corticosteroids. In conclusion, initiation of empiric antituberculous treatment for patients with SLE who are highly suspected to have CNS TB is warranted while awaiting the results of diagnostic tests. Antifungals might also be potentially useful empirically in patients with SLE who are suspected to have fungal CNS infections. However, with respect to side effects such as toxicity and high cost of antifungals, decision regarding early antifungal therapy should be guided by early and less time-consuming fungal diagnostic tests.

Adding nebulized corticosteroids to systemic corticosteroids for acute asthma in children: A systematic review with meta‐analysis

2020 ◽  
Vol 55 (10) ◽  
pp. 2508-2517
Author(s):  
Jose A. Castro‐Rodriguez ◽  
Mauricio A. Pincheira ◽  
Diana P. Escobar‐Serna ◽  
Monica P. Sossa‐Briceño ◽  
Carlos E. Rodriguez‐Martinez
Keyword(s):  
Systematic Review ◽  
Acute Asthma ◽  
Meta Analysis ◽  
Systemic Corticosteroids ◽  
Asthma In Children

The effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in critically ill adults: a systematic review with meta-analysis

2019 ◽  
Vol 45 (11) ◽  
pp. 1540-1549 ◽  
Author(s):  
Ethan Butler ◽  
Morten Hylander Møller ◽  
Oliver Cook ◽  
Anders Granholm ◽  
James Penketh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Meta Analysis ◽  
Systemic Corticosteroids ◽  
Critically Ill Adults ◽  
Ill Adults

scholarly journals Adjunctive Systemic Corticosteroids for Hospitalized Community-Acquired Pneumonia: Systematic Review and Meta-Analysis 2015 Update

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Nobuyuki Horita ◽  
Tatsuya Otsuka ◽  
Shusaku Haranaga ◽  
Ho Namkoong ◽  
Makoto Miki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Community Acquired Pneumonia ◽  
Systemic Corticosteroids

MO326CORTICOSTEROIDS FOR THE TREATMENT OF AUTOIMMUNE DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF REPORTED ADVERSE EVENTS IN RANDOMISED CONTROLLED TRIALS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rupert Major ◽  
Robert Grant ◽  
Keith Nockels ◽  
Mrinal Das ◽  
Jürgen Floege ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Autoimmune Disease ◽  
Adverse Events ◽  
Autoimmune Diseases ◽  
Iga Nephropathy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Systemic Corticosteroids ◽  
Increased Risk

Abstract Background and Aims Systemic corticosteroids are commonly used to treat autoimmune diseases such as immunoglobulin A (IgA) nephropathy. Corticosteroids are associated with increased risk of adverse events such as weight gain, hyperglycaemia, hypertension, infection and bone fracture occur frequently and affect safe long-term use. Adverse events of corticosteroids in clinical trials may have been historically under-reported. We aimed to perform a systematic review and meta-analysis of reported adverse events of corticosteroids in autoimmune diseases, with a particular focus on kidney pathologies. Method Pre-registered protocol systematic review (Prospero ID: CRD42020206650). The following databases were searched from 1980 to 2020: Placebo-controlled trials in adults with any form of autoimmune disease receiving intravenous or oral corticosteroids were included in the systematic review. Trial protocol major adverse events and all-cause mortality were included as the current study’s main outcome. Results After exclusion of duplicates between databases, 4490 OVID MEDLINE and 4987 Cochrane abstracts were reviewed. In total, 110 published clinical trials were identified for inclusion in the study: 14 clinical trials were in kidney autoimmune diseases, including 8 in IgA nephropathy. Results of their published adverse events, including where appropriate meta-analysis, will be presented. Specific results of those studies of kidney pathologies such as IgA nephropathy will be presented. Conclusion This systematic review with a pre-registered protocol identified 110 clinical trials examining systemic corticosteroid use versus placebo in autoimmune diseases. These results will help to understand whether the risks of systemic corticosteroids for autoimmune disease has been historically under-reported in the medical literature and whether a clear risk and benefit profile of corticosteroids in autoimmune disease can be assessed.

scholarly journals A living WHO guideline on drugs for covid-19

BMJ ◽  
2020 ◽  
pp. m3379 ◽  
Author(s):  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Thomas Agoritsas ◽  
François Lamontagne ◽  
Yee-Sin Leo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Health Care Systems ◽  
Meta Analysis ◽  
Panel Member ◽  
Non Profit ◽  
Systemic Corticosteroids ◽  
Hospitalised Patients ◽  
Care Systems ◽  
Patient Values

Abstract Clinical question What is the role of drug interventions in the treatment of patients with covid-19? New recommendation The latest version of this WHO living guidance provides strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir in patients with covid-19 regardless of disease severity. These recommendations follow the publication of results from the WHO SOLIDARITY trial Recommendations This guidance adds to recommendations for corticosteroids and remdesivir published in the previous versions, with no changes made in this update: ( a ) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19, ( b ) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19, ( c ) a conditional recommendation against remdesivir in hospitalised patients with covid-19. How this guideline was created WHO has partnered with the non-profit Magic Evidence Ecosystem Foundation (MAGIC) for methodologic support, to develop and disseminate living guidance for covid-19 drug treatments, based on a living systematic review and network analysis. An international standing Guideline Development Group (GDG) of content experts, clinicians, patients, and methodologists produced recommendations following standards for trustworthy guideline development using the GRADE approach. No competing interests were identified for any panel member. Understanding the new recommendation When moving from the to the strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir in patients with covid-19, the panel was informed by a living systematic review and network meta-analysis of 30 trials with 10 921 participants for hydroxychloroquine and seven trials with 7429 participants for lopinavir-ritonavir. The trials for both drugs included inpatients and outpatients. Moderate certainty evidence for both drugs demonstrated no reduction in mortality or need for mechanical ventilation. There was also low certainty of evidence for harm with both drugs, including diarrhoea and nausea/vomiting. The panel did not anticipate important variability when it comes to patient values and preferences. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and health care systems did not alter the recommendation. Updates This is a living guideline. It replaces earlier versions (4 September and 20 November 2020) and supersedes the BMJ Rapid Recommendations on remdesivir published on 2 July 2020. The previous versions can be found as data supplements. New recommendations will be published as updates to this guideline. Readers note This is the third version (update 2) of the living guideline ( BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity.

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