521 EFFICACY OF GLUCOSAMINE HYDROCHLORIDE OR SPECIALIZED ROSEHIP POWDER IN OSTEOARTHRITIS PATIENTS: AN INDIRECT COMPARISON META-ANALYSIS

Background and Objectives: The majority of patients included in trials of anti-platelet therapy are male. This systematic review and meta-analysis aimed to determine whether, in addition to aspirin, P2Y12 blockade is beneficial in both women and men with acute coronary syndromes. Methods: Electronic databases were searched and nine eligible randomised controlled studies were identified that had sex-specific clinical outcomes (n=107,126 patients). Risk Ratios (RR) and 95% Confidence Intervals (CI) were calculated for a composite of cardiovascular death, myocardial infarction or stroke (MACE), and a safety endpoint of major bleeding for each sex. Indirect comparison analysis was performed to statistically compare ticagrelor against prasugrel. Results: Compared to aspirin alone, clopidogrel reduced MACE in men (RR, 0.79; 95% CI, 0.68 to 0.92; p=0.003), but was not statistically significant in women (RR, 0.88; 95% CI, 0.75 to 1.02, p=0.08). Clopidogrel therapy significantly increased bleeding in women but not men. Compared to clopidogrel, prasugrel was beneficial in men (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02) but not statistically significant in women (RR, 0.94; 95% CI, 0.83 to 1.06; p=0.30); ticagrelor reduced MACE in both men (RR, 0.85; 95% CI, 0.77 to 0.94; p=0.001) and women (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02). Indirect comparison demonstrated no significant difference between ticagrelor and prasugrel in either sex. Compared to clopidogrel, ticagrelor and prasugrel increased bleeding risk in both women and men. Conclusion: In summary, in comparison to monotherapy with aspirin, P2Y12 inhibitors reduce MACE in women and men. Ticagrelor was shown to be superior to clopidogrel in both sexes. Prasugrel showed a statistically significant benefit only in men; however indirect comparison did not demonstrate superiority of ticagrelor over prasugrel in women.

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The Effects of Sterilization Procedures on the Cutting Efficiency of Endodontic Instruments: A Systematic Review and Network Meta-Analysis

Materials ◽

10.3390/ma14061559 ◽

2021 ◽

Vol 14 (6) ◽

pp. 1559

Author(s):

Mario Dioguardi ◽

Enrica Laneve ◽

Michele Di Cosola ◽

Angela Pia Cazzolla ◽

Diego Sovereto ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Meta Analysis ◽

Indirect Comparison ◽

Physical And Mechanical Properties ◽

Surface Characteristics ◽

Cyclic Fatigue ◽

P Value ◽

Cutting Efficiency ◽

Dental Instruments

Sterilization processes guarantee the sterility of dental instruments but can negatively affect instrument features by altering their physical and mechanical properties. The endodontic instrumentation can undergo a series of alterations, ranging from corrosion to variation in the cutting angle and then changes in the torsional properties and torsional fatigue resistance. This systematic literature review and meta-analysis aims to investigate alterations to the cutting efficiency of endodontic instruments that are induced by procedures for their disinfection and sterilization. Methodologies adopted for this investigation follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The following were used as search terms on PubMed and Scopus: “endodontic sterilization”, “endodontic autoclave”, “cyclic fatigue”, “torsional”, “cutting efficiency”, “sterilization”, “surface characteristics”, and “corrosion”. At the end of the selection process, 36 articles were identified, and seven of them are included in this systematic review. The results of a meta-analysis conducted for the use of 10 autoclaving cycles shows a standardized mean difference (SMD) of 0.80 with a p-value equal to 0.04 with respect to effect on cutting efficiency. The network meta-analysis, through direct and indirect comparison between the different autoclave cycles (0, 1, 5, 10, and 15 cycles), revealed that treatment involving 15 autoclave cycles produced the most robust results in terms of having the greatest effects in terms of altered cutting efficiency with a probability of 57.7% and a SUCRA (surface under the cumulative ranking) of 80%. The alterations in the effects on cutting efficiency appear to be triggered after five cycles of sterilization by heat (autoclave). In conclusion, the meta-analysis of the data indicates that the autoclave sterilization protocol must not be repeated more than five times to preserve cutting efficiency. Within the limitations of this review, we can therefore establish that sterilization by autoclaving alone results in steel and NiTi instruments becoming less efficient in cutting after five cycles, as measured by a reduction in cutting efficiency.

