scholarly journals Brazilian recommendations for the use of nonsteroidal anti-inflammatory drugs in patients with axial spondyloarthritis

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Ricardo da Cruz Lage ◽  
Claudia Diniz Lopes Marques ◽  
Thauana Luiza Oliveira ◽  
Gustavo Gomes Resende ◽  
Charles Lubianca Kohem ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Axial Spondyloarthritis ◽  
Meta Analysis ◽  
Evaluation Methodology ◽  
Assessment Development ◽  
Brazilian Society ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

AbstractSpondyloarthritis (SpA) is a group of chronic inflammatory systemic diseases characterized by axial and/or peripheral joints inflammation, as well as extra-articular manifestations. Over some decades, nonsteroidal anti-inflammatory drugs (NSAIDs) have been the basis for the pharmacological treatment of patients with axial spondyloarthritis (axSpA). However, the emergence of the immunobiologic agents brought up the discussion about the role of NSAIDs in the management of these patients. The objective of this guideline is to provide recommendations for the use of NSAIDs for the treatment of axSpA. A panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis of randomized clinical trials for 15 predefined questions. The Grading of Recommendations, Assessment, Development and Evaluation methodology to assess the quality of evidence and formulate recommendations were used, and at least 70% agreement of the voting panel was needed. Fourteen recommendations for the use of NSAIDs in the treatment of patients with axSpA were elaborated. The purpose of these recommendations is to support clinicians’ decision making, without taking out his/her autonomy when prescribing for an individual patient.

scholarly journals Acupuncture for post-stroke depression: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ran Liu ◽  
Kun Zhang ◽  
Qiu-yu Tong ◽  
Guang-wei Cui ◽  
Wen Ma ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Quality Of Evidence ◽  
Post Stroke ◽  
Assessment Development ◽  
Significant Difference ◽  
Post Stroke Depression ◽  
Meta Analyses

Abstract Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. Conclusions The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.

Lactoferrin Supplementation to Prevent Late-Onset Sepsis in Preterm Infants: A Meta-Analysis

2019 ◽  
Author(s):  
Abdul Razak ◽  
Asif Hussain
Keyword(s):  
Preterm Infants ◽  
Web Of Science ◽  
Late Onset ◽  
Meta Analysis ◽  
Evaluation Methodology ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Late Onset Sepsis ◽  
All Cause Mortality

Abstract Objective To systematically review and meta-analyze the role of lactoferrin supplementation to prevent late-onset sepsis (LOS) in preterm infants. Study Design Database search include PubMed, Web of Science, and Cochrane central for randomized clinical trial (RCTs). The Cochrane Grading of Recommendations Assessment, Development, and Evaluation methodology was used for summarizing the results. Results Ten RCTs involving 3,679 infants were included. Lactoferrin supplementation with or without probiotics decreased all LOS (relative risk [RR]: 0.56; 95% confidence interval [CI]: 0.36–0.86; I 2 = 58%; 10 studies; 3,470 subjects; level of evidence [LOE]: low) significantly. Similarly, lactoferrin supplementation without probiotics decreased all LOS (RR: 0.43; 95% CI: 0.29–0.62; I 2 = 0%; 8 studies; 1,209 subjects; LOE: moderate) significantly. Lactoferrin supplementation did not significantly reduce necrotizing enterocolitis (RR: 0.62; 95% CI: 0.29–1.33; I 2 = 43%; 6 studies; 3,079 subjects; LOE: low), all-cause mortality (RR: 0.74; 95% CI: 0.36–1.53; I 2 = 53%; 8 studies; 3,395 subjects; LOE: very low), bronchopulmonary dysplasia (RR: 1; 95% CI: 0.90–1.13; I 2 = 0%; 4 studies; 2,570 subjects; LOE: moderate), and threshold retinopathy of prematurity eligible for surgical treatment (RR: 0.61; 95% CI: 0.25–1.51; I 2 = 74%; 2 studies; 2,481 subjects; LOE: very low). Conclusion Low to moderate quality evidence suggests that lactoferrin supplementation reduces LOS in preterm infants. Further research is needed to improve the certainty in the evidence.

