scholarly journals Clinical safety of total glucosides of paeony adjuvant therapy for rheumatoid arthritis treatment: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Liu ◽  
Xiang Meng ◽  
Yanfang Ma ◽  
Huizhen Li ◽  
Yuqi Liu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effect ◽  
Adjuvant Therapy ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Analysis Data ◽  
Eligibility Criteria ◽  
Clinical Safety ◽  
Total Glucosides Of Paeony

Abstract Background Total glucosides of paeony (TGP), an active compound extracted from the roots of Paeonia lactiflora Pallas, has been increasingly used as the adjunctive therapy for rheumatoid arthritis (RA) patients. Though TGP could mitigate the unanticipated adverse effects during the conventional treatment of RA, high-quality evidence-based meta-analysis data on this subject are still insufficient. The objective of this study is to evaluate the clinical safety of TGP adjuvant therapy in the RA treatment. Methods PubMed, EMBASE, Web of Science, China Network Knowledge Infrastructure (CNKI), SinoMed and WanFang Data were retrieved for randomized controlled trials (RCTs) and cohort study about TGP adjuvant therapy in patients with RA up to 28 January 2021. Literatures with eligibility criteria and information were screened and extracted by two researchers independently. The RevMan5.3 software was used for data analysis with effect estimates as risk ratio (RR) with 95% confidence interval (CI). Results A total of 39 studies involving 3680 RA participants were included. There were 8 comparisons: TGP plus methotrexate (MTX) therapy versus MTX therapy, TGP plus leflunomide (LEF) therapy versus LEF therapy, TGP plus MTX and LEF therapy versus MTX plus LEF therapy, TGP plus tripterygium glycosides (TG) therapy versus TG therapy, TGP plus meloxicam (MLX) therapy versus MLX therapy and TGP plus sulfasalazine (SSZ) therapy versus SSZ therapy, TGP plus iguratimod (IGU) therapy versus IGU therapy, TGP plus prednisone acetate tablets (PAT) therapy versus PAT therapy. The meta-analysis results showed that the occurrence of hepatic adverse effect (RR = 0.31, 95% CI = 0.23–0.41, P < 0.00001) and leukopenia (RR = 0.41, 95% CI = 0.26–0.66, P = 0.0002) in TGP adjuvant therapy was significant decreased compared with non-TGP therapy. However, only TGP plus LEF therapy (RR = 0.22, 95% CI = 0.08–0.60, P = 0.003) and TGP plus MTX and LEF therapy (RR = 0.31, 95% CI = 0.22–0.42, P < 0.00001) had statistical difference in the subgroups of hepatic adverse effect. In leukopenia, TGP plus MTX and LEF therapy (RR = 0.47, 95% CI = 0.25–0.87, P = 0.02) had statistical difference. Conclusions This meta-analysis indicated that TGP adjuvant therapy might alleviate the incidence of hepatic adverse effect and leukopenia for the RA treatment compared to non-TGP therapy. The clinical safety of TGP adjuvant therapy warrant further investigation in experimental studies.

scholarly journals Effectiveness and safety of herbal medicines for induction of labour: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022499 ◽  
Author(s):  
Collins Zamawe ◽  
Carina King ◽  
Hannah Maria Jennings ◽  
Chrispin Mandiwa ◽  
Edward Fottrell
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Induction Of Labour ◽  
Quality Data ◽  
Eligibility Criteria ◽  
Significant Difference

ObjectiveThe use of herbal medicines for induction of labour (IOL) is common globally and yet its effects are not well understood. We assessed the efficacy and safety of herbal medicines for IOL.DesignSystematic review and meta-analysis of published literature.Data sourcesWe searched in MEDLINE, AMED and CINAHL in April 2017, updated in June 2018.Eligibility criteriaWe considered experimental and non-experimental studies that compared relevant pregnancy outcomes between users and non-user of herbal medicines for IOL.Data extraction and synthesisData were extracted by two reviewers using a standardised form. A random-effects model was used to synthesise effects sizes and heterogeneity was explored through I2statistic. The risk of bias was assessed using ‘John Hopkins Nursing School Critical Appraisal Tool’ and ‘Cochrane Risk of Bias Tool’.ResultsA total of 1421 papers were identified through the searches, but only 10 were retained after eligibility and risk of bias assessments. The users of herbal medicine for IOL were significantly more likely to give birth within 24 hours than non-users (Risk Ratio (RR) 4.48; 95% CI 1.75 to 11.44). No significant difference in the incidence of caesarean section (RR 1.19; 95% CI 0.76 to 1.86), assisted vaginal delivery (RR 0.73; 95% CI 0.47 to 1.14), haemorrhage (RR 0.84; 95% CI 0.44 to 1.60), meconium-stained liquor (RR 1.20; 95% CI 0.65 to 2.23) and admission to nursery (RR 1.08; 95% CI 0.49 to 2.38) was found between users and non-users of herbal medicines for IOL.ConclusionsThe findings suggest that herbal medicines for IOL are effective, but there is inconclusive evidence of safety due to lack of good quality data. Thus, the use of herbal medicines for IOL should be avoided until safety issues are clarified. More studies are recommended to establish the safety of herbal medicines.

