scholarly journals The Comparative Efficacy and Safety of Entecavir and Lamivudine in Patients with HBV-Associated Acute-on-Chronic Liver Failure: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11
Author(s):  
Jiao Yang ◽  
Hang Sun ◽  
Qi Liu
Keyword(s):  
Survival Rate ◽  
Liver Failure ◽  
Meta Analysis ◽  
Survival Rates ◽  
Term Treatment ◽  
Chronic Liver ◽  
Efficacy And Safety ◽  
Chronic Liver Failure ◽  
Long Term Treatment

Background.Currently, both of entecavir and lamivudine are effective for patients with HBV-associated acute-on-chronic liver failure (ACLF). However, there is no consensus on the efficacy of entecavir versus lamivudine for patients with HBV-associated ACLF. The aim of the study was to compare the efficacy and safety of entecavir with that of lamivudine for HBV-associated ACLF patients.Methods.Publications on entecavir versus lamivudine in HBV-associated ACLF patients were comprehensively identified. Odds ratio and mean difference were used to measure the effect.Results.Ten studies, totaling 1254 patients, were eligible. No significant differences between the two drugs presented in the 1-, 2-, 3-, or 6-month survival rates. However, after 12 months of treatment, patients prescribed entecavir had a statistically higher survival rate (p=0.008) and lower total bilirubin (p<0.0001) and alanine aminotransferase (p=0.04) levels compared to patients prescribed lamivudine. More patients achieved HBV negative levels when taking entecavir as measured at 1-, 3-, and 12-month time points and had a lower rate of HBV recurrence.Conclusion.While entecavir and lamivudine are both relatively safe and well tolerated, entecavir was more efficacious in terms of survival rate and clinical improvement in long-term treatment. Further prospective randomized controlled trials are needed to validate these results.

Long term treatment of patients with acute exacerbation of chronic liver failure by albumin dialysis

1999 ◽  
Vol 31 (1-2) ◽  
pp. 1371-1375 ◽  
Author(s):  
M Seige ◽  
B Kreymann ◽  
B Jeschke ◽  
U Schweigart ◽  
K.-F Kopp ◽  
...  
Keyword(s):  
Liver Failure ◽  
Acute Exacerbation ◽  
Term Treatment ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Albumin Dialysis ◽  
Long Term Treatment

scholarly journals Effectiveness of granulocyte colony-stimulating factor for patients with acute-on-chronic liver failure: a meta-analysis

2021 ◽  
Vol 41 (6) ◽  
pp. 383-391
Author(s):  
Wei Huang ◽  
Yuanji Ma ◽  
Lingyao Du ◽  
Shuang Kang ◽  
Chang-Hai Liu ◽  
...  
Keyword(s):  
Liver Failure ◽  
Sample Size ◽  
Meta Analysis ◽  
Survival Rates ◽  
Chronic Liver ◽  
Cochrane Library ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Chronic Liver Failure ◽  
Stimulating Factor

BACKGROUND: The safety and efficacy of granulocyte colony-stimulating factor (G-CSF) for the treatment of acute-on-chronic liver failure (ACLF) remain uncertain. Therefore, we conducted a meta-analysis to draw a firmer conclusion. METHODS: We searched the Cochrane library, PubMed, Embase, and China Biology Medicine disc to identify relevant RCTs performed before January 2020. Risk ratios (RRs) and their 95% confidence intervals (95% CIs) were calculated using a random effects model. MAIN OUTCOME MEASURES: RRs (95% CI) for 1-, 2-, and 3-month survival rates. SAMPLE SIZE: Six RCTs, including three open-label studies. RESULTS: The six studies included 246 subjects (121 in a G-CSF group and 125 in a control group). G-CSF administration significantly improved the 1-, 2-, and 3-month survival rates in patients with ACLF. The pooled RRs (95% CI, P) were 0.43 (0.27–0.69, P =.0004), 0.44 (0.32–0.62, P <.00001), and 0.39 (0.22–0.68, P =.0009), respectively. CONCLUSION: G-CSF may be beneficial and effective in the treatment of ACLF, but further studies are needed to verify this conclusion. LIMITATIONS: The sample size was small, and studies were restricted to countries in Asia. PROSPERO REGISTRATION NUMBER: CRD42021225681 CONFLICT OF INTEREST: None.

scholarly journals The efficacy and safety of nucleos(t)ide analogues in the treatment of HBV-related acute-on-chronic liver failure: a meta-analysis

2013 ◽  
Vol 12 (3) ◽  
pp. 364-372 ◽  
Author(s):  
Yu Shi ◽  
Jianqin He ◽  
Wei Wu ◽  
Jianrong Huang ◽  
Yida Yang ◽  
...  
Keyword(s):  
Liver Failure ◽  
Meta Analysis ◽  
Chronic Liver ◽  
Efficacy And Safety ◽  
Chronic Liver Failure

Efficacy and safety of long-term treatment with statins for coronary heart disease: A Bayesian network meta-analysis

2016 ◽  
Vol 254 ◽  
pp. 215-227 ◽  
Author(s):  
Yongbin Lu ◽  
Zhiyuan Cheng ◽  
Yaxue Zhao ◽  
Xiaoyu Chang ◽  
Cynthia Chan ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Term Treatment ◽  
Efficacy And Safety ◽  
Long Term Treatment

scholarly journals Uncertainty in the impact of liver support systems in acute-on-chronic liver failure: a systematic review and network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Klementina Ocskay ◽  
Anna Kanjo ◽  
Noémi Gede ◽  
Zsolt Szakács ◽  
Gabriella Pár ◽  
...  
Keyword(s):  
Liver Failure ◽  
Support Systems ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Bioartificial Liver ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Liver Support ◽  
Bioartificial Liver Support ◽  
The Impact

