Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis

Background. Graves’ ophthalmopathy (GO) is a complicated autoimmune disease. Various therapies have been used to manage GO; however the optimum therapy is not clear. Glucocorticoids (GCs) therapy is the mainstay of treatment especially for active moderate to severe patients, which needs evidence-based support. Method. We searched all the randomized controlled trials (RCTs) involving corticosteroid treatment for patients diagnosed with GO from EMBASE, Medline, and the Cochrane library and then conducted a system review and meta-analysis. The electronic search covered the period from April 1966 to March 2018. Result. Twenty-nine trials were included. GCs were proved to be beneficial for GO patients [response rate, risk ratio (RR) = 1.72, 95% confidence interval (CI): 1.28~2.31, P=0.0003], and intravenous corticosteroids worked significantly better than oral corticosteroids as ever reported. When compared with the single treatment of GCs, the combination of radiotherapy and GCs showed similar effects on response rate (RR=1.25, 95%CI: 0.91~1.73). A study proved the advantage of mycophenolate mofetil over GCs in three outcomes (response rate, RR=0.74, 95%CI: 0.63~0.88). Additional treatments such as technetium-99 methylene diphosphate (99Tc-MDP) or cyclosporine enhanced the effect of GCs on proptosis reduction, respectively (P<0.00001 and P=0.02). Conclusion. Our meta-analysis confirmed the effects of GCs in the management of GO and intravenous GCs are proved to be better than oral GCs as ever reported. Combination of radiotherapy and GCs did not enhance the effects of GCs. However, if proptosis is the main issue, combination of 99Tc-MDP or cyclosporine with GCs may be taken into consideration. The reported advantages of mycophenolate mofetil over GCs are noteworthy and need more RCTs to confirm.

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The Efficacy of Shen Shuaining Capsule on Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/7515413 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Shanshan Wang ◽

Jinfeng Zhang ◽

Ming Guo ◽

Xiaobo Lian ◽

Miaomiao Sun ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Response Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Total Efficiency ◽

Better Than

Objective. To evaluate the efficacy of Shen shuaining capsule on treating chronic kidney disease (CKD).Methods. All randomized controlled trials (RCTs) of Shen shuaining capsule in treating CKD were collected from CBM, CNKI, VIP, Wanfang, EMBASE, MEDLINE, PubMed, and Cochrane library clinical controlled trials database. Two reviewers independently performed analysis of the included trials according to the inclusion and exclusion criteria. The risk of bias tool was from the Cochrane Handbook version 5.1.0. The Review Manager 5.2 software was employed for data analysis. Funnel plot and Egger’s test were applied to evaluate publication bias.Results. 20 studies including 1606 participants met the inclusion criteria, most of which were of low quality. Meta-analysis indicated that Shen shuaining capsule was effective for CKD in terms of SCR, BUN, Hb, and response rate and with less adverse effects, of which SCR and BUN decreased significantly (MD = −84.72, 95% CI: −107.36, −62.07,P<0.00001) (MD = −4.30, 95% CI: −5.71, −2.89,P<0.00001); Hb and response rate increased significantly (MD = 9.94, 95% CI: 9.24, 10.64,P<0.00001) (OR = 4.25, 95% CI (3.32, 5.42),P<0.00001).Conclusion. Shen shuaining capsule significantly reduced SCR and BUN, increased HB, and improved total efficiency of the symptoms and signs in patients with CKD. Subgroup analysis found that Shen shuaining capsule group was better than control group. Due to low quality of the methodology of included studies, further high-quality researches were needed to study its efficacy and safety.

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Circulating noncoding RNAs as early predictive biomarkers in preeclampsia: a diagnostic meta-analysis

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00852-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Sha Su ◽

Fang Yang ◽

Linlin Zhong ◽

Lihong Pang

Keyword(s):

