scholarly journals Proprotein convertase subtilisin/kexin 9 inhibitors in reducing cardiovascular outcomes: a systematic review and meta-analysis

Heart ◽  
2019 ◽  
pp. heartjnl-2019-314763 ◽  
Author(s):  
Heyue Du ◽  
Xiaodan Li ◽  
Na Su ◽  
Ling Li ◽  
Xiaoting Hao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Baseline Risk ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Proprotein Convertase ◽  
Pcsk9 Inhibitors ◽  
Quality Evidence

BackgroundTo evaluate the effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on major adverse cardiovascular events (MACE).MethodsOur systematic review included randomised controlled trials if they studied PCSK9 inhibitors in patients for primary and/or secondary prevention of cardiovascular diseases or with hypercholesterolaemia/hyperlipidaemia. Dichotomous variables from individual studies were pooled by relative risks (RR) and their 95% CIs using the random-effect model. Risk difference (RD) in the 10-year frame was also estimated using the pooled RR and the estimated baseline risk using the control group. Grading of Recommendation Assessment, Development and Evaluation was used to assess the quality of evidence.ResultsWe included 54 trials with 97 910 patients in the analysis. Compared with controls, PCSK9 inhibitors significantly reduced the risk of MACE by 16% (RR, 0.84; 95% CI 0.79 to 0.89; RD: 47 fewer per 1000 vs 286 as the baseline risk; 95% CI 32 to 59 fewer), non-fatal myocardial infarction (MI) by 17% (RR, 0.83; 95% CI 0.74 to 0.93; RD, 35 fewer per 1000 vs 207 as the baseline; 95% CI 13 to 53 fewer) and any stroke by 25% (RR, 0.75; 95% CI 0.65 to 0.85; RD, 16 fewer per 1000 vs 61 as the baseline; 95% CI 9 to 21 fewer) with moderate quality evidence. No significant differences were found between PCSK9 inhibitors and control groups in all-cause mortality, cardiovascular death, heart failure or unstable angina with low-quality evidence.ConclusionsThis study demonstrated that PCSK9 inhibitors could significantly reduce the risk of MACE, non-fatal MI and stroke.Trial registrationPROSPERO; CRD42017073904.

Reno-vascular toxicities associated with carfilzomib: Systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21622-e21622
Author(s):  
Chintan Shah ◽  
Harini Bejjanki ◽  
Rohit Bishnoi ◽  
Ankur Jain ◽  
Subhankar Samal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Phase I ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Dose Effect ◽  
Phase Iii ◽  
Control Group ◽  
Phase Iii Clinical Trials

e21622 Background: Carfilzomib (Carf) is a novel proteasome inhibitor that is approved for patients with relapsed multiple myeloma (RMM) who have failed ≥ 1 prior lines of therapy. The incidence and seriousness of Carf associated reno-vascular toxicities (RVT) is not well known. We performed systematic review of Carf literature with meta-analysis to determine its incidence and overall risk. Methods: Initial search of literature led to a total of 175 Carf related articles. However, we used a total of 29 publications; phase I/II, phase II and phase III clinical trials (n = 3) which used Carf as monotherapy or in combination. We excluded phase I studies. Incidence rates and odds ratios (OR) were calculated with either fixed effect or random effect model based on the heterogeneity of included studies. Toxicity such as hypertension (HTN), renal failure (RF) and venous thromboembolism (VTE) were reported according to CTCAE v4.0. Results: A total of 4560 patients with various hematological and solid malignancies were included. Incidences of toxicities were: 15.9% and 4.7 % for HTN, 11.2% and 3.44% for RF, 6.47% and 2.22% for VTE, respectively for all grades and high grades in each category. When compared to control group taken from phase III clinical trials, the risk of HTN and RF due to Carf was significantly higher [OR = 2.91 and 3.32 in HTN (P < 0.001)], [OR = 1.71 and 1.79 (P < 0.05) for RF], respectively for all grade and high grade in each category. Moreover, incidence of HTN with higher than standard dose of carf (27 mg/m2 twice weekly) was significantly higher (P < 0.001). RF and VTE did not have the dose effect. Concomitant use of immunomodulator (IMiD) significantly increased, as expected, the incidence of VTE (P < 0.001). There was no variation in the incidence of RVT among newly diagnosed versus RMM (P = 0.4). Conclusions: Overall incidence and risk of hypertension and renal toxicities seems to be high when using Carf. Higher doses of Carf seem to lead to higher incidence of HTN, while the risk of VTE is higher with concomitant IMiD use. The pathophysiology for these complications is poorly understood, however it could be secondary to endothelial effect of carf. Physician should be vigilant about these effects as it can lead to poor overall outcomes.