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TCT-642 Two zotarolimus-eluting stent generations: a meta-analysis of 12 randomized trials versus other limus-eluting stents and an adjusted indirect comparison

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2012.08.679 ◽

2012 ◽

Vol 60 (17) ◽

pp. B187

Author(s):

Salvatore Cassese ◽

Gjin Ndrepepa ◽

Lamin King ◽

Tomohisa Tada ◽

Massimiliano Fusaro ◽

...

Keyword(s):

Randomized Trials ◽

Meta Analysis ◽

Indirect Comparison ◽

Adjusted Indirect Comparison

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A common reference-based indirect comparison meta-analysis of intravenous valproate versus intravenous phenobarbitone for convulsive status epilepticus

Epileptic Disorders ◽

10.1684/epd.2013.0601 ◽

2013 ◽

Vol 15 (3) ◽

pp. 314-323 ◽

Cited By ~ 18

Author(s):

Francesco Brigo ◽

Stanley C Igwe ◽

Raffaele Nardone ◽

Frediano Tezzon ◽

Luigi Giuseppe Bongiovanni ◽

...

Keyword(s):

Status Epilepticus ◽

Meta Analysis ◽

Indirect Comparison ◽

Convulsive Status Epilepticus ◽

Common Reference

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Efficacy of Once-Weekly Semaglutide vs Empagliflozin Added to Metformin in Type 2 Diabetes: Patient-Level Meta-analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa577 ◽

2020 ◽

Vol 105 (12) ◽

pp. e4593-e4604 ◽

Cited By ~ 1

Author(s):

Ildiko Lingvay ◽

Matthew S Capehorn ◽

Andrei-Mircea Catarig ◽

Pierre Johansen ◽

Jack Lawson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Weight ◽

Meta Analysis ◽

Indirect Comparison ◽

Diabetes Patient ◽

Metformin Monotherapy ◽

Efficacy Measures ◽

Meta Regression ◽

Glucagon Like Peptide 1

Abstract Context No head-to-head trials have directly compared once-weekly (OW) semaglutide, a human glucagon-like peptide-1 analog, with empagliflozin, a sodium–glucose co-transporter-2 inhibitor, in type 2 diabetes (T2D). Objective We indirectly compared the efficacy of OW semaglutide 1 mg vs once-daily (OD) empagliflozin 25 mg in patients with T2D inadequately controlled on metformin monotherapy, using individual patient data (IPD) and meta-regression methodology. Design, Setting, Participants, and Interventions IPD for patients with T2D receiving metformin monotherapy and randomized to OW semaglutide 1 mg (SUSTAIN 2, 3, 8 trials), or to OD empagliflozin 25 mg (PIONEER 2 trial) were included. Meta-regression analyses were adjusted for potential prognostic factors and effect modifiers. Main Outcome Measures The primary efficacy outcomes were change from baseline to end-of-treatment (~1 year) in HbA1c (%-point) and body weight (kg). Responder outcomes and other clinically relevant efficacy measures were analyzed. Results Baseline characteristics were similar between OW semaglutide (n = 995) and empagliflozin (n = 410). Our analyses showed that OW semaglutide significantly reduced mean HbA1c and body weight vs empagliflozin (estimated treatment difference: −0.61%-point [95% confidence interval (CI): −0.72; −0.49] and −1.65 kg [95% CI: −2.22; −1.08], respectively; both P < 0.0001). Complementary analyses supported the robustness of these results. A significantly greater proportion of patients on OW semaglutide vs empagliflozin also achieved HbA1c targets and weight-loss responses. Conclusions This indirect comparison suggests that OW semaglutide 1 mg provides superior reductions in HbA1c and body weight vs OD empagliflozin 25 mg in patients with T2D when added to metformin monotherapy.