Meta Analysis ◽

Noncoding Rnas ◽

Predictive Biomarkers ◽

Cochrane Library ◽

Clinical Value ◽

Peripheral Blood Mononuclear ◽

Meta Regression Analysis ◽

The Cochrane Library ◽

Combined Detection ◽

Better Than

Abstract Background We designed a meta-analysis to evaluate the clinical significance and efficacy of circulating noncoding RNAs (ncRNAs) in the early prediction of preeclampsia. Methods PubMed, Embase and the Cochrane Library were used to search for literature. The combined prediction performance was evaluated by calculating the area under the summary receiver operator characteristic (SROC) curve. The potential sources of heterogeneity were analysed by meta-regression analysis and subgroup analysis. All statistical analyses and mapping were performed by RevMan 5.3 and Stata 12.0. Results A total of 41 studies from 14 articles, including 557 preeclampsia patients and 842 controls, were included in our meta-analysis. All studies collected blood before onset. NcRNAs in blood performed relatively well in predicting preeclampsia. The combined sensitivity was 0.71, the specificity was 0.84, and the area under the SROC curve (AUC) was 0.86. Peripheral blood mononuclear cell (PBMC) samples showed the best diagnostic accuracy. The combined AUC was 0.93. Combined detection was better than single detection, and miRNA was better than circRNA. The heterogeneity of the study was determined by sample size, lncRNA characteristics, lncRNA source and race. Conclusion Circulating ncRNAs can be valuable biomarkers used as candidates for noninvasive early predictive biomarkers of preeclampsia and have great clinical application prospects. The clinical value of ncRNAs needs to be tested by further multicentre, comprehensive and prospective studies, and the test criteria should be established.

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A Meta-Analysis of the Clinical Efficacy of TCM Decoctions Made from Formulas in the Liuwei Dihuang Wan Categorized Formulas in Treating Diabetic Nephropathy Proteinuria

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/2427301 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10

Author(s):

Xue Gao ◽

Jianwei Shang ◽

Hongfang Liu ◽

Borui Yu

Keyword(s):

Diabetic Nephropathy ◽

Clinical Efficacy ◽

Adverse Reactions ◽

Meta Analysis ◽

Microvascular Complications ◽

Treatment Strategies ◽

Cochrane Library ◽

Urinary Protein Level ◽

The Cochrane Library ◽

Better Than

Objective. Diabetic nephropathy (DN) is one of the microvascular complications of diabetes mellitus. Proteinuria is the most important clinical characteristics of DN and an independent risk factor for disease progression of DN; reducing urine protein is the primary target of treatment strategies for DN. Liuwei Dihuang Wan Categorized Formulas (LDWCFs), a group of classic traditional Chinese medicine (TCM) formulas aiming at “kidney -tonifying”, have been widely used in the treatment of DN. This study aimed to obtain a comprehensive understanding of the TCM method “kidney-tonifying” in the treatment of DN by conducting a meta-analysis to analyze the clinical efficacy of decoctions made from the LDWCFs in the treatment of DN proteinuria. Methods. CNKI, Wanfang, Weipu, CBM, PubMed, Embase, and the Cochrane Library were searched; 14 studies were included in the meta-analysis. Results. The results showed that the overall efficacy of the LDWCFs in treating DN was significantly better than that of the comparators (OR 2.87, 95% CI 1.98–4.15, P<0.00001). These formulas showed better efficacy than the comparators in reducing 24-hour urinary protein level (MD 0.12, 95% CI 0.06–0.17, P<0.0001) and in reducing urine microalbumin excretion rate (SMD 0.87, 95% CI 0.41–1.32, P<0.0002). No serious adverse reactions were reported. Conclusions. TCM formulas included in the LDWCFs are safe and effective in the treatment of DN proteinuria. These findings suggested that the TCM therapeutic principle of “kidney-tonifying” is a valuable addition to the treatment strategies for DN.

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Efficacy and Adverse Events of Intermittent Androgen Deprivation Therapy versus Continuos Androgen Deprivation Therapy on Localized and Metastatic Prostate Cancer: A Meta-Analysis

Advanced Science Letters ◽

10.1166/asl.2018.12652 ◽

2018 ◽

Vol 24 (8) ◽

pp. 6130-6135

Author(s):

M. Gozali Arif ◽

Rizal A. H Hamid

Keyword(s):