scholarly journals Association Between Circulating Proprotein Convertase Subtilisin/Kexin Type 9 Concentrations and Cardiovascular Events in Cardiovascular Disease: A Systemic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiahui Liu ◽  
Fangfang Fan ◽  
Xingyu Luo ◽  
Wenjun Ji ◽  
Yaokun Liu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Positive Association ◽  
Systemic Review ◽  
Proprotein Convertase ◽  
Pcsk9 Inhibitors ◽  
Clinical Role ◽  
Increased Risk

Background: A large amount of evidence suggests that proprotein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors have clinical benefits in patients with cardiovascular disease (CVD). However, whether PCSK9 concentrations predict future cardiovascular (CV) events remains unclear.Methods: We conducted a meta-analysis to investigate the ability of PCSK9 concentrations to predict future CV events in patients with established CVD. A comprehensive search of electronic databases was conducted in June 2021. We included relative risk (RR) estimates with 95% CI or events of interest.Results: Eleven cohort studies including 8,471 patients with CVD were enrolled. The pooled RR of CV events for the increase in the circulating baseline PCSK9 concentrations by 1 SD showed a positive association in a random-effect model (RR 1.226, 95% CI: 1.055–1.423, P = 0.008). Similarly, the risk of the total CV events increased by 52% in the patients in the highest tertile compared with those in the lowest tertile of circulating PCSK9 concentrations (RR 1.523, 95% CI: 1.098–2.112, P = 0.012). The association between PCSK9 and CV events was stronger in stable patients with CVD, patients treated with statins, and Asian patients.Conclusions: High PCSK9 concentrations are significantly related to the increased risk of future CV events. These results enrich the knowledge of PCSK9 function and suggest the further possible clinical role of PCSK9 inhibitors.

scholarly journals Clinical Outcomes of Convalescent Plasma Transfusion Therapy in Moderate to Critically Ill Covid-19 Patients: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 191-203
Author(s):  
P. Ramakrishna ◽  
Rani Padmasree ◽  
R. Swetha ◽  
Sk. Asifuddin ◽  
A. Susedharan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Control Group ◽  
Transfusion Therapy ◽  
Standard Drug ◽  
Standard Medication ◽  
D Dimer

Background: Currently, Convalescent plasma (CP)is considered a favorable treatment option for moderate to critically ill Covid-19 patients. But there were very few systematic reviews focused on the effect of CP on clinical parameters. As a result, we undertook this systematic review to learn more about the safety and clinical benefits of convalescent plasma therapy over standard treatment (control). Methodology: We searched Pub Med, Embase and other bibliographic databases to find relevant articles between December 2019 and February 2021 and identified 10 relevant articles which compared CP therapy taken in addition to standard medication with the Control group(who received standard medication). Two independent reviewers examined all full-text articles and extracted the required information intoa predesigned proforma. Forest plots were drawn using RevMan v.5, a statistical tool offered by the Cochrane database to estimate the pooled effect. Results: The results of meta-analysis using a random effect model indicated a significant reduction in mortality rate in CP (about 27% risk reduction), a reduced length of hospital stay in about 2 days (Weighted Mean Difference: -2.53, 95% CI, -7.20 to -2.14, P<0.0001), less time to improve clinical symptoms in about 4 days (pooled mean; CP:10.82 days vs Control:15.14 days). C-Reactive Protein (CRP) concentration levels (mg/L) were well controlled with the control group than the CP group and significant changes in lymphocytes and D-dimer values were not observed after CP treatment. It was also found that no difference between CP transfusion and control was seen in improving the oxygen saturationlevels. Conclusion: CP transfusion can be considered safe and showed a significant reduction in mortality and possible benefits in clinical improvement. Patients on CP therapy had no significant benefits in improving inflammatory markers such as CRP, lymphocytes, D-dimer, or oxygen saturation levels over standard drug therapy, according to meta-analysis data.

