Risk for Infections During Treatment With Denosumab for Osteoporosis: A Systematic Review and Meta-analysis

Abstract Context Denosumab inhibits the receptor activator of nuclear factor κ-Β ligand, an immune system modulator. Safety endpoints including risk for infections were assessed as secondary outcomes in randomized controlled trials (RCTs) of the drug. Objective To assess the risk of serious adverse events of infections (SAEI) in denosumab-treated patients. Data Sources PubMed and Cochrane Central Register of Controlled Trials were searched up to May 27, 2019. Study Selection All RCTs of denosumab (60 mg every 6 months) versus any comparator were included. We excluded trials in cancer patients for prevention of skeletal-related events. Data Extraction Two reviewers independently applied selection criteria and extracted the data. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a fixed effect model. Sensitivity analysis was based on risk of bias. Data Synthesis Thirty-three studies (22 253 patients) were included. There was a higher incidence of SAEI during denosumab treatment versus any comparator (RR, 1.21; 95% CI, 1.04-1.40; I2 = 0%), mainly of ear, nose, and throat (RR, 2.66; 95% CI, 1.20-5.91) and gastrointestinal origin (RR, 1.43; 95% CI, 1.02-2.01). RR was similar in a sensitivity analysis based on adequate allocation concealment. The RR of any infection (RR, 1.03; 95% CI, 0.99-1.06) and infection-related mortality (RR, 0.50; 95% CI, 0.20-1.23) was comparable between groups. Conclusions A higher incidence of SAEI is demonstrated during treatment with denosumab in an osteoporosis dose. Nevertheless, the overall risk for any infection or related mortality is similar to comparator groups. These findings merit consideration before therapy initiation.

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

Journal of International Medical Research ◽

10.1177/03000605211006647 ◽

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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Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood – a meta-analysis

British Journal Of Nutrition ◽

10.1017/s0007114511003400 ◽

2011 ◽

Vol 107 (1) ◽

pp. 1-6 ◽

Cited By ~ 77

Author(s):

Katja Doege ◽

Donata Grajecki ◽

Birgit-Christiane Zyriax ◽

Elena Detinkina ◽

Christine zu Eulenburg ◽

...

Keyword(s):

Atopic Eczema ◽

Data Extraction ◽

Meta Analysis ◽

Significant Risk ◽

Controlled Trials ◽

Bacterial Strains ◽

Double Blind ◽

Double Blind Placebo ◽

Study Selection ◽

The Impact

In the present study, we sought to conduct a literature review of randomised, double-blind, placebo-controlled trials, which assessed the impact of probiotics intake during pregnancy on the development of eczema in children. A meta-analysis was conducted for comparison of the development of atopic eczema in children whose mothers took probiotics during pregnancyv.placebo. Study selection, quality appraisal and data extraction were performed independently and in duplicate. The studies were rated according to their size in order to calculate the influence of individual studies on the meta-analysis. A total of seven randomised, double-blind, placebo-controlled trials, published between 2001 and 2009, were selected from the PubMed and Ovid databases for the meta-analysis. The meta-analysis was performed with statistical software Stata/SE11.0. The completed meta-analysis of the seven studies shows a significant risk reduction for atopic eczema in children aged 2–7 years by the administration of probiotics during pregnancy (reduction 5·7 %;P = 0·022). However, this effect was only significant for lactobacilli (reduction 10·6 %;P = 0·045), but not for a mixture of various bacterial strains as probiotics (difference 3·06 %,P = 0·204). In conclusion, the meta-analysis shows that the administration of lactobacilli during pregnancy prevents atopic eczema in children aged from 2 to 7 years. However, a mixture of various bacterial strains does not affect the development of atopic eczema, independent of whether they contain lactobacilli or not.

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Interpersonal psychotherapy for perinatal women: a systematic review and meta-analysis protocol

Systematic Reviews ◽

10.1186/s13643-019-1158-6 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Katherine S. Bright ◽

Elyse M. Charrois ◽

Muhammad Kashif Mughal ◽

Abdul Wajid ◽

Deborah McNeil ◽

...

Keyword(s):

