T219. THE ROLE OF MELATONIN AND MELATONIN AGONISTS IN COUNTERACTING ANTIPSYCHOTIC-INDUCED METABOLIC SIDE EFFECTS: A SYSTEMATIC REVIEW

AbstractZinc is a trace element that plays an important role in the immune system and cell growth. The role of zinc in cancer treatment has been discussed for some time, however without reaching an evidenced-based consensus. Therefore, we aim to critically examine and review existing evidence on the role of zinc during cancer treatment. In January 2019, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychINFO, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of zinc therapy on cancer patients. Out of initial 5244 search results, 19 publications concerning 23 studies with 1230 patients were included in this systematic review. The patients treated with zinc were mainly diagnosed with head and neck cancer and underwent chemo-, radio- or concurrent radio-chemotherapy. Interventions included the intake of different amounts of zinc supplements and oral zinc rinses. Outcomes (primary endpoints) investigated were mucositis, xerostomia, dysgeusia, pain, weight, dermatitis and oral intake of nutrients. Secondary endpoints were survival data, quality of life assessments and aspects of fatigue, immune responses and toxicities of zinc. The studies were of moderate quality reporting heterogeneous results. Studies have shown a positive impact on the mucositis after radiotherapy. No protection was seen against mucositis after chemotherapy. There was a trend to reduced loss of taste, less dry mouth and oral pain after zinc substitution. No impact was seen on weight, QoL measurements, fatigue, and survival. The risk of side effects from zinc appears to be relatively small. Zinc could be useful in the prevention of oral toxicities during irradiation. It does not help in chemotherapy-induced side effects.

Download Full-text

Second-Generation Antipsychotics and Metabolic Side Effects: A Systematic Review of Population-Based Studies

Drug Safety ◽

10.1007/s40264-017-0543-0 ◽

2017 ◽

Vol 40 (9) ◽

pp. 771-781 ◽

Cited By ~ 56

Author(s):

Lauren Hirsch ◽

Jaeun Yang ◽

Lauren Bresee ◽

Nathalie Jette ◽

Scott Patten ◽

...

Keyword(s):

Systematic Review ◽

Side Effects ◽

Second Generation ◽

Population Based ◽

Metabolic Side Effects ◽

Second Generation Antipsychotics

Download Full-text

The role of dietary supplements, including biotics, glutamine, polyunsaturated fatty acids and polyphenols, in reducing gastrointestinal side effects in patients undergoing pelvic radiotherapy: A systematic review and meta-analysis

Clinical and Translational Radiation Oncology ◽

10.1016/j.ctro.2021.04.006 ◽

2021 ◽

Author(s):

Benjamin Bartsch ◽

Chee Kin Then ◽

Elinor Harriss ◽

Christiana Kartsonaki ◽

Anne E. Kiltie

Keyword(s):

Systematic Review ◽

Fatty Acids ◽

Side Effects ◽

Polyunsaturated Fatty Acids ◽

Dietary Supplements ◽

Meta Analysis ◽

Pelvic Radiotherapy ◽

Gastrointestinal Side Effects

Download Full-text

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Clinical Psychopharmacology and Neuroscience ◽

10.9758/cpn.2018.16.3.235 ◽

2018 ◽

Vol 16 (3) ◽

pp. 235-245 ◽

Cited By ~ 4

Author(s):

Stanley C. Igwe ◽

Francesco Brigo

Keyword(s):

Systematic Review ◽

Side Effects ◽

Randomized Controlled Trials ◽

Atypical Antipsychotics ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Metabolic Side Effects

Download Full-text

T200. METABOLIC SIDE EFFECTS OF ANTIPSYCHOTIC DRUGS – PROTOCOL OF A SYSTEMATIC REVIEW AND NETWORK- METAANALYSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.760 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S308-S308

Author(s):

Johannes Schneider-Thoma ◽

Irene Bighelli ◽

Spyridon Siafis ◽

Stefan Leucht

Keyword(s):

