scholarly journals Systematic Review and Meta-analysis of Postlicensure Observational Studies on Human Papillomavirus Vaccination and Autoimmune and Other Rare Adverse Events

2020 ◽  
Vol 39 (4) ◽  
pp. 287-293 ◽  
Author(s):  
Corinne Willame ◽  
Kartini Gadroen ◽  
Wichor Bramer ◽  
Daniel Weibel ◽  
Miriam Sturkenboom
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Adverse Events ◽  
Observational Studies ◽  
Meta Analysis ◽  
Human Papillomavirus Vaccination

scholarly journals Targeted therapies for previously treated advanced or metastatic renal cell carcinoma: systematic review and network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024691 ◽  
Author(s):  
Charlotta Karner ◽  
Kayleigh Kew ◽  
Victoria Wakefield ◽  
Natalie Masento ◽  
Steven J Edwards
Keyword(s):  
Systematic Review ◽  
Renal Cell Carcinoma ◽  
Sensitivity Analysis ◽  
Adverse Events ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Observational Studies ◽  
Meta Analysis ◽  
Targeted Treatment

ObjectiveTo compare the effectiveness and safety of treatments for advanced or metastatic renal cell carcinoma (amRCC) after treatment with vascular endothelial growth factor (VEGF)-targeted treatment.DesignSystematic review and network meta-analysis of randomised controlled trials (RCTs) and comparative observational studies. MEDLINE, EMBASE and Cochrane Library were searched up to January 2018.ParticipantsPeople with amRCC requiring treatment after VEGF-targeted treatment.InterventionsAxitinib, cabozantinib, everolimus, lenvatinib with everolimus, nivolumab, sorafenib and best supportive care (BSC).OutcomesPrimary outcomes were overall survival (OS) and progression-free survival (PFS); secondary outcomes were objective response rate (ORR), adverse events, and health-related quality of life (HRQoL).ResultsTwelve studies were included (n=5144): five RCTs and seven observational studies. Lenvatinib with everolimus significantly increased OS and PFS over everolimus (HR 0.61, 95% Credible Interval [95%CrI]: 0.36 to 0.96 and 0.47, 95%CrI: 0.26 to 0.77, respectively) as did cabozantinib (HR 0.66, 95%CrI: 0.53 to 0.82 and 0.51, 95%CrI: 0.41 to 0.63, respectively). This remained the case when observational evidence was included. Nivolumab also significantly improved OS versus everolimus (HR 0.74, 95%CrI: 0.57 to 0.93). OS sensitivity analysis, including observational studies, indicates everolimus being more effective than axitinib and sorafenib. However, inconsistency was identified in the OS sensitivity analysis. PFS sensitivity analysis suggests axitinib is more effective than everolimus, which may be more effective than sorafenib. The results for ORR supported the OS and PFS analyses. Nivolumab is associated with fewer grade 3 or grade 4 adverse events than lenvatinib with everolimus or cabozantinib. HRQoL could not be analysed due to differences in tools used.ConclusionsLenvatinib with everolimus, cabozantinib and nivolumab are effective in prolonging the survival for people with amRCC subsequent to VEGF-targeted treatment, but there is considerable uncertainty about how they compare to each other and how much better they are than axitinib and sorafenib.PROSPERO registrationnumberCRD42017071540.

scholarly journals Adverse events associated with human papillomavirus vaccines: a protocol for systematic review with network meta-analysis incorporating all randomised controlled trials comparing with placebo, adjuvants and other vaccines

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026924 ◽  
Author(s):  
Jiro Takeuchi ◽  
Hisashi Noma ◽  
Yuta Sakanishi ◽  
Takashi Kawamura
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Adverse Events ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Splitting Method ◽  
Health Concern ◽  
Human Papillomavirus Vaccine