scholarly journals The Level Of Knowledge on the Use Of NSAIDs As Analgesic For Dysmenorrhea Case In Faculty of Health Universitas Muhammadiyah Lamongan

2020 ◽  
Vol 12 (2) ◽  
pp. 287
Author(s):  
Primanitha Ria Utami ◽  
Devi Ristian Octavia ◽  
Selly Septi Fandinata
Keyword(s):  
Sampling Technique ◽  
Or Education ◽  
Pain Reliever ◽  
Level Of Knowledge ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Almost All ◽  
The University

Non-steroidal anti-inflammatory (anti-inflammatory) drugs, or better known as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) or NSAIDs are a group that has analgesic (pain reliever), anti-pyretic (fever) properties. to determine the level of knowledge on the use of NSAIDs as anti-pain in cases of dysmenorrhea in the University of Muhammadiyah Lamongan. The research design used in this research is descriptive, in taking the sample using the total sampling technique. Collecting data by distributing questionnaires with data analysis presented in tabular form. The results of this study indicate that of the 266 respondents, almost all respondents know about knowledge of dysmenorrhea well (83.8%). In the results of this study, there were still respondents who did not know the proper use of NSAIDs as analgesic. So in this case the role of pharmaceutical personnel is needed in providing information or education to people who consume NSAIDs, in order to achieve a quality of life for the community and avoid unwanted therapeutic responses. Keywords : NSAID ; dysmenorrhea ; analgesic 

scholarly journals Corticosteroids for Treating Sepsis in Adult Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Huoyan Liang ◽  
Heng Song ◽  
Ruiqing Zhai ◽  
Gaofei Song ◽  
Hongyi Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Evaluation Methodology ◽  
Cochrane Library ◽  
Assessment Development ◽  
Short Time ◽  
Long Term Mortality

ObjectiveCorticosteroids are a common option used in sepsis treatment. However, the efficacy and potential risk of corticosteroids in septic patients have not been well assessed. This review was performed to assess the efficacy and safety of corticosteroids in patients with sepsis.MethodsPubMed, Embase, and Cochrane library databases were searched from inception to March 2021. Randomized controlled trials (RCTs) that evaluated the effect of corticosteroids on patients with sepsis were included. The quality of outcomes in the included articles was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation methodology. The data were pooled by using risk ratio (RR) and mean difference (MD). The random-effects model was used to evaluate the pooled MD or RR and 95% confidence intervals (CIs).ResultsFifty RCTs that included 12,304 patients with sepsis were identified. Corticosteroids were not associated with the mortality in 28-day (RR, 0.94; 95% CI, 0.87–1.02; evidence rank, moderate) and long-term mortality (>60 days) (RR, 0.96; 95% CI, 0.88–1.05) in patients with sepsis (evidence rank, low). However, corticosteroids may exert a significant effect on the mortality in the intensive care unit (ICU) (RR, 0.9; 95% CI, 0.83–0.97), in-hospital (RR, 0.9; 95% CI, 0.82–0.99; evidence rank, moderate) in patients with sepsis or septic shock (evidence rank, low). Furthermore, corticosteroids probably achieved a tiny reduction in the length of hospital stay and ICU. Corticosteroids were associated with a higher risk of hypernatremia and hyperglycemia; furthermore, they appear to have no significant effect on superinfection and gastroduodenal bleeding.ConclusionsCorticosteroids had no significant effect on the 28-day and long-term mortality; however, they decreased the ICU and hospital mortality. The findings suggest that the clinical corticosteroids may be an effective therapy for patients with sepsis during the short time.Systematic Review Registrationhttps://inplasy.com/wp-content/uploads/2021/05/INPLASY-Protocol-1074-4.pdf

scholarly journals Efficacy of Teprenone for Prevention of NSAID-Induced Gastrointestinal Injury: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chongxiang Zhao ◽  
Jingwu Wang ◽  
Qiang Xiao
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Current Evidence ◽  
Open Label ◽  
Assessment Development ◽  
Pooled Data ◽  
Gi Symptoms ◽  
Inflammatory Drugs