Systematic Review ◽

Weight Gain ◽

Side Effects ◽

Antipsychotic Drugs ◽

Controlled Trial ◽

Sensitivity Analyses ◽

Continuous Change ◽

Randomized Controlled ◽

Metabolic Side Effects ◽

Number Of Patients

Abstract Background Antipsychotic drugs are the mainstay of the pharmacological treatment of schizophrenia, used in the acute episode of the disorder and for prevention of relapses. Unfortunately, antipsychotics cause side effects. Weight gain is one of the most prominent side effects. In line with weight gain, also alterations of lipid- and glucose homeostasis can occur and increase the risk for cardiovascular disorders. So far, the differences between the multiple antipsychotics in propensity to cause these alterations have not been examined based on data from randomized controlled trial. Therefore, we are conducting a systematic review and network-metaanalysis on metabolic side effects of antipsychotic drugs. Methods Systematic review and network-metaanalysis. Population Patients with schizophrenia. Interventions Antipsychotic drugs and placebo. Comparator In network-metaanalysis all interventions are compared with each other. For presentation of Results:, placebo will be used as reference. Outcomes The primary outcomes will be continuous change of body weight. Additional outcomes will be continuous change of blood glucose, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol as well as dichotomous values of these outcomes (i.e. number of patients with a clinically relevant increase over pathological thresholds). Study design Randomized controlled trials. Statistical analysis Network-metaanalysis. Planned network-metaregression-, subgroup- and sensitivity-analyses will address the role of the potential effect modifiers baseline weight, study duration, age, gender, ethnicity, previous antipsychotic exposure, antipsychotic dose, sponsorship, and use of enriched-design. Results Funding for this project has been received from the German Ministry of Education and Research. At the time of abstract submission, the project has just started and is currently in the stage of protocol development. Discussion At the time of the conference the protocol of the study will be developed further and the literature search will have started. Thus, on the poster, details of the analytic approach can be presented and challenges discussed. Moreover, results of the search process can be presented.

Download Full-text

Metabolic side effects of antipsychotic drugs in individuals with schizophrenia during medium- to long-term treatment: protocol for a systematic review and network meta-analysis of randomized controlled trials

Systematic Reviews ◽

10.1186/s13643-021-01760-z ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Johannes Schneider-Thoma ◽

Angelika Kapfhammer ◽

Dongfang Wang ◽

Irene Bighelli ◽

Spyridon Siafis ◽

...

Keyword(s):

Systematic Review ◽

Side Effects ◽

Antipsychotic Drugs ◽

Meta Analysis ◽

Density Lipoprotein ◽

Term Treatment ◽

Controlled Trials ◽

Metabolic Side Effects ◽

Long Term Treatment

Abstract Background Antipsychotic drugs and especially the newer compounds are known to cause metabolic side effects. However, a comprehensive comparison of the different substances regarding their propensity to cause metabolic side effects in medium- to long-term treatment of schizophrenia is lacking. Methods We will conduct a systematic review and network meta-analysis (NMA). We will include randomized controlled trials (RCTs) in which participants received either placebo or an antipsychotic (i.e. placebo-controlled trials and head-to-head comparisons of drugs). We will include studies in individuals with schizophrenia or related disorders (such as schizophreniform or schizoaffective disorders) at any stage of the disease (acute episode; maintenance phase). We will include studies with a duration of more than 3 months (medium- to long-term treatment). The primary outcome will be the change in body weight. Secondary outcomes will be the further metabolic parameters: fastening glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. We will search for eligible studies (independent of the publication status) in Cochrane Schizophrenia Group’s Study-Based Register of Trials, which is compiled by regular searches in trial registries and multiple electronic databases from their inception onwards including MEDLINE, EMBASE and PsycINFO. Additionally, we will search previously published systematic reviews and websites of pharmaceutical companies for eligible studies. At least two reviewers will independently conduct the process of study selection and data extraction. We will use the Cochrane Risk of Bias 2 tool to evaluate the risk of bias in studies. We will conduct random-effects NMA within a Bayesian framework to synthesize all evidence for each outcome. We will conduct sensitivity and subgroup analyses to assess the robustness of the findings and to explore heterogeneity. The confidence in the results will be evaluated using the Confidence in Network Meta-Analysis (CINeMA) framework. Discussion This systematic review and network meta-analysis will provide a synthesis of the existing evidence from RCTs how antipsychotic drugs differ in terms of metabolic side effects during medium- to long-term treatment. The findings have the potential to influence the choice of antipsychotic medication made by individuals with schizophrenia and their physicians. Systematic review registration PROSPERO CRD42020175414