IntroductionAdverse events following the injection (AEFIs) of human papillomavirus vaccine (HPVv) among female adolescents are still a major public health concern.MethodsAccording to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension statement for systematic reviews incorporating network meta-analyses, all prospective randomised trials will be included. The primary outcome for adverse events is topical pain during the observation period.We will mainly search 17 electronic databases from January 2000 through September 2019 with suitable Medical Subject Headings and text words for PubMed. Two reviewers will independently check the reports at the title/abstract level and identify potentially applicable studies. Then we will obtain their full texts and decide whether to include them based on the same eligible criteria.We will compare HPVv with placebo, HPVv with adjuvant and HPVv with other vaccines. Interstudy heterogeneity, publication biases or small study effects will be evaluated using conventional meta-analysis methods. The consistency of the network will be checked using tests for local and global inconsistency and the side-splitting method. To address the heterogeneity of treatment effects among the studies, we will use the multivariable random effect model.Ethics and disseminationThis pairwise or network meta-analysis does not require ethics approval. The data used here are not individual nor private. We will be able to determine which component of the vaccine induces adverse events, especially topical pain. This systematic review with network meta-analysis will provide valid answers regarding AEFIs for HPVv.PROSPERO registration numberCRD42018109265

scholarly journals Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis

The Lancet ◽  
2019 ◽  
Vol 394 (10197) ◽  
pp. 497-509 ◽  
Author(s):  
Mélanie Drolet ◽  
Élodie Bénard ◽  
Norma Pérez ◽  
Marc Brisson ◽  
Hammad Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Meta Analysis ◽  
Population Level ◽  
Human Papillomavirus Vaccination

Human papillomavirus vaccination and the risk of autoimmune disorders: A systematic review and meta-analysis

Vaccine ◽  
2019 ◽  
Vol 37 (23) ◽  
pp. 3031-3039 ◽  
Author(s):  
Hai-yin Jiang ◽  
Yu-dan Shi ◽  
Xue Zhang ◽  
Li-ya Pan ◽  
Yi-rui Xie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Meta Analysis ◽  
Autoimmune Disorders ◽  
Human Papillomavirus Vaccination

scholarly journals Inequalities in the uptake of Human Papillomavirus Vaccination: a systematic review and meta-analysis

2013 ◽  
Vol 42 (3) ◽  
pp. 896-908 ◽  
Author(s):  
Harriet Fisher ◽  
Caroline L Trotter ◽  
Suzanne Audrey ◽  
Kyle MacDonald-Wallis ◽  
Matthew Hickman
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
Meta Analysis ◽  
Human Papillomavirus Vaccination

scholarly journals The Role of Hydroxyurea to Prevent Silent Stroke in Sickle Cell Disease: Systematic Review and Meta-Analysis

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2373-2373
Author(s):  
Carla Hasson ◽  
Lisa Veling ◽  
Juan Felipe Rico ◽  
Rahul Mhaskar
Keyword(s):  
Systematic Review ◽  
Sickle Cell Disease ◽  
Adverse Events ◽  
Sickle Cell ◽  
Observational Studies ◽  
Assessment Tool ◽  
Conflicts Of Interest ◽  
Meta Analysis ◽  
Blood Transfusions ◽  
Cell Disease

Abstract Chronic blood transfusions are standard of care for stroke prevention in sickle cell disease. We evaluated hydroxyurea's efficacy in preventing silent stroke. We searched for randomized controlled trials (RCTs) and observational studies on Pubmed, CENTRAL, Embase, and Web of Science without using language/time limits. Eligible studies compared hydroxyurea with transfusions or observation to prevent silent stroke. This systematic review adheres to the Cochrane guidelines. Data were pooled using random effects model using STATA to perform meta-analysis. Methodological quality of RCTs was investigated using the Cochrane risk of bias assessment tool, while observational studies were assessed using the Downs & Black Checklist for Study Quality. One RCT enrolling 121 participants was included. There were no strokes, silent strokes, or deaths reported in either arm. There was no difference between hydroxyurea versus chronic blood transfusions (RR 1.52, 95% CI 0.57 to 4.02, P = 0.39) for adverse events. We included 10 observational studies, with 361 participants receiving hydroxyurea. There were no deaths attributed to hydroxyurea. Approximately 1% (I2 = 48.67%, 95% CI 0.0 to 0.05, 314 participants, seven comparisons) of patients receiving hydroxyurea had stroke. Approximately 18% (I2 = 91.37%, 95% CI 0.03 to 0.4, 266 participants, six comparisons) of the hydroxyurea patients had silent stroke. Approximately 24% (I2 = 88.54%, 95% CI 0.02 to 0.57, 91 participants, four comparisons) of the hydroxyurea patients had adverse events attributed to hydroxyurea. Our findings suggest that hydroxyurea is safe and may prevent silent stroke and stroke. More high-quality studies are needed. Disclosures No relevant conflicts of interest to declare.

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