scholarly journals A Systematic Review and Meta-Analysis of the Effects of Herbal Medicine Buyang Huanwu Tang in Patients with Poststroke Fatigue

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Chul Jin ◽  
Seungwon Kwon ◽  
Seung-Yeon Cho ◽  
Seong-Uk Park ◽  
Woo-Sang Jung ◽  
...  
Keyword(s):  
Adverse Events ◽  
Meta Analysis ◽  
Herbal Medicines ◽  
Efficacy Rate ◽  
Asian Countries ◽  
Severity Scale ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Fatigue Severity

Poststroke fatigue (PSF) is reported to occur in 30%–72% of all patients with stroke. PSF not only is a symptom of stroke but has also been reported to adversely affect the prognosis of patients with stroke. However, no treatment has had a significant effect on PSF. In East Asian countries, several herbal medicines have been used to treat stroke, with Buyang Huanwu Tang (BHT) being the most common. This review aimed to evaluate the efficacy and safety of BHT for PSF. A literature search was conducted on MEDLINE, CENTRAL, Scopus, CiNii, CNKI, OASIS, NDSL, and KTKP databases for randomized controlled trials that evaluated the effects and safety of BHT on PSF. Six studies (n = 427) were included. The overall methodological quality of these studies was relatively low. In the adjunctive BHT group, the meta-analysis indicated statistically significant improvements in the Fatigue Severity Scale score (mean difference −1.49, 95% CI [−2.25, −0.73]) and total clinical efficacy rate (risk ratio 0.11, 95% CI [0.03, 0.41]) compared to those in the nonherbal group. Adverse events were only reported in one study, and no serious adverse events occurred. BHT administration might be effective in the treatment of PSF. We were unable to draw definitive conclusions owing to the limitations of the included studies. The trial is registered with CRD42019130178 in PROSPERO.

scholarly journals Efficacy and Safety of Mucopolysaccharide Polysulfate Cream for Non-Exudative Eczema: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ming Li ◽  
Yan Li ◽  
Lujing Xiang ◽  
Linfeng Li
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Good Effect ◽  
Efficacy Rate ◽  
Efficacy And Safety ◽  
Tacrolimus Ointment ◽  
Randomized Controlled

Background: Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. However, there is no further research to collect and analyze these studies.Objective: This meta-analysis aimed to assess the efficacy and safety of MPS cream as monotherapy or add-on therapy for non-exudative eczema.Methods: Ten databases were searched to identify the eligible randomized controlled trials (RCTs) from their inception to July 31, 2021. Revman 5.3 software was used for the meta-analysis.Results: A total of eligible 20 studies were included. Among the 20 studies, 2 studies compared MPS cream with other moisturizers, 14 compared MPS cream plus topical corticosteroids (TCS) with TCS alone, and 4 compared with MPS cream plus tacrolimus ointment with tacrolimus ointment alone. The pooled results demonstrated that MPS cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% CI: 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment. Moreover, in comparison with TCS or tacrolimus ointment alone, the combination treatment performed better in terms of total efficacy rate, total symptom score, recurrence rate, and pruritus score. For safety, the skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events.Conclusions: MPS cream as monotherapy or add-on therapy could provide a good effect for treating non-exudative eczema with mild and tolerable skin adverse events. However, due to the suboptimal quality of the included studies, high-quality and large-sample RCTs are needed in the future for update or validation.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/PROSPERO/), identifier: CRD42021265735.

scholarly journals Efficacy and safety of colchicine in COVID-19: a meta-analysis of randomised controlled trials

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001746
Author(s):  
Kedar Gautambhai Mehta ◽  
Tejas Patel ◽  
Paragkumar D Chavda ◽  
Parvati Patel
Keyword(s):  
Adverse Events ◽  
Supportive Care ◽  
Meta Analysis ◽  
Ventilatory Support ◽  
Length Of Hospital Stay ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Quality Of Evidence ◽  
Randomised Controlled

