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

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.

scholarly journals The effect of eye protection on SARS-CoV-2 transmission: a systematic review

2021 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Justin Clark ◽  
Peter Collignon ◽  
Paul Glasziou
Keyword(s):  
Observational Studies ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Eye Protection ◽  
Before And After ◽  
Retrospective Cohort Studies ◽  
The One ◽  
General Populations ◽  
The Cochrane Library

Background: The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. Methods: We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. Findings: We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, googles and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. Interpretation: Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.

Adverse effects of androgen deprivation therapy on cognitive impairment for men with prostate cancer: A meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16506-e16506
Author(s):  
Maxine Sun ◽  
Alexander P Cole ◽  
Nawar Hanna ◽  
Quoc-Dien Trinh
Keyword(s):  
Prostate Cancer ◽  
Cognitive Impairment ◽  
Androgen Deprivation Therapy ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Case Control ◽  
Androgen Deprivation ◽  
Cochrane Library ◽  
Retrospective Data ◽  
Case Control Studies

e16506 Background: Use of androgen deprivation therapy (ADT) may confer a higher risk of cognitive impairment. Published results are variable and lack consensus. Our objective was to perform meta-analysis of the risk of overall cognitive impairment in men receiving ADT for prostate cancer. Methods: Relevant studies were identified through the search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science until December 21st2016. Articles were included if they were published in English, reported on original research with adult male subjects undergoing treatment for prostate cancer, incorporated longitudinal comparisons, and included a control group. Controlled intervention studies were required to assess an established cognitive-related endpoint that was measured by a validated instrument, and measure cognitive impairment based on the International Cognition and Cancer Task Force (ICCTF) criteria. The effect of ADT on cognitive impairment was pooled using a random-effects model for controlled intervention and case-control studies separately. Results: Of 221 abstracts, 25 were selected for full-text review, and 8 studies, with 2 controlled studies and 6 case-control studies were identified. Overall cognitive impairment was not significantly different when the results of the 2 prospective studies were pooled (OR: 1.57, 95% CI: 0.50–4.92, P= 0.44), with significant heterogeneity between estimates ( I2: 83%). In retrospective data, the odds of developing any cognitive impairment were significantly higher in men treated with ADT (HR: 1.37, 95% CI: 1.06–1.77, P= 0.02), with considerable heterogeneity ( I2: 84%). Conclusions: The relationship between overall cognitive impairment and use of ADT defined according to the ICCTF criteria in a pooled-analysis of two prospective studies was inconclusive. Although retrospective studies suggest a higher risk of overall cognitive impairment after ADT, we caution readers not to over-interpret this finding given the limitations of retrospective data. Better well-designed prospective studies are needed to assess the effect of ADT on cognitive impairment with long-term follow-up.

Efficacy of Conversion to Aflibercept for Diabetic Macular Edema Previously Refractory to Bevacizumab or Ranibizumab: A Meta-analysis of High-Quality Nonrandomized Studies

2020 ◽  
Vol 54 (8) ◽  
pp. 750-756
Author(s):  
Kang Xiao ◽  
Fu-Zhen Li ◽  
Shen-Zhi Liang ◽  
Jiong Wang ◽  
Cheng Qian ◽  
...  
Keyword(s):  
Adverse Events ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Science Data ◽  
Study Heterogeneity ◽  
Mean Differences ◽  
The Cochrane Library

Background: Aflibercept has been widely used in treating diabetic macular edema (DME). However, the effect of aflibercept in treating DME refractory to bevacizumab or ranibizumab has not been well established. Objective: To assess the therapeutic effect of switching from bevacizumab or ranibizumab to aflibercept in the treatment of refractory DME. Methods: Relevant studies were searched from 3 databases: the Cochrane Library, PubMed, and Web of Science. Data on changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events within the follow-up period were collected and pooled using weighted mean differences (WMDs) with corresponding 95% CIs in a random effects model. The between-study heterogeneity was tested using the χ2 test and the I2 statistic, and funnel plots were used to evaluate the publication bias. Results: A total of 11 nonrandomized trials met the inclusion criteria and were included in the meta-analysis. Our studies showed significant improvements in the BCVA (WMD = 100.55; 95% CI = 68.46 to 132.63; P < 0.01) and reduction in CMT (WMD = 0.09; 95% CI = 0.03 to 0.14; P < 0.01) after switching to aflibercept. Although a large amount of heterogeneity was detected in the CMT results among these studies, the sensitivity analyses showed the reliability and stability of our results. Conclusion and Relevance: There were significant improvements in both visual and anatomical outcomes after switching from bevacizumab or ranibizumab to aflibercept, without risk of adverse events. Thus, switching therapy may be a safe and effective treatment for patients with refractory DME.