Systematic Review ◽

Full Text ◽

Data Extraction ◽

Meta Analysis ◽

Mode Of Delivery ◽

Well Being ◽

Interpersonal Psychotherapy ◽

Controlled Trials ◽

Cochrane Central Register ◽

Perinatal Women

Abstract Background Interpersonal psychotherapy (IPT) is an intervention that has established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of well-being. There is limited data regarding factors that moderate and mediate the effectiveness of IPT including the timing of the intervention or the mode of delivery of IPT intervention. The objective of this systematic review and meta-analysis is to evaluate the effectiveness, feasibility, and acceptability of IPT interventions to treat perinatal psychological distress and to summarize the evidence on predictors, mediators, and moderators of IPT. Methods We will include peer-reviewed studies that recruited perinatal women. The search strategy will involve the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO), and Scopus. Study inclusion criteria include (1) randomized controlled trials, quasi-experimental studies, and pre-post studies that evaluated the effectiveness of IPT; (2) qualitative studies that evaluated feasibility and acceptability of IPT; (3) study sample included and analyzed perinatal women; and (4) publication language was English. Using pilot-tested screening and data extraction forms, two reviewers will independently review studies in three steps: (1) abstract/title screening, (2) full-text screening of potentially accepted studies, and (3) data extraction of accepted studies. Disagreements will be resolved by a third reviewer. Studies will be aggregated for meta-synthesis and meta-analysis should the data allow for this. Two independent reviewers will grade methodological quality. Discussion Findings from this review will inform future development and implementation of IPT intervention research for perinatal women. Identifying key factors of successful IPT interventions will inform intervention design and adaptation of IPT interventions to increase the likelihood that perinatal women will engage in and benefit from IPT interventions. This review will also identify key considerations for increasing the effectiveness of IPT interventions during the perinatal period. Systematic review registration PROSPERO CRD42019114292

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Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials

Critical Care ◽

10.1186/s13054-019-2596-1 ◽

2019 ◽

Vol 23 (1) ◽

Cited By ~ 6

Author(s):

Ka Man Fong ◽

Shek Yin Au ◽

George Wing Yiu Ng

Keyword(s):

Respiratory Failure ◽

Data Extraction ◽

Meta Analysis ◽

Adult Patients ◽

Cochrane Library ◽

Controlled Trials ◽

Hypoxemic Respiratory Failure ◽

Acute Hypoxemic Respiratory Failure ◽

Study Selection ◽

Screening Study

Abstract Background Patients with acute hypoxemic respiratory failure are at risk for life-threatening complications during endotracheal intubation. Preoxygenation might help reduce the risk of hypoxemia and intubation-related complications. This network meta-analysis summarizes the efficacy and safety of preoxygenation methods in adult patients with acute hypoxemic respiratory failure. Methods We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2019 for randomized controlled trials (RCT) that studied the use of conventional oxygen therapy (COT), high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), and HFNC and NIV as preoxygenation before intubation in patients with acute hypoxemic respiratory failure. Citations’ screening, study selection, data extraction, and risk of bias assessment were independently performed by two authors. The primary outcome was the lowest SpO2 during the intubation procedure. Results We included 7 RCTs (959 patients). Patients preoxygenated with NIV had significantly less desaturation than patients treated with COT (mean difference, MD 5.53, 95% CI 2.71, 8.34) and HFNC (MD 3.58, 95% CI 0.59, 6.57). Both NIV (odds ratio, OR 0.43, 95% CI 0.21, 0.87) and HFNC (OR 0.49, 95% CI 0.28, 0.88) resulted in a lower risk of intubation-related complications than COT. There were no significant mortality differences among the use of NIV, HFNC, COT, and HFNC and NIV during preoxygenation. Conclusions In adult patients with acute hypoxemic respiratory failure, NIV is a safe and probably the most effective preoxygenation method.

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Subsegmental Pulmonary Embolism Diagnosed by Computed Tomography: Incidence and Clinical Implications. A Systematic Review and Meta-Analysis of the Management Outcome Studies.

Blood ◽

10.1182/blood.v114.22.4002.4002 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4002-4002

Author(s):

Marc Carrier ◽

Marc Righini ◽

Phil Wells ◽

Arnaud Perrier ◽

David Anderson ◽

...

Keyword(s):

Research Funding ◽

Data Extraction ◽

Meta Analysis ◽

Pulmonary Arteries ◽

Controlled Trials ◽

Advisory Committees ◽

Diagnostic Strategies ◽

Study Selection ◽

Literature Search Strategy ◽

Multiple Detectors

Abstract Abstract 4002 Poster Board III-938 Background Multiple-detectors CTPA appears to have a higher sensitivity for PE as compared to single-detector CTPA. In particular, multiple-detectors CTPA allows better visualization of segmental and subsegmental pulmonary arteries, hence the proportion of patients with suspected PE in whom isolated subsegmental thrombus are reported might be higher using multiple-detectors CTPA. The clinical significance of subsegmental PE is unknown. In the PIOPED study, PE limited to subsegmental pulmonary arteries were most prevalent among patients with low-probability ventilation/perfusion (V/Q) scans. Patients with non diagnostic (low or intermediate probability) V/Q scans can be safely managed without anticoagulation. Nonetheless, patients with isolated subsegmental PE detected on CTPA are more commonly receiving anticoagulation than not. Purpose To determine whether multiple-detectors CTPA increases the proportion of PE diagnosis limited to subsegmental arteries and to assess the safety of diagnostic strategies based on CTPA. Data Source: A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews. Study Selection Twenty four articles met all the inclusions criteria (21 prospective cohort studies; 3 randomized controlled trials). Data extraction Two reviewers independently extracted data onto standardized forms. Data Synthesis A total of 2674 patients with suspected PE were included in the analyses. Of these, 1140 and 1534 patients underwent a single and multiple-detectors CTPA respectively. Conclusion The use of multiple-detectors CTPA in diagnostic strategies for PE appears to increase the proportion of patients diagnosed with subsegmental PE with comparable outcomes in patients with negative tests. This suggests that patients with subsegmental PE appear to not require anticoagulation. Disclosures: Rodger: Biomerieux: Research Funding; Boehringer Ingelheim: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Pfizer: Research Funding; Leo Pharma: Research Funding; Bayer: Research Funding; GTC Therapeutics: Research Funding.

