scholarly journals The Effectiveness and Safety of Probiotic Supplements for Psoriasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Preclinical Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Liuting Zeng ◽  
Ganpeng Yu ◽  
Yang Wu ◽  
Wensa Hao ◽  
Hua Chen
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Intestinal Flora ◽  
Controlled Trials ◽  
Skin Thickness ◽  
Randomized Controlled ◽  
Probiotic Treatment ◽  
Preclinical Trials

Background. Patients with psoriasis need long-term medication to control their condition. Recent studies suggest that changing the intestinal flora may be a potential treatment. Methods. The databases were utilized to search the randomized controlled trials (RCTs) and preclinical trials about probiotic supplement in the treatment of psoriasis. The retrieval time is from the establishment of these databases to December 2020. RevMan5.3 was used for the risk assessment of bias and meta-analysis. This systematic review was registered in PROSPERO (CRD42021232756). Results. A total of 3 RCTs involving 164 participants were included. Two RCTs showed that probiotics can improve PASI and thereby improve the condition. For inflammation-related indicators, only one RCT showed that probiotics can improve the levels of CRP and TNF-α but have no obvious improvement effect on IL6. One RCT demonstrated the total effective rate of probiotics in the treatment of psoriasis. For adverse events, one RCT showed that the incidence of adverse events of probiotic treatment was low. Preclinical studies showed that continuous intervention with oral probiotics can significantly improve the progression of psoriasis and reduce the expression of inflammatory factors. The meta-analysis showed that the PASI between two groups was of no statistical significance (SMD 1.83 [-0.41, 4.07], P = 0.11 ). Meanwhile, probiotics may improve skin thickness (SMD -5.87 [-11.34, -0.41], P = 0.04 ) in animal model. Conclusion. Prebiotics may have a positive effect on alleviating the clinical symptoms of psoriasis, but a large sample of RCTs is still needed to support its therapeutic effect in psoriasis.

Safety of Intra-Articular Hyaluronic Acid for Knee Osteoarthritis: Systematic Review and Meta-Analysis of Randomized Trials Involving More than 8,000 Patients

Cartilage ◽  
2019 ◽  
pp. 194760351988878
Author(s):  
Larry E. Miller ◽  
Samir Bhattacharyya ◽  
William R. Parrish ◽  
Michael Fredericson ◽  
Brad Bisson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Adverse Events ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Symptomatic Knee

Objective The objective of this systematic review and meta-analysis was to report the safety of intra-articular hyaluronic acid (IAHA) in patients with symptomatic knee osteoarthritis (OA). Methods We identified randomized controlled trials reporting the safety of IAHA versus IA saline in adults with symptomatic knee OA. Main safety outcomes were adverse events (AEs), local AEs, serious adverse events (SAEs), study withdrawals, and AE-related study withdrawals. Results A total of 35 randomized controlled trials with 38 group comparisons comprising 8,078 unique patients (IAHA: 4,295, IA saline: 3,783) were included in the meta-analysis. Comparing IAHA with IA saline over a median of 6 months follow-up, there were no differences in the risk of AEs (42.4% vs. 39.7%, risk ratio [RR] = 1.01, 95% CI = 0.96-1.07, P = 0.61), SAEs (1.8% vs. 1.2%, RR = 1.44, 95% CI = 0.91-2.26, P=0.12), study withdrawals (12.3% vs. 12.7%, RR = 0.99, 95% CI = 0.87-1.12, P = 0.83), or AE-related study withdrawals (2.7% vs. 2.1%, RR = 1.37, 95% CI = 0.97-1.93, P = 0.08). Local AEs, all of which were nonserious, were more common with IAHA vs. IA saline (14.5% vs. 11.7%, RR = 1.21, 95% CI = 1.07-1.36, P = 0.003) and typically resolved within days. Conclusion IAHA was shown to be safe for use in patients with symptomatic knee OA. Compared with IA saline, IAHA is associated with an increased risk of nonserious, transient local reactions. There was no evidence to suggest any additional safety risks of IAHA.

Efficacy of probiotics in multiple sclerosis: a systematic review of preclinical trials and meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Jinchi Jiang ◽  
Chuanqi Chu ◽  
Caie Wu ◽  
Chen Wang ◽  
Chengcheng Zhang ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Potential Role ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Preclinical Trials

Preliminary evidence shows the potential role of probiotics in ameliorating multiple sclerosis (MS); however, the effects of probiotics on MS remain unclear.

scholarly journals Angiogenesis Inhibitors for the Treatment of Ovarian Cancer: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials

2018 ◽  
Vol 28 (5) ◽  
pp. 903-914 ◽  
Author(s):  
Haihong Wang ◽  
Tie Xu ◽  
Lifen Zheng ◽  
Guiling Li
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
High Risk ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Angiogenesis Inhibitors ◽  
Controlled Trials ◽  
Randomized Controlled

