scholarly journals Clinical profiles of Asians with NAFLD: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Leslie Kam ◽  
Daniel Q. Huang ◽  
Margaret L.P Teng ◽  
Hirokazu Takahashi ◽  
Kenichi Tanaka ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Clinical Profile ◽  
Excessive Alcohol Consumption ◽  
Patient Level Data ◽  
Individual Patient Level ◽  
Patient Level ◽  
Level Data ◽  
Excessive Alcohol ◽  
Clinical Profiles ◽  
The Mean

Introduction: NAFLD is increasingly prevalent in Asia, where people suffer more metabolic comorbidities at a lower body mass index (BMI), suggesting potential differences in their clinical profile. Therefore, we attempted to characterize the clinical profile of Asians with NAFLD via a meta-analytic approach. Methods: We searched Pubmed, EMBASE, and Cochrane databases from January 1, 2000 to January 17, 2019. Two authors independently reviewed and selected 104 articles (2,247,754 persons) that identified NAFLD in Asians and reported relevant data, especially BMI and ALT, and excluded individuals with other liver disease and excessive alcohol consumption. Individual patient-level data were obtained from seven cohorts in Asia to complement meta-analyzed data. Results: Overall, the mean age was 52.07 (95%CI:51.28-52.85) years with those from Southeast Asia (42.66, 95%CI: 32.23-53.11) being significantly younger. The mean BMI was 26.2 kg/m2, higher in moderate-severe vs. mild hepatic steatosis (28.3 vs. 25.7) patients and NFS ≥-1.455 vs. <-1.455 (27.09 vs. 26.02), with 34% having non-obese NAFLD. The mean ALT was 31.74 U/L, higher in NFS <-1.455 vs. ≥-1.455 (33.74 vs. 27.83), though no differences were found by obesity or steatosis severity. The majority of males (85.7%) and females (60.7%) had normal to minimally elevated ALT (1-1.5x 95% ULN). Individual patient-level data analysis (N=7,668) demonstrated similar results. Conclusion: About one-third of Asians with NAFLD were non-obese and the majority did not have markedly elevated ALT. Therefore, abnormal ALT or BMI are not recommended as a criterion for NAFLD screening in this population. Additionally, there were significant differences in the clinical profiles of NAFLD among the different regions of Asia.

scholarly journals Forced vital capacity and cross-domain late-onset Pompe disease outcomes: an individual patient-level data meta-analysis

2019 ◽  
Vol 266 (9) ◽  
pp. 2312-2321
Author(s):  
Kenneth I. Berger ◽  
Steve Kanters ◽  
Jeroen P. Jansen ◽  
Andrew Stewart ◽  
Susan Sparks ◽  
...  
Keyword(s):  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Late Onset ◽  
Meta Analysis ◽  
Patient Level Data ◽  
Individual Patient Level ◽  
Patient Level ◽  
Cross Domain ◽  
Disease Outcomes ◽  
Level Data

Immune-related acute myocarditis in patients treated with immune checkpoints inhibitors: Systematic review with individual patient-level data meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24096-e24096
Author(s):  
Alexey Rumyantsev ◽  
Edgar Israelyan ◽  
Alexandra Tyulyandina ◽  
Elena Glazkova ◽  
Yury Sergeev ◽  
...  
Keyword(s):  
Systematic Review ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
High Dose ◽  
Autoimmune Myocarditis ◽  
Patient Level Data ◽  
Nccn Guidelines ◽  
Individual Patient Level ◽  
Patient Level ◽  
Level Data

e24096 Background: Immune checkpoint inhibitors can sometimes lead to fatal outcomes or significant morbidity due to immune-related adverse events (IRAE). Cardiac IRAE, especially myocarditis, are among the most fatal IRAE. There are scarce of the trials addressing the optimal therapeutic approaches for patients with IR-myocarditis. Initial therapy with high-dose steroids (1000 mg of prednisolone for 3-5 days) may be beneficial for many patients with this IRAE and this approach is endorsed by NCCN guidelines. We conducted a systematic review with individual patient-level data meta-analysis of published clinical cases to assess impact of various initial therapeutic modalities and adherence to NCCN guidelines on outcomes of immune-related myocarditis, associated with checkpoint inhibitors. Methods: We searched PubMed database for all full-text articles and abstracts on the treatment of patients with cardiac-related IRAE treated with various PD-1/PD-L1 or CTLA-4 inhibitors for years between 2012 and 2020 in English. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) tool was used to ensure transparent reporting. Main study inclusion criteria were: 1) morphologically confirmed immune-related myocarditis or highly clinically suspected autoimmune myocarditis (based on Bonaca et al, 2019 criteria); 2) clear association of IRAE and administration of check-point inhibitors; 3) availability of individual patient and treatment data. Pooled analysis of outcomes and multiple logistic regression analysis were conducted. The primary outcome of this study was rate of major cardiac adverse events (MACE) due to immune-related autoimmune myocarditis according to adherence to NCCN guidelines. MACE was defined as death or persisting significant disabilities due to myocarditis (ie, chronic heart failure, rhythm abnormalities or deterioration leading to impossibility of further anticancer treatment). Results: We identified 277 articles and screened them for title and abstract. After the review process we selected 81 studies for further analysis which described treatment course for 111 patients. Overall, 26 and 85 patients were treated with high-dose and non-high dose steroids. Among patients treated high-dose steroids therapy and non-high dose steroids 10 (38.5%) and 57 (67.1%) of patients respectively experienced MACE (HR 0.185; 95% CI 0.07-0.47; p = 0.0091). Initial treatment failure was associated with high rate of morbidity; however, 9 patients were rescued with various immunosuppressive drugs (eg, tacrolimus, alemtuzumab, tocilizumab). Conclusions: Our results support use of high-dose pulse therapy as a preferred therapeutic approach for all patients with suspected or proven immune-related myocarditis.

scholarly journals Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data

2018 ◽  
Vol 17 (10) ◽  
pp. 895-904 ◽  
Author(s):  
Luis San Román ◽  
Bijoy K Menon ◽  
Jordi Blasco ◽  
María Hernández-Pérez ◽  
Antoni Dávalos ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Imaging Features ◽  
Safety And Efficacy ◽  
Stroke Treatment ◽  
Patient Level Data ◽  
Individual Patient Level ◽  
Patient Level ◽  
Level Data
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