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Reslizumab and mepolizumab for moderate-to-severe poorly controlled asthma: an indirect comparison meta-analysis

Immunotherapy ◽

10.2217/imt-2019-0113 ◽

2019 ◽

Vol 11 (17) ◽

pp. 1491-1505 ◽

Cited By ~ 1

Author(s):

Kevin Yan ◽

Chakrapani Balijepalli ◽

Rohini Sharma ◽

Stephane Barakat ◽

Shawn X Sun ◽

...

Keyword(s):

Meta Analysis ◽

Indirect Comparison ◽

Base Case ◽

Efficacy And Safety ◽

Eosinophilic Asthma ◽

Severe Eosinophilic Asthma ◽

Global Initiative For Asthma ◽

Credible Intervals ◽

Global Initiative ◽

Eosinophil Counts

Aim: A systematic literature review and network meta-analysis assessed the efficacy and safety of reslizumab 3.0 mg/kg and mepolizumab 100 mg. Materials & methods: Eligible studies evaluated reslizumab and mepolizumab in patients with inadequately-controlled severe eosinophilic asthma. Using a Bayesian network meta-analysis, 95% credible intervals and posterior probabilities were reported. Results: Of 19 indirect efficacy comparisons performed in base-case (Global Initiative for Asthma 4/5 patients with ≥2 exacerbations in the previous year) and overall populations, significant differences favoring reslizumab were observed for severe exacerbations, FEV1 at 4 weeks and eosinophil counts at 4, 16 and 24 weeks, with no other significant differences including risk of adverse events. Conclusion: Indirect comparison of reslizumab and mepolizumab largely showed no significant differences in efficacy or safety.

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Should All Patients With HR-Positive HER2-Negative Metastatic Breast Cancer Receive CDK 4/6 Inhibitor As First-Line Based Therapy? A Network Meta-Analysis of Data from the PALOMA 2, MONALEESA 2, MONALEESA 7, MONARCH 3, FALCON, SWOG and FACT Trials

Cancers ◽

10.3390/cancers11111661 ◽

2019 ◽

Vol 11 (11) ◽

pp. 1661 ◽

Cited By ~ 4

Author(s):

Valentina Rossi ◽

Paola Berchialla ◽

Diana Giannarelli ◽

Cecilia Nisticò ◽

Gianluigi Ferretti ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Soft Tissues ◽

Meta Analysis ◽

Treatment Options ◽

Indirect Comparison ◽

Metastatic Breast ◽

Line Treatment ◽

First Line ◽

First Line Treatment

Background: We aim to understand whether all patients with hormonal receptor (HR)-positive (+)/human epidermal growth factor receptor-2 (HER2)-negative (−) metastatic breast cancer (MBC) should receive cyclin D-dependent kinase (CDK) 4/6 inhibitor-based therapy as a first-line approach. Methods: A network meta-analysis (NMA) using the Bayesian hierarchical arm-based model, which provides the estimates for various effect sizes, were computed. Results: First-line treatment options in HR+/HER2− MBC, including CDK 4/6 inhibitors combined with aromatase inhibitors (AIs) or fulvestrant (F), showed a significantly longer progression-free survival (PFS) in comparison with AI monotherapy, with a total of 26% progression risk reduction. In the indirect comparison across the three classes of CDK 4/6 inhibitors and F endocrine-based therapies, the first strategy resulted in longer PFS, regardless of specific CDK 4/6 inhibitor (HR: 0.68; 95% CrI: 0.53–0.87 for palbociclib + AI, HR: 0.65; 95% CrI: 0.53–0.79 for ribociclib + AI, HR: 0.63; 95% CrI: 0.47–0.86 for abemaciclib + AI) and patient’s characteristics. Longer PFS was also found in patients with bone-only and soft tissues limited disease treated with CDK 4/6 inhibitors. Conclusions: CDK 4/6 inhibitors have similar efficacy when associated with an AI in the first-line treatment of HR+ MBC, and are superior to either F or AI monotherapy, regardless of any other patients or tumor characteristics.