Abstract Background The role of artificial and bioartificial liver support systems in acute-on-chronic liver failure (ACLF) is still controversial. We aimed to perform the first network meta-analysis comparing and ranking different liver support systems and standard medical therapy (SMT) in patients with ACLF. Methods The study protocol was registered with PROSPERO (CRD42020155850). A systematic search was conducted in five databases. We conducted a Bayesian network meta-analysis of randomized controlled trials assessing the effect of artificial or bioartificial liver support systems on survival in patients with ACLF. Ranking was performed by calculating the surface under cumulative ranking (SUCRA) curve values. The RoB2 tool and a modified GRADE approach were used for the assessment of the risk of bias and quality of evidence (QE). Results In the quantitative synthesis 16 trials were included, using MARS®, Prometheus®, ELAD®, plasma exchange (PE) and BioLogic-DT®. Overall (OS) and transplant-free (TFS) survival were assessed at 1 and 3 months. PE significantly improved 3-month OS compared to SMT (RR 0.74, CrI: 0.6–0.94) and ranked first on the cumulative ranking curves for both OS outcomes (SUCRA: 86% at 3 months; 77% at 1 month) and 3-month TFS (SUCRA: 87%) and second after ELAD for 1-month TFS (SUCRA: 76%). Other comparisons did not reach statistical significance. QE was moderate for PE concerning 1-month OS and both TFS outcomes. Other results were of very low certainty. Conclusion PE seems to be the best currently available liver support therapy in ACLF regarding 3-month OS. Based on the low QE, randomized trials are needed to confirm our findings for already existing options and to introduce new devices.

Systematic review with meta-analysis: liver transplant provides survival benefit in patients with acute on chronic liver failure

2020 ◽  
Vol 52 (2) ◽  
pp. 222-232 ◽  
Author(s):  
Mohamed A. Abdallah ◽  
Muhammad Waleed ◽  
Matthew G. Bell ◽  
Morgan Nelson ◽  
Robert Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Failure ◽  
Liver Transplant ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Chronic Liver ◽  
Chronic Liver Failure

Efficacy and safety of long-term treatment with monthly calcifediol soft capsules in vitamin D deficient patients

2021 ◽  
Author(s):  
Jódar Esteban ◽  
Jose Luis Perez-Castrillon ◽  
Dueñas Antonio ◽  
Gonzalo Hernandez ◽  
Nieves Fernandez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Term Treatment ◽  
Efficacy And Safety ◽  
Long Term Treatment

scholarly journals Do antipsychotic drugs lose their efficacy for relapse prevention over time?

2017 ◽  
Vol 211 (3) ◽  
pp. 127-129 ◽  
Author(s):  
Stefan Leucht ◽  
John M. Davis
Keyword(s):  
Relapse Prevention ◽  
Antipsychotic Drugs ◽  
Meta Analysis ◽  
Term Treatment ◽  
First Episode ◽  
Brain Volume Loss ◽  
New Findings ◽  
Long Term Treatment ◽  
Long Term Follow Up

SummaryThere is a debate about long-term treatment of schizophrenia with antipsychotic drugs, with some experts suggesting that these drugs should be discontinued. In this issue, Takeuchi et al demonstrated by a meta-analysis of 11 trials that antipsychotic drugs maintained their efficacy for relapse prevention for 1 year, whereas patients on placebo kept getting worse. We consider these findings in the light of the current discussion about possible dose-related brain volume loss, supersensitivity psychosis, the high variability of results in long-term follow-up studies and recent approaches to discontinue antipsychotics in patients with a first-episode. The new findings speak in favour of continuing antipsychotics at the same dose, at least in patients whose condition is chronic, but the topic is complex.

scholarly journals Pharmacogenetic association between NAT2 gene polymorphisms and isoniazid induced hepatotoxicity: trial sequence meta-analysis as evidence

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Saif Khan ◽  
Raju K. Mandal ◽  
Abdulbaset Mohamed Elasbali ◽  
Sajad A. Dar ◽  
Arshad Jawed ◽  
...  
Keyword(s):  
Gene Polymorphisms ◽  
Meta Analysis ◽  
Term Treatment ◽  
Wild Type ◽  
Severe Problem ◽  
Trial Sequence ◽  
Increased Risk ◽  
Long Term Treatment ◽  
Nat2 Gene

Abstract Hepatotoxicity is a severe problem generally faced by tuberculosis (TB) patients. It is a well-known adverse reaction due to anti-TB drugs in TB patients undergoing long-term treatment. The studies published previously have explored the connection of N-acetyltransferase 2 (NAT2) gene polymorphisms with isoniazid-induced hepatotoxicity, but the results obtained were inconsistent and inconclusive. A comprehensive trial sequence meta-analysis was conducted employing 12 studies comprising 3613 controls and 933 confirmed TB cases using the databases namely, EMBASE, PubMed (Medline) and Google Scholar till December 2017. A significant association was observed with individuals carrying variant allele at position 481C&gt;T (T vs. C: P = 0.001; OR = 1.278, 95% CI = 1.1100–1.484), at position 590G&gt;A (A vs. G: P = 0.002; OR = 1.421, 95% CI = 1.137–1.776) and at position 857G&gt;A (A vs. G: P = 0.0022; OR = 1.411, 95% CI = 1.052–1.894) to higher risk of hepatotoxicity vis-à-vis wild-type allele. Likewise, the other genetic models of NAT2 gene polymorphisms have also shown increased risk of hepatotoxicity. No evidence of publication bias was observed. These results suggest that genetic variants of NAT2 gene have significant role in isoniazid induced hepatotoxicity. Thus, NAT2 genotyping has the potential to improve the understanding of the drug–enzyme metabolic capacity and help in early predisposition of isoniazid-induced hepatotoxicity.

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