scholarly journals The Efficacy and Safety of Topical β-Blockers in Treating Infantile Hemangiomas: A Meta-Analysis Including 11 Randomized Controlled Trials

Dermatology ◽  
2020 ◽  
pp. 1-11
Author(s):  
Xinhui Wang ◽  
Wei Feng ◽  
Xufeng Zhao ◽  
Ziyu Liu ◽  
Liang Dong
Keyword(s):  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Pulsed Dye Laser ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Β Blocker ◽  
Β Blockers ◽  
Oral Propranolol

<b><i>Background:</i></b> To evaluate the efficacy and safety of topical β-blockers in the treatment of superficial infantile hemangiomas (SIH) and mixed infantile hemangiomas (MIH), respectively, and compare the efficacy and safety of topical β-blockers with other interventions. <b><i>Methods:</i></b> The PRISMA guidelines were adhered to. We searched for randomized controlled trials in databases from 2010 to 2018 comparing topical β-blockers with other interventions for infantile hemangiomas. The outcomes evaluated were efficacy and adverse effects. Data analyses were performed using RevMan 5.3. Publication bias was assessed to account for bias in patient selection. <b><i>Results:</i></b> Eleven studies, involving 1,235 patients, were subjected to this meta-analysis. Six studies compared topical β-blockers with other interventions (propranolol, placebo, corticosteroids or pulsed dye laser) in treating SIH, and 5 studies evaluated the efficacy and safety of a topical β-blocker when it was combined with another intervention in treating MIH. A topical β-blocker was discovered to be as effective as oral propranolol in treating SIH (risk ratio, RR, 0.96, 95% confidence interval, CI, 0.91–1.02, <i>p</i> = 0.20, <i>I</i><sup>2</sup> = 0%), and topical β-blockers were more beneficial than placebo, corticosteroids or pulsed dye laser in treating SIH (RR 2.25, 95% CI 1.66–3.05, <i>p</i> &#x3c; 0.00001, <i>I</i><sup>2</sup> = 0%). Topical β-blockers combined with another intervention gave rise to a better clinical response in the treatment of MIH than intervention alone (RR 1.99, 95% CI 1.10–3.60, <i>p</i> = 0.02, <i>I</i><sup>2</sup> = 55%) (standard mean difference 0.80, 95% CI 0.28–1.31, <i>p</i> = 0.002, <i>I</i><sup>2</sup> = 0%). Compared with oral propranolol, topical β-blockers were associated with fewer incidences of adverse effects (RR 0.05, 95% CI 0.01–0.39, <i>p</i> = 0.004, <i>I</i><sup>2</sup> = 0%). No significant difference in adverse effects was found when a topical β-blocker was combined with another intervention in treating MIH (RR 1.01, 95% CI 0.58–1.74, <i>p</i> = 0.98, <i>I</i><sup>2</sup> = 0%). <b><i>Conclusions:</i></b> This meta-analysis provided evidence that topical β-blockers may replace oral propranolol as first-line therapy for SIH and that they are of additive value in treating MIH.

scholarly journals Efficacy and safety of nebivolol in hypertensive patients: a meta-analysis of randomized controlled trials

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052093162
Author(s):  
Jun-Ying Liu ◽  
Li-Na Guo ◽  
Wan-Zhong Peng ◽  
Yang Jiang ◽  
Ai-Li Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Second Generation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Hypertensive Patients ◽  
Randomized Controlled ◽  
Β Blockers

Purpose Our meta-analysis was undertaken to evaluate the efficacy and safety of nebivolol compared with other second-generation β blockers for hypertensive patients. Methods We searched PubMed, the Cochrane Library, EMBASE, and Clinical Trials.gov databases for randomized controlled trials (RCTs). The efficacy endpoints included systolic blood pressure (SBP), diastolic blood pressure (DBP), reduction of SBP and DBP, heart rate (HR), and adverse events (AEs). Findings Eight RCTs with 1514 patients met the inclusion criteria. HR was significantly lower in patients receiving other second-generation β blockers compared with patients receiving nebivolol. There was no difference the reduction of blood pressure (SBP and DBP) or the reduction of SBP or DBP between the groups. The incidence of AEs was lower in patients taking nebivolol compared with patients taking other second-generation β blockers. Conclusions No significant difference was demonstrated between nebivolol and other second-generation β blockers in the reduction of blood pressure, SBP, and DBP. The tolerability of nebivolol was significantly better compared with other second-generation β blockers, and nebivolol was also associated with a stable HR and a lower risk of AEs compared with other second-generation β blockers.