BackgroundAngiogenesis inhibitors showed activity in ovarian cancer, but preliminary data could not accurately reflect the survival benefit. We thus did a systematic review and meta-analysis of randomized controlled trials to reassess the efficacy and safety of angiogenesis inhibitors combined with chemotherapy for ovarian cancer.MethodsWe searched PubMed, EMBASE, Cochrane, and ClinicalTrials.gov for randomized controlled trials comparing angiogenesis inhibitors containing therapy with conventional chemotherapy alone or no further treatment. Our main outcomes were the progression-free survival (PFS), overall survival (OS), and common adverse events.ResultsFifteen trials were included (N = 8721 participants). For newly diagnosed ovarian cancer, combination treatment with angiogenesis inhibitors and chemotherapy yielded a lower risk of disease progression (hazard ratio [HR], 0.83; 95% confidence interval (CI), 0.71–0.97) and no improved OS (HR, 0.95; 95% CI, 0.86–1.05). In the high-risk progression subgroup, the addition of bevacizumab significantly improved PFS (HR, 0.72; 95% CI, 0.65–0.81) and OS (HR, 0.84; 95%CI, 0.74–0.96). In recurrent patients, the combined HR was 0.58 (95% CI, 0.52–0.65) for PFS, and for OS, the combined HR was 0.86 (95% CI, 0.79–0.94). We found no significant improvement for either PFS (HR, 0.80; 95% CI, 0.63–1.01) or OS (HR, 1.06; 95% CI, 0.88–1.28) in the pure maintenance therapy.In the overall population, angiogenesis inhibitors increased the incidence of gastrointestinal perforation (risk ratio [RR], 2.57; 95% CI, 1.66–3.97), hypertension (RR, 7.60; 95% CI, 2.79–20.70), arterial thromboembolism (RR, 2.27; 95% CI, 1.34–3.84), proteinuria (RR, 4.31; 95% CI, 2.15–8.64), and complication of wound healing (RR, 1.72, 95% CI, 1.12–2.63).ConclusionsCombination treatment with angiogenesis inhibitors and chemotherapy significantly improved PFS and OS in both patients with high-risk of progression and recurrent ovarian cancer, with an increased incidence of common adverse events. Conversely, we detected no statistically significant survival benefit in the pure maintenance setting. The main limitation of the review is clinical heterogeneity across the studies.

scholarly journals Obinutuzumab-Related Adverse Events: A Systematic Review and Meta-Analysis

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5259-5259
Author(s):  
Irina Amitai ◽  
Anat Gafter-Gvili ◽  
Pia Raanani ◽  
Ronit Gurion
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Lymphoproliferative Disorder ◽  
Meta Analysis ◽  
Lymphoproliferative Disorders ◽  
Controlled Trials ◽  
Toxicity Profile ◽  
Randomized Controlled ◽  
Grade 3

Background: Rituximab, the first FDA-approved anti-CD20 monoclonal antibody has dramatically improved outcomes for patients with CD20 positive lymphoproliferative disorders for 2 decades. Obinutuzumab was developed to potentiate activity and overcome resistance to rituximab. Clinical data suggest obinutuzumab is superior to rituximab in specific lymphoproliferative disorder, at the potential cost of increased toxicity, especially infections. In order to better define the toxicity profile of obinutuzumab as opposed to rituximab, we conducted a systematic review and meta‐analysis of all randomized controlled trials comparing obinutuzumab with rituximab, either alone or combined with chemotherapy for any CD20 positive lymphoproliferative disorder, in order to assess safety. Methods: A comprehensive search was conducted until June 2019. Two reviewers appraised the quality of trials and extracted data. The Primary outcome was grade 3 to 4 infections; secondary outcomes included any adverse events, serious adverse events, and other grade 3 to 4 hematologic toxicity. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated and pooled. A fixed‐effect model was used to pool data unless there was significant heterogeneity, in which case a random‐effects model was used. Results: Our search yielded 4 randomized controlled trials conducted between the years 2009 and 2014, including 3429 patients. Median age of patients in the trials was 58 to 62 years. The trials included patients with follicular lymphoma (FL) (2 trials), chronic lymphocytic leukemia, (1 trial), and diffuse large B cell lymphoma (1 trial). All trials compared between obinutuzumab and rituximab therapy: in 3 trials the antibody was combined with chemotherapy and in 1 trial it was given alone. In 2 trials, which included FL patients, the antibody was given also as maintenance therapy for up to 2 years. There was a statistically marginally increased rate of grade 3-4 infections (RR 1.17 [95% CI, 1.0‐1.36]) and febrile neutropenia (RR 1.23 [95% CI, 1.0‐1.5]) and a statistically significant increased rate of grade 3-4 adverse events (RR 1.15 [95% CI, 1.09‐1.2]) in the obinutuzumab arm vs rituximab. Also, the obinutuzumab arm showed increased risk of grade 3-4 thrombocytopenia (RR 2.8 [95% CI, 1.92‐4.06]), infusion related reactions (RR 2.8 [95% CI, 2.16‐3.64]) and cardiac events (RR 1.65 [95% CI, 1.11‐2.46]). There was no significant difference in grade 3-4 anemia and neutropenia rates, nor in the mortality rate at 36 months (RR 0.93 [95% CI, 0.78‐1.11]). Conclusions: Our systematic review and meta-analysis demonstrates that obinutuzumab has a more severe toxicity profile as compared to rituximab. As better clinical outcomes were reported with obinutuzumab in several CD20 positive lymphoproliferative disorders, but with more toxicity, clinicians are faced with a challenge upon deciding which therapy to choose for their patients. Disclosures Gurion: Roche: Consultancy.

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