EP.TH.305Savi Scout Radar versus Wire-Guided Localisation in Breast Cancer Surgery: A Systematic Review and Meta-Anaylsis of Surgical Outcomes

Abstract Aims Wire-guided localisation (WGL) has been the standard technique for localisation of non-palpable breast cancers (NPBC) for almost 40 years. However, WGL has disadvantages including peri-operative scheduling challenges and patient discomfort. Savi Scout localisation (SSL) is a novel alternative that utilises an implantable wireless non-radioactive reflector. A systematic review and meta-analysis was performed to compare outcomes of SSL versus WGL in NPBC surgery. Methods Embase, MEDLINE, PubMed and the Cochrane Library (1946 to December 2020) were searched using PRISMA guidelines for studies comparing SSL and WGL in NPBC surgery. Outcome measures analysed were operative duration, positive margins and re-excision. Results were pooled into meta-analyses using a Mantel-Haenszel Random-Effects model as Odds Ratios for dichotomous data and Mean Difference for continuous data. Results Four eligible peer-reviewed cohort studies involving 808 patients were identified comparing SSL (n = 462) and WGL (n = 346). There was no significant difference between SSL and WGL in operative duration (95% CI -0.27, -7.89 to 7.34, p = 0.94), positive margins (OR 0.73, 0.36 to 1.45, p = 0.36) and re-excision (OR 0.62, 0.33 to 1.16, p = 0.13). Inclusion of two non-peer-reviewed cohort studies (additional SSL n = 143, WGL n = 424) altered statistical significance for re-excision in favour of SSL (OR 0.55, 0.36 to 0.83, p = 0.004). Conclusions This study demonstrates that SSL is a safe and effective alternative to WGL. SSL uncouples pre-operative localisation from surgery, reducing scheduling challenges. This is particularly useful in the current COVID-19 climate, with pre-operative patient self-isolation requirements. SSL may decrease re-excision rates. Randomised controlled trials are required to investigate this further.

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Laparoscopic magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: systematic review and pooled analysis

Diseases of the Esophagus ◽

10.1093/dote/doz031 ◽

2019 ◽

Vol 32 (9) ◽

Cited By ~ 9

Author(s):

Nadia Guidozzi ◽

Tom Wiggins ◽

Ahmed R Ahmed ◽

George B Hanna ◽

Sheraz R Markar

Keyword(s):

Systematic Review ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Cohort Studies ◽

Reflux Disease ◽

Comparative Studies ◽

Cochrane Library ◽

Magnetic Sphincter Augmentation ◽

Device Removal ◽

Significant Difference

SUMMARY Magnetic sphincter augmentation (MSA) has been proposed as a less invasive, more appealing alternative intervention to fundoplication for the treatment of gastroesophageal reflux disease (GERD). The aim of this study was to evaluate clinical outcomes following MSA for GERD control in comparison with laparoscopic fundoplication. A systematic electronic search for articles was performed in Medline, Embase, Web of Science, and Cochrane Library for single-arm cohort studies or comparative studies (with fundoplication) evaluating the use of MSA. A random-effects meta-analysis for postoperative proton pump inhibitor (PPI) use, GERD-health-related quality of life (GERD-HRQOL), gas bloating, ability to belch, dysphagia, and reoperation was performed. The systematic review identified 6 comparative studies of MSA versus fundoplication and 13 single-cohort studies. Following MSA, only 13.2% required postoperative PPI therapy, 7.8% dilatation, 3.3% device removal or reoperation, and esophageal erosion was seen in 0.3%. There was no significant difference between the groups in requirement for postoperative PPI therapy (pooled odds ratio, POR = 1.08; 95%CI 0.40–2.95), GERD-HRQOL score (weighted mean difference, WMD = 0.34; 95%CI −0.70–1.37), dysphagia (POR = 0.94; 95%CI 0.57–1.55), and reoperation (POR = 1.23; 95%CI 0.26–5.8). However, when compared to fundoplication MSA was associated with significantly less gas bloating (POR = 0.34; 95%CI 0.16–0.71) and a greater ability to belch (POR = 12.34; 95%CI 6.43–23.7). In conclusion, magnetic sphincter augmentation achieves good GERD symptomatic control similar to that of fundoplication, with the benefit of less gas bloating. The safety of MSA also appears acceptable with only 3.3% of patients requiring device removal. There is an urgent need for randomized data directly comparing fundoplication with MSA for the treatment of GERD to truly evaluate the efficacy of this treatment approach.