Abstract 181: A Systematic Review of Interventions to Increase tPA Administration

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Mollie McDermott ◽  
Lesli E Skolarus ◽  
James F Burke
Keyword(s):  
Systematic Review ◽  
Public Education ◽  
Small Sample Size ◽  
Case Reports ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Fixed Effect Model ◽  
Small Sample ◽  
Eligibility Criteria ◽  
Design Elements

Introduction: Rates of tPA administration remain low nationally and globally despite its demonstrated efficacy. We performed a systematic review and meta-analysis of interventions to increase the rate of tPA administration. Methods: We searched PubMed and EMBASE to identify all studies (excluding case reports) published between 1995 and January 8, 2015 documenting interventions to increase the utilization of tPA. We screened each study with pre-specified inclusion and exclusion criteria. Design elements and study data were extracted from eligible studies. The principal summary measure was the percentage change in rate of tPA administration. Fixed and random effects meta-analytic models were built to summarize the effect of intervention compared to control as well as intervention subtypes. Results: Our search yielded 1457 results of which 25 met eligibility criteria. We identified 13 pre-post studies and 11 randomized or quasi-experimental studies. Included studies utilized EMS (n=14), telemedicine (n=6), and public education (n=5). Intervention settings included urban (n=13), rural (n=4), and combined (n=4). In a fixed effect model, tPA administration was significantly higher in the intervention arm across all studies that limited enrollment to ischemic stroke patients (n=14) with a risk ratio (RR) of 1.71. Interventions involving EMS were associated with an increased rate of tPA administration with a RR of 1.51, (95% CI: 1.43-1.59, p<0.0001); promoting public education RR = 2.62, (95% CI: 1.54-4.43, p<0.01); and utilizing telemedicine RR = 2.97, (95% CI: 2.61-3.39, p<0.0001). Conclusions: Interventions to increase tPA use appear to have considerable efficacy. Comparative inferences between intervention types are limited by small sample size and intervention heterogeneity.

scholarly journals Symptomatology of COVID-19 - Lessons from a meta-analysis across 13 countries

2021 ◽  
Vol 12 (11) ◽  
pp. 3-15
Author(s):  
Champika Saman Kumara Gamakaranage ◽  
Dineshani Hettiarachchi ◽  
Dileepa Ediriweera ◽  
Saroj Jayasinghe
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Clinical Manifestations ◽  
Analysis Data ◽  
Data Sources ◽  
Data Abstraction ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Altered Level ◽  
Comprehensive Picture

Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Aims and Objectives: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Materials and Methods: Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing were used to identify 7176 articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included in meta-analysis. Data abstraction and analysis: PRISMA guidelines used for data abstraction and a table was generated by feeding it with numbers and proportions of each symptom described. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence rates and 95% confident intervals were calculated. Results: Selected 14 studies, either cross-sectional or cohort studies are analyzed. There were 2,660 confirmed cases of COVID-19. The majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea, and India and one article from Europe. There were a total of 32 symptoms identified from the meta-analysis and additional 7 symptoms were identified from reference searching. The most common symptoms were (prevalence >50%): fever (79.56%, 95% CI: 72.17–86.09%), malaise (63.3%, 95% CI: 53.1–73.0%), cough (56.7%, 95% CI: 48.6–64.6%), and cold (55.6%, 95% CI: 45.2–65.7%). Symptoms of intermediate incidence (5–49%) were anosmia, sneezing, ocular pain, fatigue, sputum production, arthralgia, tachypnea, palpitation, headache, chest tightness, shortness of breath, chills, myalgia, sore throat, anorexia, weakness, diarrhea, rhinorrhea, dizziness, nausea, altered level of consciousness, vomiting, and abdominal pain. Rare symptoms (<5%): tonsil swelling, hemoptysis, conjunctival injection, lymphadenopathy, and rash. Conclusion: We found (25/32, from meta-analysis) symptoms to be present in ≥5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified is different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.