Download Full-text

The role of melatonin and melatonin agonists in counteracting antipsychotic-induced metabolic side effects

International Clinical Psychopharmacology ◽

10.1097/yic.0000000000000135 ◽

2016 ◽

Vol 31 (6) ◽

pp. 301-306 ◽

Cited By ~ 15

Author(s):

Hee Ryung Wang ◽

Young Sup Woo ◽

Won-Myong Bahk

Keyword(s):

Side Effects ◽

Metabolic Side Effects

Download Full-text

Controlling TIME: How MNK Kinases Function to Shape Tumor Immunity

Cancers ◽

10.3390/cancers12082096 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2096

Author(s):

Thao N.D. Pham ◽

Christina Spaulding ◽

Hidayatullah G. Munshi

Keyword(s):

Systematic Review ◽

Immune System ◽

Side Effects ◽

Immune Cells ◽

Cancer Development ◽

Interacting Protein ◽

Immune Systems ◽

Adaptive Immune ◽

Adaptive Immune Systems

A number of studies have clearly established the oncogenic role for MAPK-interacting protein kinases (MNK) in human malignancies. Modulation of MNK activity affects translation of mRNAs involved in cancer development, progression, and resistance to therapies. As a result, there are ongoing efforts to develop and evaluate MNK inhibitors for cancer treatment. However, it is important to recognize that MNK activity also plays an important role in regulating the innate and adaptive immune systems. A better understanding of the role of MNK kinases and MNK-mediated signals in regulating the immune system could help mitigate undesired side effects while maximizing therapeutic efficacy of MNK inhibitors. Here, we provide a systematic review on the function of MNK kinases and their substrates in immune cells.

Download Full-text

Metabolic and Endocrine Toxicities of Mitotane: A Systematic Review

Cancers ◽

10.3390/cancers13195001 ◽

2021 ◽

Vol 13 (19) ◽

pp. 5001

Author(s):

Marta Bianchini ◽

Giulia Puliani ◽

Alfonsina Chiefari ◽

Marilda Mormando ◽

Rosa Lauretta ◽

...

Keyword(s):

Systematic Review ◽

Side Effects ◽

Thyroid Dysfunction ◽

Menstrual Disorders ◽

Metabolic Systems ◽

Menopausal Women ◽

Glucocorticoid Replacement Therapy ◽

Safety Assessments ◽

Reliable Marker

Despite the pivotal role of mitotane in adrenocortical carcinoma (ACC) management, data on the endocrine toxicities of this treatment are lacking. The aim of this systematic review is to collect the available evidence on the side effects of mitotane on the endocrine and metabolic systems in both children and adults affected by adrenal carcinoma. Sixteen articles on 493 patients were included. Among the adrenal insufficiency, which is an expected side effect of mitotane, 24.5% of patients increased glucocorticoid replacement therapy. Mineralocorticoid insufficiency usually occurred late in treatment in 36.8% of patients. Thyroid dysfunction is characterized by a decrease in FT4, which occurs within 3–6 months of treatment in 45.4% of patients, while TSH seems to not be a reliable marker. Dyslipidemia is characterized by an increase in both LDL-c and HDL-c (54.2%). Few studies have found evidence of hypertriglyceridemia. In males, gynecomastia and hypogonadism can occur after 3–6 months of treatment (38.4% and 35.6%, respectively), while in pre-menopausal women, mitotane can cause ovarian cysts and, less frequently, menstrual disorders. Most of these side effects appear to be reversible after mitotane discontinuation. We finally suggest an algorithm that could guide metabolic and endocrine safety assessments in patients treated with mitotane for ACC.

Download Full-text