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Laparoscopic Excision Versus Open Excision for the Treatment of Choledochal Cysts: A Systematic Review and Meta-Analysis

International Surgery ◽

10.9738/intsurg-d-14-00165.1 ◽

2015 ◽

Vol 100 (1) ◽

pp. 115-122 ◽

Cited By ~ 20

Author(s):

Chen Zhen ◽

Zhang Xia ◽

Li Long ◽

Ma Lishuang ◽

Yu Pu ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Choledochal Cyst ◽

Meta Analysis ◽

Bile Leak ◽

Cochrane Library ◽

Cyst Excision ◽

Significant Difference ◽

Laparoscopic Excision ◽

Open Excision

Abstract In 1723, Vater first described choledochal cyst and in 1977, Todani et al classified this disease. For many years, open excision (OP) as the standard procedure made a great impact in the treatment of choledochal cyst. Since 1995, when Farello et al first reported laparoscopic choledochal cyst excision, laparoscopic excision (LA) has been used worldwide. However, its safety remains a major concern. The aim of this meta-analysis was to compare OP with LA in treating choledochal cyst and then to determine whether LA is safe and valid. The design of this study involved systematic review and meta-analysis. Data sources were Medline, Ovid, Elsevier, Google Scholar, Embase, and Cochrane library. The study selection entailed comparative cohort studies. For data extraction, 2 investigators independently assessed selected studies and extracted the following information: study characteristics, quality, outcomes data, etc. For the results, 7 comparative cohort studies about the effectiveness of LA compared with OP were performed meta-analysis. The results showed that although the LA group had a longer operative time (MD = 56.57; 95% CI = 32.20–80.93; P < 0.00001), LA had a shorter duration of hospital stay (MD = −1.93; 95% CI = −2.51 to −1.36; P < 0.00001), and recovery of bowel function (MD = −0.94; 95% CI = −1.33 to −0.55; P < 0.00001). Meta-analysis found no significant difference between most of the 2 groups: bile leak (RR = 0.60; 95% CI = 0.29–1.24; P = 0.17), abdominal bleeding (RR = 0.33; 95% CI = 0.01–8.98; P = 0.51), pancreatitis (RR = 0.26, 95% CI = 0.06–1.03; P = 0.06), total postoperative complications (RR = 1.04; 95% CI = 0.66–1.62; P = 0.88). The LA group had significant lower rates in intraoperative blood transfusion (RR = 0.20; 95% CI = 0.11–0.38; P < 0.00001), and adhesive intestinal obstruction (RR = 0.17, 95% CI = 0.04–0.77; P = 0.02). In conclusion, compared with open excision, laparoscopic excision is a safe, valid, and feasible alternative to open excision.

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Influence of Femoral Version on the Outcomes of Hip Arthroscopic Surgery for Femoroacetabular Impingement or Labral Tears: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211009192 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712110091

Author(s):

Chenghui Wang ◽

Yaying Sun ◽

Zheci Ding ◽

Jinrong Lin ◽

Zhiwen Luo ◽

...

Keyword(s):

Systematic Review ◽

Patient Satisfaction ◽

Femoroacetabular Impingement ◽

Arthroscopic Surgery ◽

Harris Hip Score ◽

Cochrane Library ◽

Femoral Version ◽

Labral Tears ◽

Significant Difference ◽

Secondary Outcomes

Background: It remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears. Purpose: To review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV. Study Design: Systematic review; Level of evidence, 4. Methods: Embase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable. Results: Included in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), –3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, –0.70 [96% CI, –8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, –3.09 [95% CI, –7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, –1.92 [95% CI, –6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04). Conclusion: The results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

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Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

BMC Women s Health ◽

10.1186/s12905-021-01180-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Micaele Maria Lopes Castro ◽

Maria Karolina Martins Ferreira ◽

Iasmin Encaua Essashika Prazeres ◽

Paula Beatriz de Oliveira Nunes ◽

Marcela Baraúna Magno ◽

...

Keyword(s):

Systematic Review ◽

Quantitative Analysis ◽

Periodontal Diseases ◽

Hormonal Contraceptive ◽

Cochrane Library ◽

Hormonal Contraceptives ◽

Clinical Parameters ◽

Significant Difference ◽

Meta Analyses ◽

The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

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Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/8470235 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Yijuan Hu ◽

Dongling Zhong ◽

Qiwei Xiao ◽

Qiang Chen ◽

Juan Li ◽

...

Keyword(s):

Systematic Review ◽

Treatment Duration ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Clinical Effects ◽

Balance Function ◽

Balance Impairment ◽

Kinesio Taping ◽

Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

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Digital models and orthodontic diagnosis: what degree of reliability?