Influence of Hyaluronan Nasal Dressing on Clinical Outcome after Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 31 (4) ◽  
pp. 256-259 ◽  
Author(s):  
Jianneng Chen ◽  
Xuan Wang ◽  
Luzan Chen ◽  
Jie Liu
Keyword(s):  
Systematic Review ◽  
Clinical Outcome ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Sinus Surgery ◽  
Control Group ◽  
Effect Model ◽  
Control Intervention

Introduction Hyaluronan nasal dressing might be promising in promoting reepithelialization after endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the effects of hyaluronan nasal dressing on clinical outcome after ESS. Methods Medical literature data bases were systematically searched. Randomized controlled trials (RCT) that assessed the effect of hyaluronan nasal dressing on the outcome after ESS were included. The results were searched and data were extracted and assessed for quality. The primary outcome was reepithelization. Meta-analysis was performed by using the random-effect model. Results Four RCTs, which involved 352 patients, were included in the meta-analysis. Overall, compared with control intervention, hyaluronan nasal dressing significantly promoted reepithelization (odds ratio [OR] 3.18 [95% confidence interval {CI}, 1.33-7.59]; p = 0.009) and reduced edema (OR 0.45 [95% CI, 0.23-0.89]; p = 0.02) after ESS. However, hyaluronan nasal dressing failed to reduce synechia (OR 0.45 [95% CI, 0.19-1.03]; p = 0.06), crust (OR 1.00 [95% CI, 0.20-5.09]; p = 1.00), and infection (OR 0.84 [95% CI, 0.46-1.53]; p = 0.56) compared with the control group in patients who underwent ESS. Conclusion Compared with “Control intervention” indicates standard nasal dressing without hyaluronan, resorbable hyaluronan nasal dressing could significantly improve reepithelization and decrease edema but had no influence on synechia, crust, and infection after ESS.

Cardiotoxicity associated with carfilzomib: Systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21674-e21674
Author(s):  
Chintan Shah ◽  
Rohit Bishnoi ◽  
Harini Bejjanki ◽  
Ankur Jain ◽  
Subhankar Samal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Phase I ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Dose Effect ◽  
Phase Iii ◽  
Control Group ◽  
Coronary Syndrome

e21674 Background: Carfilzomib (Carf)is a novel proteasome inhibitor (PI) that is approved for patients with relapsed multiple myeloma (RMM) who have failed ≥ 1 prior lines of therapy. The incidence and seriousness of Carf associated cardiotoxicity (CT) is not well defined. We hypothesize that CT is more frequent than that seen with other PIs. We performed systematic review of Carf literature with meta-analysis to determine its incidence and overall risk. Methods: Initial search of literature led to a total of 175 Carf related articles. However, we used 29 publicatons; phase I/II, phase II and phase III (n = 3) clinical trials in which Carf was used as monotherapy or in combination with other chemo agents. We excluded phase I studies and studies without CT data. Incidence rates and odds ratios (OR) were calculated with either fixed effect or random effect model based on the heterogeneity of included studies. Toxicity was reported according to CTCAE v4.0. Results: A total of 4560 patients with various hematological and solid malignancies were included. Incidence of all grades and high grades (≥ 3) CT (including arrhythmias, CHF with LVEF drop, and coronary syndrome) were 7.8% and 4.72%, respectively. When compared to control group taken from phase III clinical trials, the risk of developing CT due to Carf was significantly higher with OR of 1.90 and 2.03 (P < 0.01) for all grades and high grades, respectively. Moreover, incidence of CT was significantly higher in Carf combination therapy (9.85%) compared to Carf monotherapy (5.40%) (P = 0.01). Furthermore, incidence of high grade CT was 7.5% and 5% with and without concomitant immunomodulatory agent (IMiD), respectively (P = 0.004). There was no variation in the incidence of CT among newly diagnosed versus RMM (P = 0.6), and no Carf dose effect. Mortality rate associated with cardiotoxicity was 1.5%. Conclusions: Overall incidence of Carf related CT seems to be higher than that reported with other PIs. Although, the pathophysiology is poorly understood, this trend could potentially be secondary to irreversible nature of proteasome inhibition by Carf. There seems to be a significant increase in CT with combination of Carf and an IMiD. Prior therapies and higher Carf doses have no effect on CT incidence.