Adverse Events ◽

Androgen Deprivation Therapy ◽

Observational Studies ◽

Meta Analysis ◽

Androgen Deprivation ◽

Cochrane Library ◽

Psa Progression ◽

The Cochrane Library ◽

Better Than ◽

Overall Mortality

To evaluate clinical data from published trials on efficacy and adverse events of intermittent androgen deprivation therapy (IAD) and continuous androgen deprivatin therapy (CAD). This study searched Medline, Sience direct and the Cochrane Library through August 2016 without year restriction but only english journal were included suplemented using Preferred Reporting Items for Systematic Reviews and Meta-analysis of Observational Studies in Epidemiology Guidelines. Result: 10 Studies were identified and up to 4403 patients were pooled. When compared to CAD, IAD was not statistically difference in term of overall mortality and 3 years PSA progression. But when compared to CAD, IAD was statistically better than CAD in the term reduce pain burden. Conclusions: This study conclude that the efficacy between CAD and IAD was not significant different. IAD is better to minimize pain as adverse events than CAD.

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Effects of the Mat Pilates Method on Body Composition: Systematic Review With Meta-Analysis

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0171 ◽

2020 ◽

Vol 17 (6) ◽

pp. 673-681

Author(s):

Allysiê Priscilla de Souza Cavina ◽

Eduardo Pizzo Junior ◽

Aryane Flauzino Machado ◽

Taíse Mendes Biral ◽

Leonardo Kesrouani Lemos ◽

...

Keyword(s):

Systematic Review ◽

Body Composition ◽

Healthy Adult ◽

Meta Analysis ◽

Abdominal Circumference ◽

Cochrane Library ◽

Fat Percentage ◽

Pilates Method ◽

The Cochrane Library ◽

Better Than

Background: The objective of this systematic review was to determine the efficacy of the mat Pilates method on body composition in healthy adult subjects compared with traditional exercise or control condition models. Design: Systematic review with meta-analysis. Data sources: MEDLINE, EMBASE, SPORTDiscus, PEDro, SciELO, CINAHAL, and the Cochrane Library. Results: A total of 10 eligible studies were selected for revision. The findings of this review demonstrated that the mat Pilates method was not more effective than the traditional exercise or control condition models for the analyzed variables (body mass index, lean mass, body fat percentage, and abdominal circumference). Moreover, in the exploratory analysis with older people, adults, and overweight/obese individuals, the mat Pilates method was also not superior for the analyzed outcomes. Conclusion: The findings of this study suggest that the mat Pilates method is no better than the control condition or other types of training to reduce body composition.

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Efficacy of PD-1/PD-L1 Inhibitors in Ovarian Cancer: A Single-arm Meta-analysis

10.21203/rs.3.rs-412259/v1 ◽

2021 ◽

Author(s):

Jue Zhu ◽

Lifeng Yan ◽

Qiming Wang

Keyword(s):

Ovarian Cancer ◽

Web Of Science ◽

Response Rate ◽

Meta Analysis ◽

Systematic Search ◽

Cochrane Library ◽

Limited Efficacy ◽

The Cochrane Library

Abstract Several studies have evaluated the efficacy of PD-1/PD-L1 inhibitors in ovarian cancer; however, the response rate varies. This study aims to explore the efficacy of anti-PD-1/PD-L1 therapy in ovarian cancer. A quantitative meta-analysis was performed through a systematic search in PubMed, Web of Science, and the Cochrane Library. The pooled ORR was calculated and compared. Fifteen trials were included in this meta-analysis. Our analyses showed that the pooled ORR of all included studies was 19% (95% CI: 13%, 27%). Single PD-1/PD-L1 inhibitors had the lowest ORR of 9% (95% CI: 7%, 12%), while the combination of PD-1/PD-L1 inhibitors and chemotherapy had the highest ORR of 36% (95% CI: 24%, 51%). This study showed that PD-1/PD-L1 inhibitors alone have limited efficacy for ovarian cancer. The combination of PD-1/PD-L1 inhibitors and chemotherapy could be chosen as the recommended modality for further study.