BackgroundColchicine, an anti-inflammatory drug is prescribed nowadays for COVID-19. In this meta-analysis, we evaluated efficacy and safety of colchicine in patients with COVID-19.MethodsWe searched databases for randomised controlled studies evaluating efficacy and/or safety of colchicine as compared with supportive care in patients with COVID-19. The efficacy outcomes were mortality, ventilatory support, intensive care unit (ICU) admission and length of hospital stay. The safety outcomes were adverse events, serious adverse events and diarrhoea. A meta-analytical summary was estimated using random effects model through Mantle-Hanzle method. An I2 test was used to assess heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess quality of evidence for each outcome.ResultsOut of 69 full texts assessed, 6 studies (16148 patients with COVID-19) were included in meta-analysis. Patients receiving colchicine did not show significant reduction in mortality (risk difference, RD −0.00 (95% CI −0.01 to 0.01), I2=15%), ventilatory support (risk ratio, RR 0.67 (95% CI 0.38 to 1.21), I2=47%), ICU admission (RR 0.49 (95% CI 0.19 to 1.25), I2=34%), length of hospital stay (mean difference: −1.17 (95% CI −3.02 to 0.67), I2=77%) and serious adverse events (RD −0.01 (95% CI −0.02 to 0.00), I2=28%) than those who received supportive care only. Patients receiving colchicine had higher rates of adverse events (RR 1.58 (95% CI 1.07 to 2.33), I2=81%) and diarrhoea (RR 1.93 (95% CI 1.62 to 2.29), I2=0%) than supportive care treated patients. The GRADE quality of evidence was moderate for most outcomes.ConclusionThe moderate quality evidence suggests no benefit of addition of colchicine to the standard care regimen in patients with COVID-19.

scholarly journals Ivabradine added to usual care in patients with heart failure: a systematic review with meta-analysis and trial sequential analysis

2021 ◽  
pp. bmjebm-2021-111724
Author(s):  
Mathias Maagaard ◽  
Emil Eik Nielsen ◽  
Naqash Javaid Sethi ◽  
Ning Liang ◽  
Si-Hong Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Usual Care ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Trial Sequential Analysis ◽  
Serious Adverse Events ◽  
All Cause Mortality

ObjectivesTo assess the beneficial and harmful effects of adding ivabradine to usual care in participants with heart failure.DesignA systematic review with meta-analysis and trial sequential analysis.Eligibility criteriaRandomised clinical trials comparing ivabradine and usual care with usual care (with or without) placebo in participants with heart failure.Information sourcesMedline, Embase, CENTRAL, LILACS, CNKI, VIP and other databases and trial registries up until 31 May 2021.Data extractionPrimary outcomes were all-cause mortality, serious adverse events and quality of life. Secondary outcomes were cardiovascular mortality, myocardial infarction and non-serious adverse events. We performed meta-analysis of all outcomes. We used trial sequential analysis to control risks of random errors, the Cochrane risk of bias tool to assess the risks of systematic errors and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the certainty of the evidence.ResultsWe included 109 randomised clinical trials with 26 567 participants. Two trials were at low risk of bias, although both trials were sponsored by the company that developed ivabradine. All other trials were at high risk of bias. Meta-analyses and trial sequential analyses showed that we could reject that ivabradine versus control reduced all-cause mortality (risk ratio (RR)=0.94; 95% CI 0.88 to 1.01; p=0.09; high certainty of evidence). Meta-analysis and trial sequential analysis showed that ivabradine seemed to reduce the risk of serious adverse events (RR=0.90; 95% CI 0.87 to 0.94; p<0.00001; number needed to treat (NNT)=26.2; low certainty of evidence). This was primarily due to a decrease in the risk of ‘cardiac failure’ (RR=0.83; 95% CI 0.71 to 0.97; p=0.02; NNT=43.9), ‘hospitalisations’ (RR=0.89; 95% CI 0.85 to 0.94; p<0.0001; NNT=36.4) and ‘ventricular tachycardia’ (RR=0.59; 95% CI 0.43 to 0.82; p=0.001; NNT=212.8). However, the trials did not describe how these outcomes were defined and assessed during follow-up. Meta-analyses showed that ivabradine increased the risk of atrial fibrillation (RR=1.19; 95% CI 1.04 to 1.35; p=0.008; number needed to harm (NNH)=116.3) and bradycardia (RR=3.95; 95% CI 1.88 to 8.29; p=0.0003; NNH=303). Ivabradine seemed to increase quality of life on the Kansas City Cardiomyopathy Questionnaire (KCCQ) (mean difference (MD)=2.92; 95% CI 1.34 to 4.50; p=0.0003; low certainty of evidence), but the effect size was small and possibly without relevance to patients, and on the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) (MD=−5.28; 95% CI −6.60 to −3.96; p<0.00001; very low certainty of evidence), but the effects were uncertain. Meta-analysis showed no evidence of a difference between ivabradine and control when assessing cardiovascular mortality and myocardial infarction. Ivabradine seemed to increase the risk of non-serious adverse events.Conclusion and relevanceHigh certainty evidence shows that ivabradine does not seem to affect the risks of all-cause mortality and cardiovascular mortality. The effects on quality of life were small and possibly without relevance to patients on the KCCQ and were very uncertain for the MLWHFQ. The effects on serious adverse events, myocardial infarction and hospitalisation are uncertain. Ivabradine seems to increase the risk of atrial fibrillation, bradycardia and non-serious adverse events.PROSPERO registration number: CRD42018112082.