scholarly journals Obesity paradigm and web-based weight loss programs: an updated systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Leila Jahangiry ◽  
Mahdieh Abbasalizad Farhangi
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Health Care Systems ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Group Versus ◽  
Control Group ◽  
Web Based ◽  
Care Systems

Abstract Backgrounds Web-based therapeutic approaches are new and attractive tools for primary health care systems due to their time and cost-saving nature and their accessibility for different populations. The aim of the current systematic review and meta-analysis is to summarize the results of studies evaluating the effect of web-based interventional programs on weight loss among overweight and obese individuals. Methods A literature review from 2000 to 2016 was conducted. Studies were included in the study if they had adult participants with body mass index (BMI) ≥ 25 kg/m2, a web-user intervention arm, and a non-web user control arm, with the primary aim of weight loss. Weight change in the interventional group versus control group was pooled with the random-effect model. Data were extracted on sample characteristics, drop-outs, weight loss, intervention duration, and the amount of weight loss. The mean weighted difference and 95% confidence intervals (CI) were calculated. Results Eight studies met the inclusion criteria and included in the final model. Overall, using the web-based interventions had a weak non-significant effect on weight loss in overweight and obese individuals (WMD 0.56 kg, CI − 3.474, 4.592; P = 0.786). The most important reason was the unadjusted baseline weight of experimental and control groups in included studies, although the stratified analysis showed that, low study quality score and not using feedback and goal-setting in the study were the main factors diminishing the effectiveness of web-based intervention treatment group. Conclusion The results of the current meta-analysis indicated no effectiveness of web-based interventional programs in the weight loss of overweight and obese individuals. Although the great between-study heterogeneity and a small number of included studies further highlight the need for additional researches in this field.

scholarly journals Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252461
Author(s):  
Athira Balakrishnan ◽  
Sandra Puthean ◽  
Gautam Satheesh ◽  
Unnikrishnan M. K. ◽  
Muhammed Rashid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blended Learning ◽  
Effect Size ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Pharmacy Education ◽  
Cochrane Library ◽  
Control Group ◽  
Effect Model

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling. Key findings A total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41). Conclusion BL is associated with better academic performance and achievement than didactic teaching in pharmacy education.

scholarly journals Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3568
Author(s):  
Andryanto Sutanto ◽  
Citrawati Dyah Kencono Wungu ◽  
Hendri Susilo ◽  
Henry Sutanto
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Cardiovascular Diseases ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Major Adverse Cardiovascular Events ◽  
Lifestyle Modifications ◽  
Diet Control

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and obesity is a major risk factor that increases the morbidity and mortality of CVDs. Lifestyle modifications (e.g., diet control, physical exercise and behavioral changes) have been the first-line managements of obesity for decades. Nonetheless, when such interventions fail, pharmacotherapies and bariatric surgery are considered. Interestingly, a sudden weight loss (e.g., due to bariatric surgery) could also increase mortality. Thus, it remains unclear whether the bariatric surgery-associated weight reduction in patients with obesity and CVDs is beneficial for the reduction of Major Adverse Cardiovascular Events (MACE). Here, we performed a systematic literature search and meta-analysis of published studies comparing MACE in patients with obesity and CVDs who underwent bariatric surgery with control patients (no surgery). Eleven studies, with a total of 1,772,305 patients, which consisted of 74,042 patients who underwent any form of bariatric surgery and 1,698,263 patients with no surgery, were included in the systematic review. Next, the studies’ data, including odds ratio (OR) and adjusted hazard ratio (aHR), were pooled and analyzed in a meta-analysis using a random effect model. The meta-analysis of ten studies showed that the bariatric surgery group had significantly lower odds of MACE as compared to no surgery (OR = 0.49; 95% CI 0.40–0.60; p < 0.00001; I2 = 93%) and the adjustment to confounding variables in nine studies revealed consistent results (aHR = 0.57; 95% CI 0.49–0.66; p < 0.00001; I2 = 73%), suggesting the benefit of bariatric surgery in reducing the occurrence of MACE in patients with obesity and CVDs (PROSPERO ID: CRD42021274343).