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Efficacy of PD-1/PD-L1 inhibitors in ovarian cancer: a single-arm meta-analysis

Journal of Ovarian Research ◽

10.1186/s13048-021-00862-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Jue Zhu ◽

Lifeng Yan ◽

Qiming Wang

Keyword(s):

Ovarian Cancer ◽

Web Of Science ◽

Response Rate ◽

Meta Analysis ◽

Systematic Search ◽

Cochrane Library ◽

Limited Efficacy ◽

The Cochrane Library

AbstractSeveral studies have evaluated the efficacy of PD-1/PD-L1 inhibitors in ovarian cancer; however, the response rate varies. This study aims to explore the efficacy of anti-PD-1/PD-L1 therapy in ovarian cancer. A quantitative meta-analysis was performed through a systematic search in PubMed, Web of Science, and the Cochrane Library. The pooled ORR was calculated and compared. Fifteen trials were included in this meta-analysis. Our analyses showed that the pooled ORR of all included studies was 19% (95% CI: 13%, 27%). Single PD-1/PD-L1 inhibitors had the lowest ORR of 9% (95% CI: 7%, 12%), while the combination of PD-1/PD-L1 inhibitors and chemotherapy had the highest ORR of 36% (95% CI: 24%, 51%). This study showed that PD-1/PD-L1 inhibitors alone have limited efficacy for ovarian cancer. The combination of PD-1/PD-L1 inhibitors and chemotherapy could be chosen as the recommended modality for further study.

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Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis

Pharmacology ◽

10.1159/000515788 ◽

2021 ◽

pp. 1-9

Author(s):

Shan Deng ◽

Yonghao Yu

Keyword(s):

Femur Fracture ◽

Meta Analysis ◽

Sensory Block ◽

Cochrane Library ◽

Rescue Analgesia ◽

Block Level ◽

Block Time ◽

Sedation Scores ◽

The Difference ◽

The Cochrane Library

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Patients who received DEX infusion had a significant longer time to rescue analgesia compared with those without DEX coadministration. DEX treatment seemed to reduce the visual analog score; however, the significance did not reach any statistical difference. DEX as an analgesic adjuvant did not reduce the onset of sensory block time, shorten the time to achieve maximum sensory block level, and provide a longer duration of sensory block. The difference in mean sedation scores between 2 groups was not statistically significant. As for adverse effects, DEX therapy significantly increased the rate of hypotension. In conclusion, dexmedetomidine as a local anesthetic adjuvant in femur fracture surgery had a longer duration of rescue analgesia. However, the incidence of hypotension was markedly increased in these patients. It was worth noting that the evidence was of low to moderate quality.

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EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211004277 ◽

2021 ◽

pp. 174749302110042

Author(s):

Grace Mary Turner ◽

Christel McMullan ◽

Olalekan Lee Aiyegbusi ◽

Danai Bem ◽

Tom Marshall ◽

...

Keyword(s):

Systematic Review ◽

Stroke Risk ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Cochrane Library ◽

Control Group ◽

Large Sample Size ◽

Hazard Ratios ◽

Increased Risk ◽

The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

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Long-term oncologic outcomes of transanal TME compared with transabdominal TME for rectal cancer: a systematic review and meta-analysis

Surgical Endoscopy ◽

10.1007/s00464-021-08615-7 ◽

2021 ◽

Author(s):

Jae Young Moon ◽

Min Ro Lee ◽

Gi Won Ha

Keyword(s):

Rectal Cancer ◽

Meta Analysis ◽

Disease Free Survival ◽

Distant Recurrence ◽

Oncologic Outcomes ◽

Cochrane Library ◽

Transanal Total Mesorectal Excision ◽

Random Effects Models ◽

The Cochrane Library

Abstract Background Transanal total mesorectal excision (TaTME) appears to have favorable surgical and pathological outcomes. However, the evidence on survival outcomes remains unclear. We performed a meta-analysis to compare long-term oncologic outcomes of TaTME with transabdominal TME for rectal cancer. Methods PubMed, EMBASE, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random-effects models. Outcome measures were overall survival (OS), disease-free survival (DFS), and local and distant recurrence. Results We included 11 nonrandomized studies that examined 2,143 patients for the meta-analysis. There were no significant differences between the two groups in OS, DFS, and local and distant recurrence with a RR of 0.65 (95% CI 0.39–1.09, I2 = 0%), 0.79 (95% CI 0.57–1.10, I2 = 0%), 1.14 (95% CI 0.44–2.91, I2 = 66%), and 0.75 (95% CI 0.40–1.41, I2 = 0%), respectively. Conclusion In terms of long-term oncologic outcomes, TaTME may be an alternative to transabdominal TME in patients with rectal cancer. Well-designed randomized trials are warranted to further verify these results.

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