scholarly journals Efficacy and harms of convalescent plasma for treatment of hospitalized COVID-19 patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Alejandro Piscoya ◽  
Luis Ng-Sueng ◽  
Angela Parra del Riego ◽  
Renato Cerna-Viacava ◽  
Vinay Pasupuleti ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Improvement ◽  
Meta Analysis ◽  
Random Effect ◽  
Standard Of Care ◽  
Serious Adverse Events ◽  
Quality Of Evidence ◽  
All Cause Mortality ◽  
Grade Methodology

IntroductionWe systematically reviewed benefits and harms of convalescent plasma (CP) in hospitalized COVID-19 patients.Material and methodsRandomized controlled trials (RCTs) and observational studies assessing CP effects on hospitalized, adult COVID-19 patients were searched until November 24, 2020. We assessed risk of bias (RoB) using Cochrane RoB 2.0 and ROBINS-I tools. Inverse variance random effect meta-analyses were performed. Quality of evidence was evaluated using GRADE methodology. Primary outcomes were all-cause mortality, clinical improvement, and adverse events.ResultsFive RCTs (n = 1067) and 6 cohorts (n = 881) were included. Three and 1 RCTs had some concerns and high RoB, respectively; and there was serious RoB in all cohorts. Convalescent plasma did not reduce all-cause mortality in RCTs of severe (RR = 0.60, 95% CI: 0.33–1.10) or moderate (RR = 0.60, 95% CI: 0.09–3.86) COVID-19 vs. standard of care (SOC); CP reduced all-cause mortality vs. SOC in cohorts (RR = 0.66, 95% CI: 0.49–0.91). Convalescent plasma did not reduce invasive ventilation vs. SOC in moderate disease (RR = 0.85, 95% CI: 0.47–1.55). In comparison to placebo + SOC, CP did not affect all-cause mortality (RR = 0.75, 95% CI: 0.48–1.16) or clinical improvement (HR = 1.07, 95% CI: 0.82–1.40) in severe patients. Adverse and serious adverse events were scarce, similar between CP and controls. Quality of evidence was low or very low for most outcomes.ConclusionsIn comparison to SOC or placebo + SOC, CP did not reduce all-cause mortality in RCTs of hospitalized COVID-19 patients. Convalescent plasma did not have an effect on other clinical or safety outcomes. Until now there is no good quality evidence to recommend CP for hospitalized COVID-19 patients.

scholarly journals A Meta-Analysis of Arsenic Trioxide Combined with Transcatheter Arterial Chemoembolization for Treatment of Primary Hepatic Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Ling He ◽  
Qingyun Xu ◽  
Liguo Chen ◽  
Ruixue Chen
Keyword(s):  
Meta Analysis ◽  
Efficacy Rate ◽  
Malignant Tumours ◽  
Hepatic Carcinoma ◽  
Randomized Controlled ◽  
Primary Hepatic Carcinoma ◽  
One Year ◽  
The One ◽  
Arterial Chemoembolization