scholarly journals The Effect of Physical Activity on Glycemic Variability in Patients With Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Xingyun Zhu ◽  
Lina Zhao ◽  
Jing Chen ◽  
Chu Lin ◽  
Fang Lv ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Glycemic Variability ◽  
Control Group ◽  
Effect Model ◽  
Patients With Diabetes

PurposeThe effect of physical activity on glycemic variability remains controversial. This meta-analysis aimed to assess the overall effect of physical activity treatment on glycemic variability in patients with diabetes.MethodsPubMed/MEDLINE, Embase, and Cochrane databases were searched for clinical trials that conducted in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of the mean amplitude of glycemic excursion (MAGE), time in range (TIR), time above range (TAR), or time below range (TBR). Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly.ResultsIn total, thirteen trials were included. Compared with the control group, physical activity intervention was significantly associated with increased TIR (WMDs, 4.17%; 95% CI, 1.11 to 7.23%, P&lt;0.01), decreased MAGE (WMDs, -0.68 mmol/L; 95% CI, -1.01 to -0.36 mmol/L, P&lt;0.01) and decreased TAR (WMDs, -3.54%; 95% CI, -5.21 to -1.88%, P&lt;0.01) in patients with diabetes, but showed insignificant effects on TBR. Patients with higher baseline BMI levels was associated with a greater decrease in MAGE (β=-0.392, 95% CI: -0.710, -0.074), and patients with lower baseline HbA1c levels was associated with a greater increase in TBR during physical activities (β=-0.903, 95% CI: -1.550, -0.255).ConclusionPhysical activity was associated with significantly decreased glycemic variability in patients with diabetes. Patients with higher BMI might benefit more from physical activity therapy in terms of a lower MAGE. Hypoglycemia associated with physical activity treatment still warranted caution, especially in patients with intensive glycemic control.Systematic Review RegistrationPROSPERO [CRD42021259807].

scholarly journals The Improving Effect and Safety of Probiotic Supplements on Patients with Osteoporosis and Osteopenia: A Systematic Review and Meta-Analysis of 10 Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Liuting Zeng ◽  
Ganpeng Yu ◽  
Kailin Yang ◽  
Wensa Hao ◽  
Hua Chen
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Effect Model ◽  
Literature Searches ◽  
Language Literature

Aim. Probiotics are considered to be bone metabolism regulators, and their efficacy as an adjuvant treatment option for osteoporosis is still controversial. The purpose of this study is to compare the available data from randomized controlled trials (RCT) of probiotics in the treatment of osteoporosis and osteopenia. Methods. As of June 2021, databases such as Medline, Embase, Web of Science, and Central Cochrane Library have been used for English-language literature searches and CNKI and China Biomedical Database have been used for Chinese-language literature searches. RevMan 5.3 was used for bias risk assessment, heterogeneity detection, and meta-analysis. This research has been registered in PROSPERO (CRD42020085934). Results. This systematic review and meta-analysis included 10 RCTs involving 1156. Compared with the placebo, the absolute value of lumbar spine’s BMD was not statistically significant (WMD 0.04 (−0.00, 0.09), P = 0.07 , random effect model), while the percentage of lumbar spine’s BMD was higher (SMD 1.16 (0.21, 2.12), P = 0.02 , random effect model). Compared with the control group, the percentage of total hip’s BMD was not statistically significant (SMD 0.52 (−0.69, 1.73), P = 0.40 , random effect model). The safety analysis showed that, compared with control group, the adverse events in the experimental group were not statistically significant (RR 1.02 (0.92, 1.12), P = 0.70 , fixed effect model). Conclusion. Probiotics may be safety supplements to improve the lumbar spine’s BMD of patients with osteoporosis and osteopenia. More large-sample, random-controlled, high-quality RCTs are needed to further verify the effectiveness and safety of probiotics in intervening osteoporosis or osteopenia.

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