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Bayesian splines versus fractional polynomials in network meta-analysis

BMC Medical Research Methodology ◽

10.1186/s12874-020-01113-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Andreas Heinecke ◽

Marta Tallarita ◽

Maria De Iorio

Keyword(s):

Meta Analysis ◽

Indirect Comparison ◽

Real Data ◽

Multiple Time ◽

Computationally Efficient ◽

Fractional Polynomials ◽

Time Points ◽

Model Based ◽

Multiple Treatments ◽

Indirect Comparisons

Abstract Background Network meta-analysis (NMA) provides a powerful tool for the simultaneous evaluation of multiple treatments by combining evidence from different studies, allowing for direct and indirect comparisons between treatments. In recent years, NMA is becoming increasingly popular in the medical literature and underlying statistical methodologies are evolving both in the frequentist and Bayesian framework. Traditional NMA models are often based on the comparison of two treatment arms per study. These individual studies may measure outcomes at multiple time points that are not necessarily homogeneous across studies. Methods In this article we present a Bayesian model based on B-splines for the simultaneous analysis of outcomes across time points, that allows for indirect comparison of treatments across different longitudinal studies. Results We illustrate the proposed approach in simulations as well as on real data examples available in the literature and compare it with a model based on P-splines and one based on fractional polynomials, showing that our approach is flexible and overcomes the limitations of the latter. Conclusions The proposed approach is computationally efficient and able to accommodate a large class of temporal treatment effect patterns, allowing for direct and indirect comparisons of widely varying shapes of longitudinal profiles.

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A systematic review and network meta-analysis of adjuvant therapy for curatively resected biliary tract cancers

Current Oncology ◽

10.3747/co.27.5465 ◽

2020 ◽

Vol 27 (1) ◽

Cited By ~ 2

Author(s):

M. Kish ◽

K. Chan ◽

K. Perry ◽

Y.J. Ko

Keyword(s):

Systematic Review ◽

Adjuvant Therapy ◽

Biliary Tract ◽

Meta Analysis ◽

Indirect Comparison ◽

Standard Of Care ◽

Phase Iii ◽

Quality Data ◽

Qualitative Synthesis ◽

Tract Cancer

Background Recent randomized controlled trials (rcts) have contributed high-quality data about adjuvant therapy in curatively resected biliary tract cancer (btc); however, a standard approach to treating those patients still has not been developed.Methods We conducted a systematic review of published studies and abstracts up to and including June 2018, choosing rcts involving patients with btc receiving adjuvant chemotherapy after complete surgical resection. Network meta-analysis methods were used for indirect comparisons of overall survival (os) and relapse-free survival (rfs) for various adjuvant therapies.Results Five rcts were included in qualitative synthesis, and three rcts (bilcap, prodige 12–accord 18, and bcat) had data sufficient for inclusion in the meta-analysis. Results from the indirect comparison demonstrated no significant improvement in os for capecitabine compared with gemcitabine or with gemcitabine–oxaliplatin (gemox), the hazard ratios (hrs) being 0.82 [95% confidence interval (ci): 0.53 to 1.27] and 0.86 (95% ci: 0.56 to 1.34) respectively. Similarly, no significant improvement in rfs was observed for capecitabine compared with gemcitabine or gemox.Conclusions Although in the present analysis, we found no statistically significant improvements in os or rfs for capecitabine compared with gemox or gemcitabine, capecitabine can—until further prospective trials are completed— be considered the standard of care in the adjuvant setting based on a single randomized phase iii study.

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