scholarly journals Does periodontitis represent a risk factor for rheumatoid arthritis? A systematic review and meta-analysis

2019 ◽  
Vol 11 ◽  
pp. 1759720X1985851 ◽  
Author(s):  
Railson de Oliveira Ferreira ◽  
Raíra de Brito Silva ◽  
Marcela Baraúna Magno ◽  
Anna Paula Costa Ponte Sousa Carvalho Almeida ◽  
Nathália Carolina Fernandes Fagundes ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Risk Factor ◽  
Quantitative Analysis ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Control Group ◽  
Case Group ◽  
Eligibility Criteria ◽  
Inflammatory Profile

Periodontitis is an inflammatory disease of dental supporting tissues (gingiva, periodontal ligament, and bone) and it has been suggested as a possible etiology for rheumatoid arthritis (RA). In this systematic review, we aim to verify if periodontitis represents a risk factor for RA. Electronic databases were consulted until March 2018 considering eligibility criteria focusing on: (P, participants) adults; (E, exposure) with periodontitis; (C, comparison) without periodontitis; and (O, outcome) development of RA. Quality assessment of studies and risk-of-bias evaluation were also performed. To undertake a quantitative analysis, the number of persons with RA and a total number of participants for the case group (with periodontitis) and control group (without periodontitis) were used to calculate the odds ratio (OR) with a 95% confidence interval (CI). A total of 3888 articles were identified, and nine studies were considered eligible. Seven of 9 articles suggested an association among diseases by the common pro-inflammatory profiles. The pooled analysis of 3 articles showed a higher RA prevalence for persons with periodontitis ( n = 1177) than controls ( n = 254) (OR 1.97; CI 1.68–2.31; p < 0.00001). However, considerable heterogeneity among studies was verified (I2 = 96%, p < 0.00001). Periodontitis may represent a risk factor for RA by heredity, bacterial infection, and the pro-inflammatory profile shared between both diseases. Although most of the elective studies report an association between periodontitis and RA, the quantitative analysis showed a high heterogeneity, leading to the need for further studies.

scholarly journals Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis

2017 ◽  
Vol 76 (6) ◽  
pp. 1101-1136 ◽  
Author(s):  
Sofia Ramiro ◽  
Alexandre Sepriano ◽  
Katerina Chatzidionysiou ◽  
Jackie L Nam ◽  
Josef S Smolen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Serious Infections ◽  
Safety Outcomes

ObjectivesTo assess the safety of synthetic (s) and biological (b) disease-modifying antirheumatic drugs (DMARDs) for the management of rheumatoid arthritis (RA) to inform the European League Against Rheumatism recommendations for the management of RA.MethodsSystematic literature review (SLR) of observational studies comparing any DMARD with another intervention for the management of patients with RA. All safety outcomes were included. A comparator group was required for the study to be included. Risk of bias was assessed with the Hayden's tool.ResultsTwenty-six observational studies addressing diverse safety outcomes of therapy with bDMARDs met eligibility criteria (15 on serious infections, 4 on malignancies). Substantial heterogeneity precluded meta-analysis. Together with the evidence from the 2013 SLR, based on 15 studies, 7 at low risk of bias, patients on bDMARDs compared with patients on conventional sDMARDs had a higher risk of serious infections (adjusted HR (aHR) 1.1 to 1.8)—without differences across bDMARDs—a higher risk of tuberculosis (aHR 2.7 to 12.5), but no increased risk of infection by herpes zoster. Patients on bDMARDs did not have an increased risk of malignancies in general, lymphoma or non-melanoma skin cancer, but the risk of melanoma may be slightly increased (aHR 1.5).ConclusionsThese findings confirm the known safety pattern of bDMARDs, including both tumour necrosis factor-α inhibitor (TNFi) and non-TNFi, for the treatment of RA.

scholarly journals Anti-basal ganglia antibodies in primary obsessive–compulsive disorder: systematic review and meta-analysis