scholarly journals The efficacy and safety of bamlanivimab treatment against COVID-19: A meta-analysis

2021 ◽  
Author(s):  
Huairong Xiang ◽  
Bei He ◽  
Yun Li ◽  
Xuan Cheng ◽  
Qizhi Zhang ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Positive Treatment ◽  
The Cochrane Library

Background: Bamlanivimab is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in worldwide. We performed a meta-analysis to investigate the efficacy and safety of bamlanivimab treatment in patients with COVID-19. Methods: We searched articles from Web of Science, PubMed, Embase, the Cochrane Library and MedRxiv between 30 January 2020 and August 5, 2021. We selected randomized clinical trials (RCTs) and observational studies with a control group to assess the efficiency of bamlanivimab in treating patients with COVID-19. Results: Our meta-analysis retrieved 3 RCTs and 7 cohort studies including 14461 patients. Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease. The combination of bamlanivimab and etesevimab may had a greater potential for positive treatment outcome. Conclusion: Bamlanivimab has demonstrated clinical efficacy on mild or moderate ill patients with COVID-19 to prevent hospitalization, reduce severity and mortality from the disease. Combinations of two or more monoclonal antibody increase the effect. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients'population that could benefit from bamlanivimab are warranted in the future.

scholarly journals Adverse Events Associated With Anti-IL-23 Agents: Clinical Evidence and Possible Mechanisms

2021 ◽  
Vol 12 ◽  
Author(s):  
Yi Ru ◽  
Xiaojie Ding ◽  
Ying Luo ◽  
Hongjin Li ◽  
Xiaoying Sun ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adverse Event ◽  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
The Cochrane Library ◽  
Specific Symptoms

BackgroundAnti-interleukin (IL)-23 agents are widely used for autoimmune disease treatment; however, the safety and risks of specific symptoms have not been systematically assessed.ObjectivesThe aim of this study was to summarize the characteristics and mechanisms of occurrence of five immunological and non-immunological adverse events caused by different anti-IL-23 agents.MethodsThe Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched for eligible randomized clinical trials published from inception through May 1, 2020. Randomized clinical trials that reported at least one type of adverse event after treatment were included, regardless of sex, age, ethnicity, and diagnosis. Two investigators independently screened and extracted the characteristics of the studies, participants, drugs, and adverse event types. The Cochrane Handbook was used to assess the methodological quality of the included randomized clinical trials. Heterogeneity was assessed using the I2 statistic. Meta-regression was applied to determine the sources of heterogeneity, and subgroup analysis was used to identify the factors contributing to adverse events.ResultsForty-eight studies were included in the meta-analysis, comprising 25,624 patients treated with anti-IL-23 agents. Serious immunological or non-immunological adverse events were rare. Anti-IL-12/23-p40 agents appeared to cause adverse events more easily than anti-IL-23-p19 agents. The incidence of cancer did not appear to be related to anti-IL-23 agent treatment, and long-term medication could lead to mental diseases. The prevention of complications should be carefully monitored when administered for over approximately 40 weeks to avoid further adverse reactions, and the incidence of infection was the highest among general immunological adverse events.ConclusionsThe application of anti-IL-23 agents induced a series of immunological and non-immunological adverse events, but these agents tend to be well-tolerated with good safety profiles.

scholarly journals Vitamin D Deficiency Increases the Risk of Diabetic Retinopathy: A Meta-Analysis of Observational Studies

