Quality of Life, Adverse Events, and Reintervention Outcomes after Laparoscopic Radiofrequency Ablation for Symptomatic Uterine Fibroids: A Meta-Analysis

2019 ◽  
Vol 26 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Letao Lin ◽  
Haocheng Ma ◽  
Jian Wang ◽  
Haitao Guan ◽  
Min Yang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiofrequency Ablation ◽  
Adverse Events ◽  
Meta Analysis ◽  
Uterine Fibroids ◽  
Laparoscopic Radiofrequency Ablation

scholarly journals Acupuncture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030713 ◽  
Author(s):  
Dacheng Li ◽  
Li Zhu ◽  
Daming Liu
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Adverse Events ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Oesophageal Reflux ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Oesophageal Reflux Disease

IntroductionRefractory gastro-oesophageal reflux disease (rGORD) is a common disease, affecting patients’ quality of life. Since conventional medicines have limitations, like low effective rates and adverse events, acupuncture may be a promising therapy for rGORD. While no related systematic review has been published, the present study is designed to evaluate the efficacy and safety of acupuncture for rGORD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from establishment of the database to 31 August 2019. There will be no limitations on language, and all articles will be screened and collected by two reviewers independently. RevMan V.5.3.5 software will be used for meta-analysis, and the conduction of study will refer to the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. The efficacy and safety of acupuncture for rGORD will be evaluated based on outcomes, including global symptom improvement, oesophageal sphincter function test measured by high-resolution manometry, quality of life, recurrence rate and adverse events.Ethics and disseminationThere is no necessity for this study to acquire an ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42018111912.

scholarly journals Efficacy and safety of guselkumab for the treatment of patients with moderate-to-severe plaque psoriasis: A metaanalysis of randomized clinical trials

2020 ◽  
Vol 19 (2) ◽  
pp. 433-440
Author(s):  
Xing-Bao Tao ◽  
Yin-Qiu Huang ◽  
Yi-Hong Zhou ◽  
Lv-Lang Zhang ◽  
Yao-Kai Chen
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Adverse Events ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Double Blind ◽  
Severe Plaque Psoriasis ◽  
Central Registry

Purpose: To conduct a systematic analysis on data from randomized controlled trials (RCTs) on different doses of guselkumab, and provide high-quality evidence for its use in the treatment of patients with moderate-to-severe plaque psoriasis (PsO). Methods: Related studies were searched using online search engines including MEDLINE, PubMed, and central registry of Cochrane controlled trials from January 2001 to October 2017. Only randomized, placebo-controlled, double-blind clinical trials involving guselkumab- and placebo-treated PsO subjects were included. Results: Five eligible double-blind, randomized, and placebo-controlled trials involving patients with moderate-to-severe PsO subjects treated with guselkumab were included. Compared with the placebo groups, the proportion of patients with improvements in Psoriasis Area and Severity Index (PASI) 75 (RR= 12.14; 95% CI= 9.11-16.16; p < 0.001); PASI 90 (RR= 23.26; 95% CI =14.57-37.13; p < 0.001), and PASI 100 (RR = 37.66; 95% CI = 15.81-89.69; p < 0.001) were significantly higher than those in guselkumab-treated groups. Furthermore, the guselkumab-treated groups showed significant decreases in Physician’s Global Assessment (PGA) score (RR = 10.46; 95% CI = 7.96-13.83; p < 0.001) and the Dermatology Life Quality Index (DLQI) score (SMD = -1.3; 95% CL = -1.4 to -1.19; p < 0.001), when compared with the placebo groups. However, there were no significant differences in adverse events (AEs) (RR = 1.01; 95% CL = 0.93-1.11; p > 0.05); severe adverse events (SAEs) (RR = 1.32; 95% CI =0.69-2.54; p > 0.05) and study discontinuations (RR = 0.79; 95% CI = 0.42-1.48; p > 0.05) between the two groups. Conclusion: This meta-analysis summarizes available evidence for the use of guselkumab in psoriasis. The results suggest that guselkumab is superior to placebo in moderate-to-severe psoriasis, and is welltolerated, effective, and safe in improving the severity of disease and quality of life. Keywords: Guselkumab, Effectiveness, Safety, Plaque psoriasis, Meta-analysis, Quality of life

scholarly journals Delayed Release Phosphatidylcholine is Effective for Treatment of Ulcerative Colitis: A Meta-Analysis

2021 ◽  
Author(s):  
Wolfgang Stremmel ◽  
Hüseyin Vural ◽  
Osman Evliyaoglu ◽  
Ralf Weiskirchen
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Adverse Events ◽  
Meta Analysis ◽  
Life Quality ◽  
Release Formulation ◽  
P Values ◽  
Randomized Controlled ◽  
Intestinal Mucus