2014 ◽  
Vol 205 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Daniel M. Pearlman ◽  
Haily S. Vora ◽  
Brian G. Marquis ◽  
Souhel Najjar ◽  
Lauren A. Dudley
Keyword(s):  
Basal Ganglia ◽  
Obsessive Compulsive Disorder ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Neuropsychiatric Disorders ◽  
Control Group ◽  
Pool Data ◽  
Obsessive Compulsive ◽  
Eligibility Criteria ◽  
Compulsive Disorder

BackgroundAutoimmune-mediated basal ganglia dysfunction is implicated in the pathophysiology of neuropsychiatric disorders commonly manifesting with obsessive–compulsive features (e.g. Sydenham chorea). The relationship between autoimmunity and primary obsessive–compulsive disorder (OCD), however, is less clear.AimsTo pool data on serum and cerebrospinal fluid (CSF) anti-basal ganglia antibody (ABGA) positivity in primary OCD (without neurological or autoimmune comorbidity) relative to controls or neuropsychiatric disorders previously associated with increased odds of ABGA positivity.MethodWe performed electronic database and hand-searches for studies meeting pre-specified eligibility criteria from which we extracted data using a standardised form. We calculated pooled estimates of ABGA positivity using a random-effects model.ResultsSeven case–control studies totalling 844 participants met the eligibility criteria. Meta-analysis showed that a significantly greater proportion of those with primary OCD were ABGA seropositive compared with various controls (odds ratio (OR) = 4.97, 95% CI 2.88–8.55, P<0.00001). This effect was not associated with heterogeneity or publication bias, and remained significant after stratifying the analysis by age, gender, disease severity, illness duration, immunostaining methodology, study quality, publication type, kind of control group, and sample size. There were no significant differences in ABGA seropositivity for comparisons between primary OCD and Tourette syndrome, attention-deficit hyperactivity disorder or paediatric acute-onset neuropsychiatric syndrome. Results of one study testing CSF samples showed that a significantly greater proportion of participants with primary OCD were ABGA CSF-positive compared with healthy controls (OR = 5.60, 95% CI 1.04–30.20, P = 0.045).ConclusionsOdds of ABGA seropositivity are increased fivefold in primary OCD compared with controls, but are comparable to those associated with disorders previously associated with ABGA, providing circumstantial evidence of autoimmunity in a subset of those with primary OCD. Further experimental studies are needed to ascertain whether this relationship is causal.

Pork Consumption in Relation to Body Weight and Composition: A Systematic Review and Meta-analysis

2020 ◽  
Vol 44 (4) ◽  
pp. 513-525
Author(s):  
Ruopeng An ◽  
Jianxiu Liu ◽  
Ruidong Liu
Keyword(s):  
Body Weight ◽  
Lean Mass ◽  
Keyword Search ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Experimental Studies ◽  
Cochrane Library ◽  
Fat Percentage ◽  
Eligibility Criteria ◽  
Pork Consumption

Objectives: In this study, we systematically synthesized scientific evidence on pork consumption in relation to body weight and composition among adults. Methods: We performed a keyword search using Cochrane Library, PubMed, Web of Science, CINAHL, and Google Scholar. We conducted a meta-analysis to estimate the pooled effect size of pork consumption on body weight and composition. Results: Overall, 12 studies met the eligibility criteria for inclusion in the review. Among the experimental studies without daily total energy intake restrictions, pork intake was associated with a reduction in body weight by 0.86 kg (95% CI = 0.17-1.55) and body fat percentage by 0.77% (95% CI = 0.11%-1.43%); pork intake was not associated with change in lean mass. Among the experimental studies with energy restrictions, pork intake was associated with a reduction in body weight by 5.56 kg (95% CI = 0.55-10.59), lean mass by 1.50 kg (95% CI = 1.39-1.62), and fat mass by 6.60 kg (95% CI = 6.42-6.79). Among the observational studies, pork intake was not associated with overweight/obesity. Conclusions: Findings on pork consumption in relation to body weight/composition differed by study design. Future experimental studies using representative samples are warranted to examine the effect of fresh/lean pork consumption on body weight and composition in the general population and by subgroups.