Comparing the Efficacy and Safety of Intralesional Verapamil With Intralesional Triamcinolone Acetonide in Treatment of Hypertrophic Scars and Keloids: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Pu Wang ◽  
Luosha Gu ◽  
Hongsen Bi ◽  
Qifei Wang ◽  
Zelian Qin
Keyword(s):  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Triamcinolone Acetonide ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Hypertrophic Scars ◽  
Efficacy And Safety ◽  
Skin Atrophy ◽  
Randomized Controlled ◽  
First Session

Abstract Background Clinical treatment of hypertrophic scars (HS) and keloids is often unsatisfactory. Intralesional injections of triamcinolone acetonide (TAC) and verapamil are widely used to treat HS and keloids, but their efficacy and safety are controversial. Objectives: To conduct a meta-analysis of the effectiveness and safety of verapamil and TAC in the treatment of HS and keloids. Methods Embase, Google Scholar, and PubMed were searched for randomized controlled trials (RCTs) from inception to February 2020. RCTs that evaluated treatment effects with the Vancouver Scar Scale or reported adverse effects were included. The continuous data and the dichotomous variables were analyzed as mean difference (MD) and relative risk (RR), respectively. Results Seven RCTs (461 patients) were included. Compared to baseline, TAC rapidly changed the △height (MD=0.07; P&lt;0.05) and △pliability (MD=0.23; P&lt;0.05) after the first session, with no significant differences in the △height (after last session: MD=0.50; P=0.42), △pigmentation (after first session: MD=0.07; P=0.51, after last session: MD=-0.10; P=0.14), △vascularity(after first session: MD=-0.25; P=0.57, after last session: MD=-0.02; P=0.79) and △pliability (after last session MD=0.52; P=0.48). Although total adverse effects (RR=0.42; P=0.1) were not significantly different, in the subgroup analysis, the incidence of telangiectasia (RR=0.04; P&lt;0.05) and skin atrophy (RR=0.10; P&lt;0.05) but not pain (RR=1.27; P=0.77) was significantly lower with verapamil than with TAC. Conclusions Verapamil may be an effective substitute for TAC. Although total adverse effects did not change, the incidence of telangiectasia and skin atrophy was lower with verapamil than with TAC.

scholarly journals Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jian Liu ◽  
Ting Wang ◽  
Zhen-Hua Zhu
Keyword(s):  
Adverse Effects ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Knee Pain ◽  
Meta Analysis ◽  
Knee Function ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Knee Oa ◽  
Randomized Controlled

Abstract Background The clinical utility of radiofrequency (RF) in patients with knee osteoarthritis (OA) remains unclear. We conducted a meta-analysis to systematically evaluate the efficacy and safety of RF treatment in patients with knee OA. Methods Searches of the PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases were performed through August 30, 2021. The major outcomes from published randomized controlled trials (RCTs) involving patients with knee OA were compared between RF and control groups, including Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Global Perceived Effect (GPE) scale, and adverse effects at available follow-up times. Results Fifteen RCTs involving 1009 patients were included in this meta-analysis, and the results demonstrated that RF treatment correlated with improvements in pain relief (VAS/NRS score, all P < 0.001) and knee function (WOMAC, all P < 0.001) at 1–2, 4, 12, and 24 weeks after treatment as well as patients’ degree of satisfaction with treatment effectiveness (GPE scale, 12 weeks, P < 0.001). OKSs did not differ significantly between the two groups. Moreover, treatment with RF did not significantly increase adverse effects. Subgroup analysis of knee pain indicated that the efficacy of RF treatment targeting the genicular nerve was significantly better than intra-articular RF at 12 weeks after treatment (P = 0.03). Conclusions This meta-analysis showed that RF is an efficacious and safe treatment for relieving knee pain and improving knee function in patients with knee OA.

scholarly journals Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110066
Author(s):  
Hua Zhang ◽  
Bo Wang ◽  
Jie He ◽  
Zhongju Du
Keyword(s):  
Radiofrequency Ablation ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Randomized Controlled

Objective To evaluate the efficacy and safety of radiofrequency ablation for the treatment of knee osteoarthritis. Methods A literature review was conducted using the PubMed, Cochrane Review, Embase, and Google Scholar databases. Two reviewers independently assessed the eligibility of all retrieved studies. The research was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the reliability and verity of the results. The statistical analysis was performed using STATA version 13.0. Results Nine randomized controlled trials were collected for the data extraction and meta-analysis. Significant differences in the pain score at 4, 12, and 24 weeks were found between patients treated with radiofrequency ablation and those treated with placebo. Furthermore, the use of radiofrequency ablation was associated with an improved outcome of the Western Ontario and McMaster Universities Arthritis Index at 4, 12, and 24 weeks. No serious adverse events were observed in any patients who underwent radiofrequency ablation. Conclusion Radiofrequency ablation is efficacious and safe for reducing pain and improving knee function in patients with knee osteoarthritis, without increasing the risk of adverse effects.

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