Background: Phosphatidylcholine (PC) is intrinsically missing in intestinal mucus of patients with ulcerative colitis. Topical supplementation with delayed intestinal release PC formulations is assumed to compensate this lack. Three monocenter randomized controlled trials (RCTs) with a 30% PC containing lecithin were successful, whereas 1 trial with > 94% PC containing lecithin failed. Objectives: Evaluation of 30% PC-containing lecithin provided in a delayed intestinal release formulation for treatment efficacy of ulcerative colitis evaluated by meta-analysis of three RCT’s. Methods: Meta-analysis of 3 studies was performed using RevMan 5.3 software. Odds ratio (OR) and 95% Cl were calculated for remission, clinical and endoscopic improvement, histology and life quality. p-values less than 0.05 were accepted as significant. Results: The meta-analysis of 3 RTCs with 160 included patients with ulcerative colitis verified that PC improved the rate of remission (OR = 9.68), as well as clinical (OR = 30.58) and endoscopic outcome (OR = 36.73). Within the available patient population also histology and quality of life became better. All effects were significant over placebo. Achieved remission was maintained in a higher percentage of patients under intestinal release PC formulation compared to placebo. The profile of adverse events was identical to the placebo population. Conclusions: A 30% PC containing lecithin in delayed intestinal release formulation improves clinical and endoscopic outcomes, histologic activity and quality of life in patients with ulcerative colitis. For the patients lack of adverse events is an important consideration.

Discontinuation of adjuvant sunitinib due to adverse events in patients with high-risk renal cell carcinoma after nephrectomy: A combined analysis of phase III trials.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 215-215
Author(s):  
Somedeb Ball ◽  
Kyaw Zin Thein ◽  
Miguel Quirch ◽  
Nimesh Adhikari ◽  
Nicholas C. D'Cunha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Cell Carcinoma ◽  
High Risk ◽  
Adverse Events ◽  
Dose Reduction ◽  
Meta Analysis ◽  
Treatment Discontinuation ◽  
Phase Iii ◽  
High Grade

215 Background: Dysregulation in the vascular endothelial growth factor (VEGF) pathway has been implicated in the pathogenesis of renal cell carcinoma (RCC). Sunitinib is an oral VEGF receptor tyrosine kinase inhibitor and has been approved in the adjuvant treatment of high-risk RCC. However, there are significant adverse events, impacting patients’ quality of life, and leading to treatment discontinuation. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of high-grade toxicities and the rate of treatment discontinuation due to adverse events. Methods: We conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts from inception through June 2018. Phase III RCTs which utilized adjuvant sunitinib in high risk RCC after nephrectomy and mentioned treatment interruption or discontinuation or dose reduction due to adverse events were included. Mantel-Haenszel (MH) method was used to calculate the estimated pooled risk ratio (RR) with 95% confidence interval (CI). Fixed effects model was applied. Results: Two phase III RCTs with a total of 1866 patients were eligible. Studies utilized sunitinib versus placebo. The randomization ratio was 1:1 in both ASSURE and S-TRAC studies. The incidence of high-grade adverse events was 568 (60.5%) in sunitinib group versus 183 (19.6%) in placebo arm, with the relative risk of 3.10 (95% CI: 2.69 – 15.93, P < 0.001). The reduction in dose was reported in 541 (57.9%) in study arm versus 86 (9.2%) in placebo group. The pooled RR for dose reduction was statistically significant at 6.28 (95% CI: 5.10 – 7.74, P < 0.001). The treatment discontinuation rate was 27.9% higher with sunitinib than with placebo (RR - 4.14; 95% CI: 3.31 – 5.16, P < 0.001). Conclusions: Our meta-analysis demonstrated that the rate of dose reduction, treatment discontinuation and the risk of grade 3 and 4 adverse events were notably high in sunitinib group. Timely recognition and proper supportive care are entailed in minimizing those adverse events which may ultimately improve patients’ quality of life and overall compliance.

Barrier Protection Measures for the Management of Allergic Rhinitis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 34 (4) ◽  
pp. 564-572
Author(s):  
Xianzhen Chen ◽  
Chuntao Deng ◽  
Jiaoping Mi ◽  
Mo Chen ◽  
Yanfei Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Adverse Events ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Good Choice ◽  
Protection Measures ◽  
Statistical Heterogeneity ◽  
Rhinitis Symptom