Primary hepatic carcinoma (PHC) is one of the most common malignant tumours in the world. More and more research has shown that As2O3combined with TACE has a good curative effect in treating PHC. The objectives of this study were to evaluate the therapeutic efficacy and safety of As2O3combined with TACE in treating PHC. The CNKI, VIP, Wanfang, PubMed, and Cochrane databases were searched from their inception until December 2015. Randomized controlled trials (RCTs) comparing As2O3combined with TACE versus TACE alone in treating PHC were identified. Stata SE 12.0 was used for data analysis. 17 RCTs with 1055 patients were included. Meta-analysis showed that, compared with TACE alone, As2O3combined with TACE showed significant effects in improving the clinical efficacy rate (P<0.01), decreasing the value of alpha-fetoprotein (P<0.01), increasing the one-year survival rate (P<0.01), and improving the quality of life of PHC patients (P<0.01). Fifteen studies had mentioned adverse events, but no serious adverse effects were reported in any of the included trials. In conclusion, As2O3combined with TACE therapy appears to be potentially effective in treating PHC and is generally safe. However, further studies with rigorous designs trials and multiregional cooperation trials are needed.

Herbal Medicine for Cervicogenic Dizziness: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Hyunjoo Oh ◽  
Seungwon Shin ◽  
Euiju Lee ◽  
Won-Seok Chung
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Serious Adverse Events ◽  
Reliable Effect ◽  
Cervicogenic Dizziness ◽  
Active Controls

Abstract Background: Herbal medicines (HMs) have been widely used in the treatment of cervicogenic dizziness (CGD) based on their empirical effectiveness and safety. Herein, we reviewed and evaluated the clinical evidence on the efficacy and safety of HM for CGD. Methods: Among the relevant studies published up to December 2019 in 11 electronic databases, only randomised controlled trials (RCTs) were included. The studies’ methodological quality was assessed using the revised Cochrane risk-of-bias tool for randomised trials, and the strength of evidence for the main findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: All 17 included RCTs with 1,797 participants were conducted with six types of modified HM prescriptions and three types of active controls. More than half of the included studies were of low quality because of the high risk of bias due to deviations from the intended intervention. HMs plus active controls were more effective in CGD treatment than active controls alone. HMs plus antivertigo drugs, HMs plus manual therapy, and HMs plus acupuncture therapy were all effective in CGD treatment, with HMs plus antivertigo drugs showing the most reliable effect. All HM prescriptions were effective for specific patterns of CGD when administered with active controls, with Banxia Baizhu Tianma tang and Dingxuan tang demonstrating the most reliable effect. No serious adverse events were reported in all included studies. Conclusions: The current evidence suggests that HMs may enhance the treatment effect on CGD when combined with other treatments without serious adverse events. Further high-quality evidence is needed to draw a definite conclusion.Systematic review registration: PROSPERO (registration number: CRD42020199222), and the Research Registry (Review Registry Unique Identifying Number: reviewregistry1036)

scholarly journals Delayed Release Phosphatidylcholine is Effective for Treatment of Ulcerative Colitis: A Meta-Analysis

2021 ◽  
Author(s):  
Wolfgang Stremmel ◽  
Hüseyin Vural ◽  
Osman Evliyaoglu ◽  
Ralf Weiskirchen
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Adverse Events ◽  
Meta Analysis ◽  
Life Quality ◽  
Release Formulation ◽  
P Values ◽  
Randomized Controlled ◽  
Intestinal Mucus