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Systematic Review and Meta-Analysis of Randomized Controlled Trials of Xingnaojing Treatment for Stroke

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/210851 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Weijun Peng ◽

Jingjing Yang ◽

Yang Wang ◽

Weihao Wang ◽

Jianxia Xu ◽

...

Keyword(s):

Adverse Events ◽

Randomized Controlled Trials ◽

Conventional Treatment ◽

Large Scale ◽

Data Extraction ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Study Selection ◽

Mild Impairment

Objective. Xingnaojing injection (XNJ) is a well-known traditional Chinese patent medicine (TCPM) for stroke. The aim of this study is to assess the efficacy of XNJ for stroke including ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).Methods. An extensive search was performed within using eight databases up to November 2013. Randomized controlled trials (RCTs) on XNJ for treatment of stroke were collected. Study selection, data extraction, quality assessment, and meta-analysis were conducted according to the Cochrane standards, and RevMan5.0 was used for meta-analysis.Results. This review included 13 RCTs and a total of 1,514 subjects. The overall methodological quality was poor. The meta-analysis showed that XNJ combined with conventional treatment was more effective for total efficacy, neurological deficit improvement, and reduction of TNF-αlevels compared with those of conventional treatment alone. Three trials reported adverse events, of these one trial reported mild impairment of kidney and liver function, whereas the other two studies failed to report specific adverse events.Conclusion. Despite the limitations of this review, we suggest that XNJ in combination with conventional medicines might be beneficial for the treatment of stroke. Currently there are various methodological problems in the studies. Therefore, high-quality, large-scale RCTs are urgently needed.

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Effect of Therapeutic Exercise on Pain and Disability in the Management of Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis of Randomized Trials

Physical Therapy ◽

10.2522/ptj.20120412 ◽

2013 ◽

Vol 93 (8) ◽

pp. 1026-1036 ◽

Cited By ~ 74

Author(s):

Lucia Bertozzi ◽

Ivan Gardenghi ◽

Francesca Turoni ◽

Jorge Hugo Villafañe ◽

Francesco Capra ◽

...

Keyword(s):

Neck Pain ◽

Randomized Trials ◽

Data Extraction ◽

Meta Analysis ◽

Relevant Literature ◽

Controlled Trials ◽

Cochrane Central Register ◽

Therapeutic Exercise ◽

Short Term ◽

Evidence Database

BackgroundGiven the prevalence of chronic nonspecific neck pain (CNSNP) internationally, attention has increasingly been paid in recent years to evaluating the efficacy of therapeutic exercise (TE) in the management of this condition.PurposeThe purpose of this study was to conduct a current review of randomized controlled trials concerning the effect of TE on pain and disability among people with CNSNP, perform a meta-analysis, and summarize current understanding.Data SourcesData were obtained from MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro), and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to August 2012. Reference lists of relevant literature reviews also were tracked.Study SelectionAll published randomized trials without any restriction regarding time of publication or language were considered for inclusion. Study participants had to be symptomatic adults with only CNSNP.Data ExtractionTwo reviewers independently selected the studies, conducted the quality assessment, and extracted the results. Data were pooled in a meta-analysis using a random-effects model.Data SynthesisSeven studies met the inclusion criteria. Therapeutic exercise proved to have medium and significant short-term and intermediate-term effects on pain (g=−0.53, 95% confidence interval [CI]=−0.86 to −0.20, and g=−0.45, 95% CI=−0.82 to −0.07, respectively) and medium but not significant short-term and intermediate-term effects on disability (g=−0.39, 95% CI=−0.86 to 0.07, and g=−0.46, 95% CI=−1.00 to −0.08, respectively).LimitationsOnly one study investigated the effect of TE on pain and disability at follow-up longer than 6 months after intervention.ConclusionsConsistent with other reviews, the results support the use of TE in the management of CNSNP. In particular, a significant overall effect size was found supporting TE for its effect on pain in both the short and intermediate terms.