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.384 ◽

2021 ◽

Vol 8 ◽

Author(s):

ABDOUL Hafizou RABE ◽

Fatima SALEK ◽

Intissar El IDRISSI ◽

Fatima ZAOUI ◽

Hicham BENYAHIA

Keyword(s):

Systematic Review ◽

Numerical Models ◽

Meta Analysis ◽

Physical Models ◽

Cochrane Library ◽

Digital Models ◽

Significant Difference ◽

Clinically Significant ◽

Conventional Models ◽

Plaster Models

Abstract Background: Our study aims to evaluate, through a systematic review, the reliability of numerical models compared to conventional models on the main parameters of orthodontic diagnosis Method: four databases were consulted: PubMed; Google Scholar, Cochrane Library, and Ebscohost. The research included published studies since 2010, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies. Results: Among 3811 selected references, only five studies met our inclusion criteria. In the systematic review, there were statistical differences between the digital models and the plaster models. However, this difference is clinically acceptable. On the other hand, there are some limitations, relative to the types of the severity of the congestion, the elapsed time to digitize, and the numerical means. Conclusion: The results of our systematic review have shown that there is no clinically significant difference between the numerical and physical models for the majority of diagnostic parameters.

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Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2020.20 ◽

2019 ◽

Vol 8 (2) ◽

pp. 125-132

Author(s):

Fahime Khorasani ◽

Fariba Ghaderi ◽

Parvin Sarbakhsh ◽

Parisa Ahadi ◽

Elahe Khorasani ◽

...

Keyword(s):

Systematic Review ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Meta Analysis ◽

Cochrane Library ◽

Control Groups ◽

Pelvic Floor Muscle Exercises ◽

Significant Difference ◽

Prevention And Treatment ◽

Pfm Strength

Objectives: The present systematic review focused on the prevention or treatment of three main types of pelvic floor dysfunctions (PFDs) specifically pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) using physiotherapy and pelvic floor muscle exercises (PFMEs). With regard to the breadth of the problem, there is not much evidence grounded on the best management. The main purpose of this systematic review was to evaluate the effects of physiotherapy and PFMEs on the prevention and treatment of pregnancy-related PFDs; namely, POP, FI, and UI. Therefore, this review incorporated studies comparing the use of physiotherapy and PFMEs with every other existing interventions. Methods: This systematic review and meta-analysis was conducted on randomized-controlled-trial (RCT) articles and quasi-RCT designs through a search in the studies published with no time limits until December 2017 in the databases of PubMed (Medline), Web of Science, Scopus, Embase, Cochrane Library, and ProQuest. The meta-analysis was also applied for data synthesis. Moreover, heterogeneity was assessed using Cochran’s Q test and I2 index. Results: A total number of 26 RCTs were examined in this review in which the outcome variables were related to POP, UI, and FI prevalence; POP, UI, and FI severity, as well as pelvic floor muscle (PFM) strength and endurance. In most articles, UI prevalence or severity in intervention groups had significantly improved compared with those in controls. The number of studies examining POP and FI was also relatively low. In two studies, FI severity or prevalence in intervention groups had significantly enhanced in comparison with those in control groups; however, FI prevalence in two articles had been reported lower in intervention groups than that in control groups although no significant difference had been observed. There was also no significant improvement in intervention groups in two other studies in this respect. Besides, three articles had not reported traces of improvement in POP, as well as a significant difference between intervention and control groups. Nevertheless, two studies had found a significant improvement in POP in this regard. Based on meta-analysis results for the variable of PFM strength, Cochran’s Q test (P<0.001) and I2 index (90.02) indicated heterogeneity between studies; so, a random-effect meta-analysis was applied to estimate overall effect sizes. The overall mean differences following intervention between the study groups were also equal to 6.94, with a 95% CI (1.36 to 12.52). Conclusions: It was concluded that physiotherapy and PFMEs might have effects on pregnancy-related UI, but they had not consistently reduced FI severity or prevalence and failed to constantly improve POP.

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The efficacy of remdesivir in coronavirus disease 2019 (COVID-19): a systematic review

Iranian Journal of Microbiology ◽

10.18502/ijm.v12i5.4597 ◽

2020 ◽

Author(s):

Amirhossein Roshanshad ◽

Alireza Kamalipour ◽

Mohammad Ali Ashraf ◽

Romina Roshanshad ◽

Sirous Jafari ◽

...