2017 ◽  
Author(s):  
Xiang Zhang ◽  
Guo-Tao Pan ◽  
Zeng-Li Zhang ◽  
Shasha Tao
Keyword(s):  
Vitamin D ◽  
Diabetic Retinopathy ◽  
Vitamin D Deficiency ◽  
Observational Studies ◽  
Meta Analysis ◽  
Microvascular Complications ◽  
Final Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
The Cochrane Library

Background: Diabetic retinopathy (DR) is one of the most prominent pathological microvascular complications in diabetes. A series of studies reported that vitamin D deficiency was associated with increased prevalence of retinopathy in diabetic patients but the results were inconsistent. In this study we focused on evaluating the relationship between vitamin D deficiency and DR by conducting a meta-analysis of observational studies. Methods: Systematic computerized searches were performed in PubMed, MEDLINE, and the Cochrane Library for relevant original articles till November 20, 2016. The pooled odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated to assess the associated value of vitamin D deficiency to the risk of DR. 9 studies including 6332 participants were subjected to final analysis. Results: The results indicated that vitamin D deficiency increases the risk of DR (OR = 1.57, 95% CI 1.32-1.87) with a little heterogeneity (I2 = 23%). In addition, the subgroup analysis demonstrated that there were obvious heterogeneities in T2DM (I2 = 47.8%). Sensitivity analysis showed that the results were relatively stable and reliable. Conclusion: our meta-analysis demonstrated that vitamin D deficiency could increase the risk of DR.

scholarly journals Use of Antibiotics and Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1174 ◽  
Author(s):  
Fausto Petrelli ◽  
Michele Ghidini ◽  
Antonio Ghidini ◽  
Gianluca Perego ◽  
Mary Cabiddu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Antibiotic Use ◽  
Cochrane Library ◽  
Cancer Occurrence ◽  
Incident Cancer ◽  
Increased Risk ◽  
The Cochrane Library ◽  
Risk Of Cancer

The association between antibiotic use and risk of cancer development is unclear, and clinical trials are lacking. We performed a systematic review and meta-analysis of observational studies to assess the association between antibiotic use and risk of cancer. PubMed, the Cochrane Library and EMBASE were searched from inception to 24 February 2019 for studies reporting antibiotic use and subsequent risk of cancer. We included observational studies of adult subjects with previous exposure to antibiotics and available information on incident cancer diagnoses. For each of the eligible studies, data were collected by three reviewers. Risk of cancer was pooled to provide an adjusted odds ratio (OR) with a 95% confidence interval (CI). The primary outcome was the risk of developing cancer in ever versus non-antibiotic users. Cancer risk’s association with antibiotic intake was evaluated among 7,947,270 participants (n = 25 studies). Overall, antibiotic use was an independent risk factor for cancer occurrence (OR 1.18, 95%CI 1.12–1.24, p < 0.001). The risk was especially increased for lung cancer (OR 1.29, 95%CI 1.03–1.61, p = 0.02), lymphomas (OR 1.31, 95%CI 1.13–1.51, p < 0.001), pancreatic cancer (OR 1.28, 95%CI 1.04–1.57, p = 0.019), renal cell carcinoma (OR 1.28, 95%CI 1.1–1.5, p = 0.001), and multiple myeloma (OR 1.36, 95%CI 1.18–1.56, p < 0.001). There is moderate evidence that excessive or prolonged use of antibiotics during a person’s life is associated with slight increased risk of various cancers. The message is potentially important for public health policies because minimizing improper antibiotic use within a program of antibiotic stewardship could also reduce cancer incidence.

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

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Xiaofang Tu ◽  
Yan Dong ◽  
Hongmei Zhang ◽  
Qing Su
Keyword(s):  
Mycophenolate Mofetil ◽  
Response Rate ◽  
Meta Analysis ◽  
Corticosteroid Treatment ◽  
Cochrane Library ◽  
Graves Ophthalmopathy ◽  
Oral Corticosteroids ◽  
System Review ◽  
The Cochrane Library ◽  
Better Than

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.

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

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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