Background: The study aimed to conduct a systematic review and meta-analysis comparing the efficacy of teprenone with control or other drugs for reducing the incidence of gastrointestinal (GI) adverse events in patients receiving long-term non-steroidal anti-inflammatory drugs (NSAIDs).Methods: Databases of PubMed, Embase, BioMed Central, CENTRAL, and Google Scholar were searched up to November 10th, 2020 for randomized controlled trials (RCTs) comparing teprenone with control or other drugs. A random-effects model was used for the meta-analysis. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used for assessing the certainty of evidence.Results: Seven RCTs were included. Six compared teprenone with control and one with famotidine. Meta-analysis indicated a statistically significant reduced risk of GI ulcers in patients receiving teprenone as compared to control after 12 weeks/3months (RR 0.37 95% CI 0.17, 0.18 I2 = 0% p = 0.01). Pooled data of three open-label studies indicated statistically significant reduction of GI symptoms in patients on teprenone as compared to control at 6 months and 12 months, but not at 3 months. Comparing teprenone with control, our analysis indicated non-significant but a tendency of better reduction in Modified Lanza Score (MLS) with teprenone. The RCT comparing teprenone to famotidine demonstrated better reduction of MLS with famotidine. The certainty of evidence-based on GRADE was deemed to be low.Conclusion: Low-quality evidence indicates a beneficial role of teprenone in preventing GI injuries in patients receiving long-term NSAIDs. Further high-quality RCTs comparing teprenone with placebo as well as other gastroprotective drugs are needed to strengthen current evidence.

scholarly journals Does the Preemptive Use of Oral Nonsteroidal Anti-inflammatory Drugs Reduce Postoperative Pain in Surgical Removal of Third Molars? A Meta-analysis of Randomized Clinical Trials

2015 ◽  
Vol 62 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Fábio Wildson Gurgel Costa ◽  
Diego Felipe Silveira Esses ◽  
Paulo Goberlânio de Barros Silva ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Carlos Diego Lopes Sá ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Preemptive Analgesia ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory

Abstract The purpose of this study was to investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) in third-molar surgery. A PubMed literature search was conducted for articles restricted to the English language using the following terms (DeCS/MeSH) or combinations: analgesia, third molar, and preemptive. From a total of 704 articles, 6 (n = 420 subjects) were selected. All studies presented a low risk of bias (Cochrane criteria) but exhibited high heterogeneity of methods. Two studies were excluded from the meta-analysis because they did not have adequate numeric values (dichotomous data) for the calculations. Preemptive analgesia showed no significant benefit (n = 298, P = .2227, odds ratio: 2.30, 0.60–8.73) in reducing postoperative pain after removal of lower impacted third molars. However, there was a probable direct relationship between the effectiveness of NSAIDs in preemptive analgesia for removal of third molars and its selectivity for the cyclooxygenase-2 (COX-2). Preemptive analgesia did not have a significant effect in reducing postoperative pain after removal of lower impacted third molars. More homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs' selectivity for COX-2 and treatment effectiveness.

scholarly journals Clinical pharmacological particular qualities of original ibuprofen different forms in treatment of diseases manifesting by pain

2021 ◽  
Vol 23 (2) ◽  
pp. 175-180
Author(s):  
Mikhail V. Pchelintsev ◽  
Keyword(s):  
Clinical Trials ◽  
Present Article ◽  
Randomized Clinical Trials ◽  
Analgesic Efficacy ◽  
Special Consideration ◽  
Nociceptive Pain ◽  
Efficacy And Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

In the present article, the role of non-steroidal anti-inflammatory drugs in treatment of different diseases manifesting by nociceptive pain is viewed. Special consideration is given to Ibuprofen, which is very often used as a non-prescription analgesic and/or anti-pyretic agent. Using the examples of randomized clinical trials and meta-analyzes carried on their basis, a high comparative analgesic efficacy and safety of use of original ibuprofen, Nurofen®, in different pharmaceutical forms in particular in a form of rapidly absorbed tablets and in combination with paracetamol.

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