Background: Phosphatidylcholine (PC) is intrinsically missing in intestinal mucus of patients with ulcerative colitis. Topical supplementation with delayed intestinal release PC formulations is assumed to compensate this lack. Three monocenter randomized controlled trials (RCTs) with a 30% PC containing lecithin were successful, whereas 1 trial with > 94% PC containing lecithin failed. Objectives: Evaluation of 30% PC-containing lecithin provided in a delayed intestinal release formulation for treatment efficacy of ulcerative colitis evaluated by meta-analysis of three RCT’s. Methods: Meta-analysis of 3 studies was performed using RevMan 5.3 software. Odds ratio (OR) and 95% Cl were calculated for remission, clinical and endoscopic improvement, histology and life quality. p-values less than 0.05 were accepted as significant. Results: The meta-analysis of 3 RTCs with 160 included patients with ulcerative colitis verified that PC improved the rate of remission (OR = 9.68), as well as clinical (OR = 30.58) and endoscopic outcome (OR = 36.73). Within the available patient population also histology and quality of life became better. All effects were significant over placebo. Achieved remission was maintained in a higher percentage of patients under intestinal release PC formulation compared to placebo. The profile of adverse events was identical to the placebo population. Conclusions: A 30% PC containing lecithin in delayed intestinal release formulation improves clinical and endoscopic outcomes, histologic activity and quality of life in patients with ulcerative colitis. For the patients lack of adverse events is an important consideration.

scholarly journals Safety of Denosumab Versus Zoledronic Acid in Patients with Bone-related Diseases A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Wenhao Luo ◽  
Ye Li
Keyword(s):  
Adverse Events ◽  
Web Of Science ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Skeletal Related Events ◽  
Better Than

IntroductionBoth Dmab and ZA have been widely used in the prevention and treatment of bone-related diseases, while which drug is an optimal treatment in terms of safety and efficacy remains controversial.Material and methodsPubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 1st January 2021, and were evaluated by Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Randomized controlled trials comparing Dmab versus ZA in patients with bone-related diseases were included.ResultsA total of 13 studies involving 21042 participants were included. The incidence of total adverse events was significantly lower in patients receiving Dmab treatment than in those undergoing ZA treatment(OR= 0.84, 95% CI = 0.75–0.94, P = 0.003). 9 trials comparing Dmab with ZA further showed that Dmab was significantly better than ZA in controlling serious adverse events (OR = 0.91, 95% CI = 0.85–0.99, P = 0.02). Compared to ZA, Dmab was correlated with a lower incidence of skeletal-related events (OR = 0.77, 95% CI = 0.70–0.85, P = 0.00001). However, no significant difference was found in the rate of infection events between Dmab and ZA (OR = 1.06, 95% CI = 0.93–1.20, P =0.39).ConclusionsThis study demonstrated superiority of Dmab over ZA in treating bone-related diseases in terms of safety and efficacy.

scholarly journals Sublingual immunotherapy for pollen allergic rhinitis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Lufang Feng ◽  
Liujiao Cao ◽  
Peijing Yan ◽  
Xiajing Chu ◽  
Na Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Adverse Events ◽  
Sublingual Immunotherapy ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Specific Ige ◽  
Cochrane Library ◽  
Serious Adverse Events

Intro Allergic rhinitis（AR） is a common condition which can significantly impair quality of life. This study aimed to illustrate the efficacy and safety of sublingual immunotherapy (SLIT) on pollen AR patients. Methods Four electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were searched from their inception until September 2019. Two reviewers （FLF and CLJ） independently extracted the data. The Cochrane’s Risk of Bias tool was used to assess the quality of included studies. The outcomes of study were calculated by MD or SMD with 95%CI. A meta-analysis was performed using RevMan 5.3 software. Results In this systematic review, a total of 8 articles were included, involving 785 participants. The quality of the included studies ranged from low to moderate. The results of the meta-analysis showed that compared with placebo, a significant reduction of nasal symptoms were observed on SLIT (MD = −0.84, 95% CI = −1.47 to −0.22, P < 0.05), IgE (SMD =0.46, 95% CI = 0.16 to 0.76, P < 0.05); No significant effect on medication scores (MD = −0.41, 95% CI = −0.89 to 0.07, P =0.10). No serious adverse events were reported, and symptoms of adverse events were reported more frequently in the gastrointestinal symptoms. Conclusion SLIT can effectively relieve rhinitis symptoms and decrease the level of specific-IgE for pollen allergic rhinitis patients and the safety was verified. But due to the low quality of studies, more high-quality randomized trials are needed to provide stronger evidence of the conclusion.

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