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Effect of Taping on Spinal Pain and Disability: Systematic Review and Meta-Analysis of Randomized Trials

Physical Therapy ◽

10.2522/ptj.20130619 ◽

2015 ◽

Vol 95 (4) ◽

pp. 493-506 ◽

Cited By ~ 26

Author(s):

Carla Vanti ◽

Lucia Bertozzi ◽

Ivan Gardenghi ◽

Francesca Turoni ◽

Andrew A. Guccione ◽

...

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Myofascial Pain ◽

Data Extraction ◽

Meta Analysis ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Spinal Pain ◽

Controlled Trials ◽

Cochrane Central Register

Background Taping is a widely used therapeutic tool for the treatment of musculoskeletal disorders, nevertheless its effectiveness is still uncertain. Purpose The purpose of this study was to conduct a current review of randomized controlled trials (RCTs) concerning the effects of elastic and nonelastic taping on spinal pain and disability. Data Sources MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, ISI Web of Knowledge, and SPORTDiscus databases were searched. Study Selection All published RCTs on symptomatic adults with a diagnosis of specific or nonspecific spinal pain, myofascial pain syndrome, or whiplash-associated disorders (WAD) were considered. Data Extraction Two reviewers independently selected the studies and extracted the results. The quality of individual studies was assessed using the PEDro scale, and the evidence was assessed using GRADE criteria. Data Synthesis Eight RCTs were included. Meta-analysis of 4 RCTs on low back pain demonstrated that elastic taping does not significantly reduce pain or disability immediately posttreatment, with a standardized mean difference of −0.31 (95% confidence interval=−0.64, 0.02) and −0.23 (95% confidence interval=−0.49, 0.03), respectively. Results from single trials indicated that both elastic and nonelastic taping are not better than placebo or no treatment on spinal disability. Positive results were found only for elastic taping and only for short-term pain reduction in WAD or specific neck pain. Generally, the effect sizes were very small or not clinically relevant, and all results were supported by low-quality evidence. Limitations The paucity of studies does not permit us to draw any final conclusions. Conclusion Although different types of taping were investigated, the results of this systematic review did not show any firm support for their effectiveness.

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Effect of Premorbid Beta-Blockers on Mortality in Patients With Sepsis: A Systematic Review and Meta-Analysis

Journal of Intensive Care Medicine ◽

10.1177/08850666211052926 ◽

2021 ◽

pp. 088506662110529

Author(s):

Daisuke Hasegawa ◽

Ryota Sato ◽

Narut Prasitlumkum ◽

Kazuki Nishida

Keyword(s):

Systematic Review ◽

Beta Blockers ◽

Data Extraction ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Short Term ◽

Cross Sectional ◽

Short Term Mortality ◽

The Impact

Objective The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis. Data Sources We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813). Study Selection Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use. Data Extraction Two authors extracted the patients’ characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality. Data Synthesis Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; P = .12; I2 = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; P < .001; I2 = 0%). Conclusion Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.

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Effect of different visual presentations on the comprehension of prognostic information: a systematic review

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01612-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eman Abukmail ◽

Mina Bakhit ◽

Chris Del Mar ◽

Tammy Hoffmann

Keyword(s):

Systematic Review ◽

Survival Curve ◽

Data Extraction ◽

Meta Analysis ◽

Visual Presentation ◽

Free Text ◽

Cochrane Central Register ◽

Prognostic Information ◽

Study Selection ◽

Central Register

Abstract Background Understanding prognostic information can help patients know what may happen to their health over time and make informed decisions. However, communicating prognostic information well can be challenging. Purpose To conduct a systematic review to identify and synthesize research that has evaluated visual presentations that communicate quantitative prognostic information to patients or the public. Data sources MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and the Cochrane Central Register of Controlled Trials (CENTRAL) (from inception to December 2020), and forward and backward citation search. Study selection Two authors independently screened search results and assessed eligibility. To be eligible, studies required a quantitative design and comparison of at least one visual presentation with another presentation of quantitative prognostic information. The primary outcome was comprehension of the presented information. Secondary outcomes were preferences for or satisfaction with the presentations viewed, and behavioral intentions. Data extraction Two authors independently assessed risk of bias and extracted data. Data synthesis Eleven studies (all randomized trials) were identified. We grouped studies according to the presentation type evaluated. Bar graph versus pictograph (3 studies): no difference in comprehension between the groups. Survival vs mortality curves (2 studies): no difference in one study; higher comprehension in survival curve group in another study. Tabular format versus pictograph (4 studies): 2 studies reported similar comprehension between groups; 2 found higher comprehension in pictograph groups. Tabular versus free text (3 studies): 2 studies found no difference between groups; 1 found higher comprehension in a tabular group. Limitations Heterogeneity in the visual presentations and outcome measures, precluding meta-analysis. Conclusions No visual presentation appears to be consistently superior to communicate quantitative prognostic information.

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