Background Pharmacotherapy for allergic rhinitis (AR) still remains unsatisfying regarding its effect and safety. Barrier protection measures may be a good choice for the patients with AR. Objective To assess the efficacy and safety of barrier protection measures in the treatment of AR. Methods We selected relevant randomized controlled trials published between January 1, 1990, and February 20, 2019, by searching Embase, PubMed, Cochrane, Web of Knowledge, and ClinicalTrials.gov. The primary outcome for this analysis was rhinitis symptom scores, overall quality of life, nasal peak inspiratory flow (NPIF), and adverse events. Differences were expressed as weighted mean difference (WMD) with 95% confidence intervals (CIs) for continuous outcomes. Statistical heterogeneity across trials was assessed with the statistic ( P < .1) and the I2 statistic. Results Fifteen RCTs (with data for 1154 participants) satisfied our inclusion criteria. The types of barrier protection measures comprised cellulose, pollen blocker cream, microemulsion, and nasal filter. To reduce the potential risk of bias and heterogeneity, we carried out subgroup analysis according to different types of barrier protection measures (cellulose: WMD = –2.18, 95% CI, –3.01 to –1.35, P < .00001; pollen blocker cream: WMD = –4.55, 95% CI, –6.10 to –3.00, P < .00001; microemulsion: WMD = –0.22, 95% CI, –0.42 to –0.03, P = .03). Findings from our meta-analysis show that, compared with placebo, barrier protection measures can yield improved symptomatic control for AR, with no increase in adverse events. Furthermore, barrier protection measures can improve the quality of life and NPIF. Conclusion Although further studies are still needed, our findings clearly lend support to barrier protection measures as a safe and efficacious option for the treatment of AR patients.

scholarly journals Gefitinib versus docetaxel in treated non-small-cell lung cancer: a meta-analysis

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Bing Wang ◽  
Zhanjie Zuo ◽  
Fang Li ◽  
Kun Yang ◽  
Minjun Du ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Disease Control ◽  
Meta Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Life Improvement

AbstractThe objective of this study was to perform a meta-analysis to evaluate the efficacy and toxicity of gefitinib and docetaxel in treated patients with non-small-cell lung cancer (NSCLC). Methods. A literature search was performed using PubMed and CNKI databases for relevant keywords and the Medical Subject Headings. After further full-text screening, 10 clinical trials were included in the final meta-analysis. Specific odds ratios (OR) and confidence intervals were calculated. Results. The outcomes of treatment efficacy included disease control rates, quality-of-life improvement rates, 3~4 grade adverse events. Comparing gefitinib to docetaxel for NSCLC patients, the pooled odds ratios (OR) of disease control rates was 1.09, (95% confidential index [CI] = 0.84–1.43), the pooled OR of quality-of-life improvement rates was 2.49, (95% CI = 1.77–3.49), the pooled OR of 3~4 grade adverse events was 0.49, (95% CI = 0.32–0.75). Conclusion. Gefitinib was found to significantly improve patients’ quality-of-life and obviously decrease patients’ adverse events of 3~4 grade.There is no difference of disease control rates between gefitinib and docetaxel.

scholarly journals Effectiveness and adverse events of topical and allergen immunotherapy for atopic dermatitis: a systematic review and network meta-analysis protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Luis Guillermo Gómez-Escobar ◽  
Hansel Mora-Ochoa ◽  
Andrea Vargas Villanueva ◽  
Loukia Spineli ◽  
Gloria Sanclemente ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Atopic Dermatitis ◽  
Adverse Events ◽  
Random Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Allergen Specific Immunotherapy ◽  
Statistical Heterogeneity

Abstract Background Atopic dermatitis (AD) is an inflammatory chronic condition that affects the skin of children and adults and has an important impact on the quality of life. Treatments for AD are based on environmental controls, topical and systemic therapies, and allergen-specific immunotherapy (AIT). However, it remains unclear the effectiveness and adverse events of AIT and all conventional topical treatments compared with placebo and each other for AD. Methods We will search five electronic databases [Central Cochrane register of controlled trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and LILACS] from inception until November 2019 with no language restriction, and we will include experimental studies [randomized controlled trials (RCTs), and quasi-RCTs]. The primary outcome is global and specific skin symptoms assessment. Secondary outcomes are hospital length of stay, quality of life, and adverse events. Reviewers independently will extract data from the studies that meet our inclusion criteria and will assess the risk of bias of individual primary studies. We will conduct random effects pairwise meta-analyses for the observed pairwise comparisons with at least two trials. Then, we will perform random-effects Bayesian network meta-analysis (NMA) to obtain treatment effects for all possible comparisons and to provide a hierarchy of all interventions for each outcome. Possible incoherence between direct and indirect sources of evidence will be investigated locally (if possible) and globally. To investigate sources of statistical heterogeneity, we will perform a series of meta-regression analyses based on pre-specified important effect modifiers. Two authors will appraise the certainty of the evidence for each outcome applying the GRADE’s framework for NMA. Discussion The findings of this systematic review will shed the light on the effectiveness and adverse events of all possible comparisons for treating AD and on the quality of the collated evidence for recommendations. It will also provide critical information to health care professionals to comprehend and manage this disease at different age stages, treatment type, duration, and severity of atopic dermatitis. Systematic review registration PROSPERO Protocol ID CRD42019147106

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