scholarly journals Effects of Ramadan Observance on Dietary Intake and Body Composition of Adolescent Athletes: Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1574 ◽  
Author(s):  
Khaled Trabelsi ◽  
Achraf Ammar ◽  
Omar Boukhris ◽  
Jordan M Glenn ◽  
Nick Bott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Composition ◽  
Dietary Intake ◽  
Body Mass ◽  
Meta Analysis ◽  
Analysis Data ◽  
Control Group ◽  
Adolescent Athletes ◽  
Eligibility Criteria ◽  
Body Fat Content

To evaluate the effects of Ramadan observance on dietary intake, body mass and body composition of adolescent athletes (design: systematic review and meta-analysis; data sources: PubMed and Web of Science; eligibility criteria for selecting studies: single-group, pre-post, with or without control-group studies, conducted in athletes aged <19 years, training at least 3 times/week, and published in any language before 12 February 2020). Studies assessing body mass and/or body composition and/or dietary intake were deemed eligible. The methodological quality was assessed using ‘QualSyst’. Of the twelve selected articles evaluating body mass and/or body composition, one was of strong quality and eleven were rated as moderate. Ten articles evaluated dietary intake; four were rated as strong and the remaining moderate in quality. Continuation of training during Ramadan did not change body mass from before to the first week (trivial effect size (ES) = −0.011, p = 0.899) or from before to the fourth week of Ramadan (trivial ES = 0.069, p = 0.277). Additionally, Ramadan observance did not change body fat content from before to the first week (trivial ES = −0.005, p = 0.947) and from before to the fourth week of Ramadan (trivial ES = -0.057, p = 0.947). Lean body mass remained unchanged from before to the fourth week of Ramadan (trivial ES = −0.025, p = 0.876). Dietary data showed the intake of energy (small ES = -0.272, p = 0.182), fat (trivial ES = 0.044, p = 0.842), protein (trivial ES = 0.069, p = 0.720), carbohydrate (trivial ES = 0.075, p = 0.606) and water (trivial ES = −0.115, p = 0.624) remained essentially unchanged during as compared to before Ramadan. Continued training of adolescent athletes at least three times/week during Ramadan observance has no effect on body mass, body composition or dietary intake.

scholarly journals Epidemiology of echinococcosis in Iran: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shima Mahmoudi ◽  
Setareh Mamishi ◽  
Maryam Banar ◽  
Babak Pourakbari ◽  
Hossein Keshavarz
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cyst Formation ◽  
Analysis Data ◽  
Diagnostic Methods ◽  
Control Measures ◽  
Clinical Aspects ◽  
Monitoring And Control ◽  
Eligibility Criteria ◽  
Larval Stages

Abstract Background Echinococcosis is a zoonotic disease caused by the larval stages of taeniid cestodes of the genus Echinococcus. The two major types of infection in humans are cystic echinococcosis (CE) or hydatidosis and alveolar echinococcosis (AE). It is endemic in some parts of the world, such as the Middle East, with Iran being a part of it. This systematic review and meta-analysis were conducted to determine the prevalence of CE and AE echinococcosis and their epidemiological and clinical aspects in Iran. Methods Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from 1 January 1990 to 8 August 2017. The prevalence of CE and AE echinococcosis was estimated using the random effects meta-analysis. Heterogeneity was evaluated by subgroup analysis. Data were analyzed by STATA version 12. Results Of the 2051 records identified in the mentioned electronic databases, Seventy-eight articles met our eligibility criteria, with a total of 214124individuals. The meta-analysis was performed on only 37 out of 78 included studies. The pooled prevalence of CE and AE in Iran was 5% [95% confidence interval )CI(: 3-6%] and 2% [95% CI: 0-5%], respectively. Subgroup meta-analysis revealed that the prevalence of CE was significantly higher in North [9%, 95% CI: 4-18%] and West of Iran [6%, 95% CI: 3-11%], patients younger than 40 years of age [7%, 95% CI: 4-12%], villagers and nomads [6%, 95% CI: 2-12%], and studies that used the combination of serological, clinical, and imaging diagnostic methods [7%, 95% CI: 5-9%]. There were no significant differences between the prevalence of CE among low and high-quality studies. Housewives were the most affected group by hydatidosis (n=24/77, 31%), followed by illiterate people (n=11/77, 14%) and farmers (n= 9/77, 12%). Liver [55%, 95% CI: 46-65%] and lung [28%, 95% CI, 22-35%] were the most common sites of cyst formation. Conclusions Given to the importance of echinococcosis on human health and domestic animals industry, it is necessary to implement monitoring and control measures in this regard.

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