scholarly journals USE OF FLUNARIZINE AS A PREVENTIVE FOR VESTIBULAR MIGRAINE CRISES IN COMPARISON WITH OTHER DRUGS: SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Author(s):  
Lara Estupina Braghieri ◽  
Paula Lopes ◽  
Osmar Person ◽  
Fernando Junior ◽  
Priscila Bogar
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Vestibular Migraine ◽  
Moderate Degree ◽  
Level Of Evidence ◽  
Grade Method ◽  
Episodic Vertigo ◽  
Preventive Drug

INTRODUCTION: Vestibular migraine is the main cause of episodic vertigo and the second most common cause of dizziness in adults. Treatment for vestibular migraine encompasses the prevention of crises and the control of acute symptoms. Flunarizine works by preventing the contraction of labyrinthine vessels and altering blood flow, thus preventing symptoms. Due to the high prevalence of the disease, its negative impacts on individual health and increased expenditure on public health, preventive pharmacological and non-pharmacological treatment must be implemented early. PURPOSE: To evaluate the efficacy of Flunarizine as a preventive for migraine and vestibular crises compared to other preventive drugs. MATERIAL AND METHODS: Scientific articles were searched in the databases using the terms (vestibular migraine OR migrainous vertigo) AND (flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, including 3 randomized clinical trials comparing flunarizine and other preventive drugs in terms of efficacy and safety for preventing migraine vertigo attacks. The studies were analyzed using a ROB table, analysis using the GRADE method and meta-analysis. RESULTS: Qualitatively, the analysis showed that flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with a moderate degree of evidence, a relative risk of 0.34 and a confidence interval of 0.15 to 0.76. CONCLUSIONS: There are few studies available in the scientific literature on the use of flunarizine in vestibular migraine, many of which are heterogeneous among themselves, mainly in the way of evaluating and monitoring patients, carried out mainly through subjective methods. The meta-analysis showed a positive result for flunarizine as a preventive drug for the studied population. Furthermore, in all the studies analyzed, no serious side effects resulting from the use of the medication were reported, which makes it safe for patients to use. Flunarizine is a good drug for the prevention of vestibular migraine, especially in reducing the number of attacks, with a good level of evidence.

scholarly journals Therapeutic Plasma Exchange in Myasthenia Gravis: A Systematic Literature Review and Meta-Analysis of Comparative Evidence

2021 ◽  
Vol 12 ◽  
Author(s):  
Tina S. Ipe ◽  
Adeola R. Davis ◽  
Jay S. Raval
Keyword(s):  
Literature Review ◽  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Systematic Literature Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Therapeutic Plasma Exchange ◽  
Cochrane Library ◽  
Pubmed Database

Background: Patients with Myasthenia Gravis (MG) can be treated acutely with therapeutic plasma exchange (TPE) or intravenous immune globulin (IVIG). To date, there is no definitive understanding of which of the two treatments is more effective and safer. The purpose of this study was to systematically review the literature on the comparative efficacy and safety of TPE to other available treatments for MG.Methods: A systematic literature search for studies published between 1997 and 2017 was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using two database sources, MEDLINE (through the PubMed database) and Cochrane Library.Results: The search strategy resulted in 535 articles whose abstracts were reviewed. Among these, 165 full texts articles were reviewed for eligibility and 101 articles were excluded. Of the 165 articles, 64 articles were included for a systematic literature and 11 articles for a meta-analysis.Conclusions: This systematic literature review and meta-analysis of treatment options showed that there was a higher response rate with TPE than IVIG in acute MG patients and patients undergoing thymectomy. There was no difference in mortality between the two treatment options. Our findings highlight the need for additional randomized clinical trials in these patients with MG.

scholarly journals Efficacy and safety of TiNO-coated stents versus drug-eluting coronary stents. Systematic literature review and meta-analysis

2020 ◽  
Author(s):  
Frederic C. Daoud ◽  
Louis Létinier ◽  
Nicholas Moore ◽  
Pierre Coste ◽  
Pasi P. Karjalainen
Keyword(s):  
Sensitivity Analysis ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Coronary Syndrome ◽  
Drug Eluting

AbstractBackgroundRandomized clinical trials (RCTs) comparing percutaneous coronary interventions (PCI) with titanium-nitride-oxide coated stents (TiNOS) versus drug-eluting stents (DES) in coronary artery disease (CAD) have been published.ObjectivesTo compare the efficacy and safety of PCI with TiNOS versus DES at 1 and 5-year follow-up, in all CAD including acute coronary syndrome (ACS).MethodsA prospective systematic literature review and meta-analysis of RCTs were conducted according to published methods (Cochrane, PRISMA, GRADE). Medline, Embase, Cochrane database, Web of Science were searched on March 08, 2018. Fixed-effects Mantel-Haenszel pooled risk ratios (RR), TiNOS over DES, with 95% confidence intervals (CI) were computed with sensitivity analysis.ResultsFive RCTs were eligible with n = 1,855 TiNOS vs. n = 1,363 DES at 1-year and n = 783 vs. n = 771 at 5-year follow-up. One-year RRs in ACS patients: Major Adverse Cardiac Events (MACE) 0.93 [0.72, 1.20], recurrent myocardial infarction (MI) 0.42 [0.28, 0.63], probable or definite stent thrombosis (ST): 0.35 [0.20, 0.64]. Estimates were robust to sensitivity analysis. Certainty of evidence was high in MACE, moderate in MI and ST due to the limited number of cases. Data were insufficient to draw conclusions about stable CAD patients and 5-year outcomes.ConclusionsThis meta-analysis showed in ACS patients, similar risk of MACE with TiNOS and DES, at 1- year follow-up, and suggested a lower risk of MI and ST with TiNOS than with DES. These two safety signals in MI and ST with the current use of DES require further investigations.SLR registrationPROSPERO CRD42018090622 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=90622

Systematic Literature Review and Network Meta-analysis (NMA) of SGLT2i as Monotherapy for Type 2 Diabetes Mellitus (T2DM)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1159-P
Author(s):  
GLENN M. DAVIES ◽  
ANN MARIE MCNEILL ◽  
ELIZA KRUGER ◽  
STACEY L. KOWAL ◽  
FLAVIA EJZYKOWICZ ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis
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