scholarly journals The Efficacy of Tiapride and Carbamazepine Combination Therapy in Reducing Alcohol Withdrawal Symptoms: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 52 (05) ◽  
pp. 209-216 ◽  
Author(s):  
Sahar Latifi ◽  
Thomas Messer
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Alcohol Withdrawal ◽  
Meta Analysis ◽  
Alcohol Withdrawal Syndrome ◽  
Statistical Homogeneity ◽  
Alcohol Abstinence ◽  
Alternative Treatment Option ◽  
Significant Efficacy ◽  
Z Value

AbstractThe combination of tiapride (TIA) and carbamazepine (CBZ) as an alternative treatment option to benzodiazepines and clomethiazole has been investigated by several investigations. We performed a systematic review and meta-analysis to further explore the efficacy of this combination in order to render more definite answers whether this combination can be recommendable in the clinical practice. We systematically searched electronic databases including PubMed (MEDLINE), EMBASE, OVID, Cochrane, Google Scholar, and Scopus for human studies. Statistical homogeneity was checked by χ2 test and I2 using Cochran heterogeneity statistic. Our analysis showed a significant efficacy of the combination of TIA and CBZ in reducing alcohol withdrawal syndrome (AWS) (p<0.0001, z-value: 4.07). The cumulative analysis illustrated that the favorable efficacy of this combination therapy has been consistent over time. Our study shows that the combination of TIA/CBZ is an effective treatment in management of AWS in patients with alcohol abstinence. However, the safety of this combination could not be proven, so we recommend its prescription after an informed consent.

scholarly journals Comparative efficacy of various pharmacologic treatments of alcohol withdrawal syndrome: A systematic review and network meta-analysis

2021 ◽  
Author(s):  
Qu Li ◽  
◽  
Xue-Ping Ma ◽  
Alimujiang Simayi ◽  
Xiao-Li Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Alcohol Withdrawal Syndrome ◽  
Comparative Efficacy ◽  
First Choice ◽  
Review Question ◽  
Pharmacologic Treatments

Review question / Objective: Lorazepam and other benzodiazepines (BZDs) are considered the first choice for treatment of Alcohol withdrawal syndrome (AWS). But they have significant addiction potential and can cause fatal respiratory depression if used in large doses. The aim of our study is to conduct a network meta-analysis to provide some data support for the clinical treatment of AWS. The patients were persons with alcohol withdrawal. The intervention being studied must be a comparison of the efficacy of the two pharmacologic treatments. The study should not be included if two pharmacologic treatments belonging to the same category were compared. All studies must include one of the following outcomes: Clinical Institute Withdrawal Assessment, revised (CIWA-Ar) score, length of hospital stay, length of intensive care unit (ICU) stay, and the incidence of delirium or seizures. Condition being studied: Side effects and safety of eleven types of agents currently used to treat alcohol withdrawal syndrome.

Triple versus LAMA/LABA combination therapy for Japanese patients with COPD: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Akira Koarai ◽  
Mitsuhiro Yamada ◽  
Tomohiro Ichikawa ◽  
Naoya Fujino ◽  
Tomotaka Kawayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Japanese Patients

scholarly journals Triple versus LAMA/LABA combination therapy for patients with COPD: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Koarai ◽  
Mitsuhiro Yamada ◽  
Tomohiro Ichikawa ◽  
Naoya Fujino ◽  
Tomotaka Kawayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Triple Therapy ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Beta Agonist ◽  
History Of ◽  
Dyspnea Score ◽  
Long Acting

Abstract Background Recently, the addition of inhaled corticosteroid (ICS) to long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination therapy has been recommended for patients with COPD who have severe symptoms and a history of exacerbations because it reduces the exacerbations. In addition, a reducing effect on mortality has been shown by this treatment. However, the evidence is mainly based on one large randomized controlled trial IMPACT study, and it remains unclear whether the ICS add-on treatment is beneficial or not. Recently, a large new ETHOS trial has been performed to clarify the ICS add-on effects. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety including ETHOS trial. Methods We searched relevant randomized control trials (RCTs) and analyzed the exacerbations, quality of life (QOL), dyspnea symptom, lung function and adverse events including pneumonia and mortality, as the outcomes of interest. Results We identified a total of 6 RCTs in ICS add-on protocol (N = 13,579). ICS/LAMA/LABA treatment (triple therapy) significantly decreased the incidence of exacerbations (rate ratio 0.73, 95% CI 0.64–0.83) and improved the QOL score and trough FEV1 compared to LAMA/LABA. In addition, triple therapy significantly improved the dyspnea score (mean difference 0.33, 95% CI 0.18–0.48) and mortality (odds ratio 0.66, 95% CI 0.50–0.87). However, triple therapy showed a significantly higher incidence of pneumonia (odds ratio 1.52, 95% CI 1.16–2.00). In the ICS-withdrawal protocol including 2 RCTs, triple therapy also showed a significantly better QOL score and higher trough FEV1 than LAMA/LABA. Concerning the trough FEV1, QOL score and dyspnea score in both protocols, the differences were less than the minimal clinically important difference. Conclusion Triple therapy causes a higher incidence of pneumonia but is a more preferable treatment than LAMA/LABA due to the lower incidence of exacerbations, higher trough FEV1 and better QOL score. In addition, triple therapy is also superior to LABA/LAMA due to the lower mortality and better dyspnea score. However, these results should be only applied to patients with symptomatic moderate to severe COPD and a history of exacerbations. Clinical Trial Registration: PROSPERO; CRD42020191978.

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