Keyword(s):

Systematic Review ◽

Adverse Event ◽

Cohort Studies ◽

Clinical Improvement ◽

Day Treatment ◽

Mortality Rates ◽

Severe Adverse Event ◽

Adverse Event Rate ◽

Significant Difference ◽

Event Rates

Background and Objectives: Researchers all around the world are working hard to find an effective treatment for the new coronavirus 2019. We performed a comprehensive systematic review to investigate the latest clinical evidence on the efficacy and safety of treatment with Remdesivir in hospitalized patients with COVID-19. Materials and Methods: We performed a systematic search in Pubmed, Embase, Web of Science, Google scholar and MedRxiv for relevant observational and interventional studies. The outcomes measures were mortality rates, improvement rates, time to clinical improvement, all adverse event rates and severe adverse event rates. Results: Three randomized controlled trials and 2 cohort studies were included in our study. In the 2 cohort studies, patients received Remdesivir for 10 days. 2 RCTs evaluated 10-day efficacy of treatment with Remdesivir versus placebo group and the other RCT compared its 5-day regimen versus 10-day regimen. Visual inspection of the forest plots revealed that the efficacy of Remdesivir was not much different in reducing 28-day mortality versus 14-day mortality rates. Besides, 10-day treatment regimen overpowered 5-day treatment and placebo in decreasing time to clinical improvement. All adverse event rates did not have a significant difference; however, severe adverse event rate was lower in the 5-day Remdesivir group compared to the 10-day and placebo groups. Conclusion: 5-day course of Remdesivir therapy in COVID-19 patients is probably efficacious and safe, and patients without invasive mechanical ventilation benefit the most. Treatment can be extended to 10 days if satisfactory improvement is not seen by day 5. Most benefits from Remdesivir therapy take place in the first 14 days of the start of the treatment.

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The association of fracture risk in atrial fibrillation patients and long-term anticoagulant therapy category: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.10683 ◽

2021 ◽

Vol 9 ◽

pp. e10683

Author(s):

Jun Chen ◽

Lingchun Lyu ◽

Jiayi Shen ◽

Chunlai Zeng ◽

Cheng Chen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Hip Fracture ◽

Fracture Risk ◽

Hip Fractures ◽

Observational Studies ◽

Meta Analysis ◽

Cochrane Library ◽

Hip Fracture Risk ◽

Significant Difference

Objective Our study aimed to assess the risk of all fractures and hip fractures in patients with atrial fibrillation (AF) who took non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin. Methods We searched PubMed, Embase, and Cochrane Library and Clinical Trials.gov Website. Reviewed related researches up to January 31, 2020, to identify studies with more than 12 months of follow-up data. The protocol for this systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO Number: CRD42020156893). Results We included five RCT studies, and five observational studies that contained a total of 326,846 patients in our meta-analysis. Our meta-analysis showed that patients taken NOACs had no significant all fracture risk (RR = 0.91, 95% CI [0.81–1.01]) and hip fracture risk (RR = 0.92, 95% CI [0.82–1.03]) compared with those taken warfarin. Subanalysis showed that the risk of all fractures and hip fractures treated by NOACs were significant lower compared with warfarin in observational studies compared with RCT studies. Also, a subanalysis across the duration of anticoagulation showed the NOACs users have lower all fracture risk than warfarin users when the duration of anticoagulation ≤2 years (RR = 0.89, 95% CI [0.80–0.99]). Further analysis, significant lower all fracture risk in the rivaroxaban therapy (RR = 0.81; 95% CI [0.76–0.86]) compared with warfarin but no statistical significance in hip fracture. There were no significant difference of all fracture risk and hip fracture risk in dabigatran, apixaban, and edoxaban therapy compared with warfarin. Conclusion The meta-analysis demonstrated that NOACs associated with a significantly lower all fracture risk compared with warfarin when the duration of anticoagulation more than 2 years. Rivaroxaban users had lower risk of all fracture than warfarin users in AF patients. But there was no evidence to verify apixaban, edoxaban, and dabigatranin could decrease all fracture and hip fracture risk compared with warfarin.

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Rituximab for Eosinophilic Granulomatosis with Polyangiitis: a Systematic Review of Observational Studies

Rheumatology ◽

10.1093/rheumatology/keab046 ◽

2021 ◽

Author(s):

Vincenzo G Menditto ◽

Giulia Rossetti ◽

Diletta Olivari ◽

Alessia Angeletti ◽

Marco Rocchi ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Granulomatosis With Polyangiitis ◽

Case Reports ◽

Case Series ◽

Biologic Agents ◽

Cochrane Library ◽

Eosinophilic Granulomatosis With Polyangiitis ◽

Extensive Literature ◽

Eosinophilic Granulomatosis

Abstract Objective to analyze the available evidence about the use of rituximab (RTX) and other biologic agents in Eosinophilic Granulomatosis with Polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials. Methods A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases and an extensive literature search on other biologic agents. Results 45 papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in pANCA positive subgroup. Conclusion Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impairs a clear interpretation of results and limits their transferability in clinical practice. Differences in design, enrollment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable.

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