scholarly journals Profile and frequency of antiparkinsonian drugs adverse reactions: a systematic review and meta-analysis

2021 ◽  
Vol 13 (3) ◽  
pp. 75-81
Author(s):  
A. A. Tappakhov ◽  
T. E. Popova ◽  
A. I. Vasilev ◽  
T. G. Govorova ◽  
Yu. I. Khabarova ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Drug Reactions ◽  
Randomized Controlled ◽  
The Relationship ◽  
Ci Calculation ◽  
Antiparkinsonian Drugs

Objective: to assess the predictors and prevalence of adverse drug reactions (ADRs) associated with antiparkinsonian drugs.Materials and methods. 18 clinical studies and randomized controlled trials were included in the analysis. We combined all registered ADRs for each drug and made direct comparisons with odds ratio (OR) and 95% confidence interval (95% CI) calculation.Results and discussion. Levodopa/benserazide (LB) had the best safety profile among levodopa drugs. Levodopa/carbidopa (LC) compared with LB was associated with more frequent development of nausea (OR=2.8; 95% CI: 1.51–5.21), aggravation of parkinsonism (OR=4.44; 95% CI: 2.12–9.28) and dizziness (OR=3.32; 95% CI: 1.5–7.33; p=0.002). Piribedil had the lowest number of ADRs among dopamine receptor agonists. Dizziness was more common with pramipexole and ropinirole than with levodopa (OR=1.82; 95% CI: 1.21–2.74 and OR=1.65; 95% CI: 1.11–2.44 respectively). Increased daytime sleepiness and peripheral edema have also been associated with pramipexole. Arterial hypertension was present in 9.6% of patients prescribed with piribedil. Amantadine compared with pramipexole was associated with a higher risk of hallucinations (OR=2.27; 95% CI: 1.24–4.12) and constipation (OR=2.40; 95% CI: 1.14–5.05). Patients prescribed with selegeline had higher odds of dizziness (OR=3.40; 95% CI: 1.76–6.55) and hallucinations (OR=4.30; 95% CI: 1.83–10.09) compared to rasagiline.Conclusion. Based on the results, we propose a diagram of the relationship between ADRs and their frequency with antiparkinsonian drugs. We hope that the study will find clinical application and allow neurologists to consider the effectiveness and the expected risks of ADRs in the treatment of PD.

scholarly journals Compound Taxus chinensis Capsule Combined with Chemotherapy for Non-Small-Cell Lung Cancer: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Keshuai Li ◽  
Haibo Cheng ◽  
Weixing Shen ◽  
Elaine Lai-Han Leung ◽  
Shao Le ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Small Cell ◽  
Controlled Trials ◽  
Taxus Chinensis ◽  
Small Cell Lung ◽  
Randomized Controlled

Background. Compound Taxus chinensis capsule (CTCC), an antitumor Chinese patent medicine, has been commonly prescribed as an adjunctive agent to chemotherapy for the management of non-small-cell lung cancer (NSCLC); however, the effects of CTCC added to chemotherapy for NSCLC patients have never been comprehensively evaluated or summarized. Purpose. To assess the synergistic effects of CTCC and chemotherapy on NSCLC. Study Design. Evidence-based study, systematic review, and quantitative meta-analysis. Methods. This systematic review and meta-analysis was implemented in accordance with the PRISMA (Preferred Reported Items for Systematic Review and Meta-Analysis) guidelines. Eight databases including China National Knowledge Infrastructure, SINOMED, China Biomedical Literature Database, Wanfang Database, VIP, PubMed, Cochrane Library, and EMBASE were searched for relevant RCTs from their inception until May 24, 2021, and hand-searching was also carried out to identify additional studies. All randomized controlled trials (RCTs) that compared CTCC combined with chemotherapy versus chemotherapy alone were included in our study. The Cochrane Risk-of-Bias tool was used to determine the risk of bias and methodological quality of the included RCTs. Review Manager 5.3 software was used for comprehensive analysis. The primary outcome measure for this study was the disease control rate (DCR), and the secondary outcomes included the objective response rate (ORR), adverse reactions, and quality of life (QOL). Results. Six RCTs with a total sample size of 410 were finally included. The pooled data showed that, compared with chemotherapy alone, CTCC combined with chemotherapy significantly improved DCR (RR = 1.15, 95% CI: 1.06–1.25, P  = 0.006), ORR (RR = 1.38, 95% CI: 1.18–1.63, P  < 0.00001), and QOL (MD = 8.69, 95% CI: 7.26–10.13, P  < 0.006) and reduced the incidence of total adverse reactions (RR = 0.48, 95% CI: 0.38–0.60, P  < 0.00001). The subgroup analyses indicated that CTCC plus chemotherapy significantly improved gastrointestinal reactions ( P  = 0.004), leukopenia ( P  = 0.0009), thrombocytopenia ( P  = 0.01), rash ( P  = 0.002), and fever ( P  = 0.007). Conclusion. Based on the available evidence, compared with chemotherapy alone, CTCC used as an adjunctive agent to chemotherapy for NSCLC can improve the clinical efficacy and quality of life and decrease the likelihood of adverse reactions, suggesting that CTCC might be an effective and safe adjunctive medicine to chemotherapy for NSCLC. However, considering the relatively small sample size and the inherent imperfections of the included randomized controlled trials, more high-quality clinical trials with longer follow-up time are needed to further assess the efficacy and safety of this combined treatment regimen.

scholarly journals The preventive effect of dexmedetomidine on adverse reactions induced by uterotonics in cesarean section: a meta-analysis

2019 ◽  
Author(s):  
Lingxi Kong(Former Corresponding Author) ◽  
Xuefeng Shan ◽  
Hongmei Wang ◽  
Yingying Ren ◽  
Yang Yang ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Drug Reactions ◽  
Preventive Effect ◽  
Facial Flushing ◽  
Randomized Controlled ◽  
The Cochrane Library

Abstract Background: To evaluate the preventive effect of dexmedetomidine(DEX) on adverse reactions induced by uterotonics used in cesarean section. Methods: Randomized controlled trials(RCTs) comparing dexmedetomidine with placebo on preventing the side effects of uterotonics in cesarean section were searched in PubMed, The Cochrane Library, and CNKI. Results: Fifteen articles with 1174 patients were included in this study. Compared with placebo, DEX significantly reduced the incidence of adverse drug reactions, such as nausea, vomiting, facial flushing, chest distress, hypertension and tachycardia ([OR = 0.12, 95% CI (0.09, 0.17), P < 0.00001], [OR = 0.12, 95% CI (0.09, 0.18), P < 0.00001], [OR = 0.21, 95% CI (0.16, 0.29), P < 0.00001], [OR = 0.19,95%CI (0.12,0.30), P < 0.00001], [OR=0.09, 95%CI (0.05,0.14), P < 0.00001], [OR=0.04, 95%CI (0.02,0.07), P < 0.00001]),which were induced by uterotonics used in cesarean section. Conclusion: Dexmedetomidine can prevent adverse reactions including nausea, vomiting, facial flushing, chest distress, hypertension and tachycardia caused by uterotonics used in cesarean section.

Interventions to Reduce Alcohol Harms in Low and Middle Income Countries: a Systematic Review and Meta Analysis

2018 ◽  
Author(s):  
Joao Ricardo Nickenig Vissoci
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Randomized Controlled Trials ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Middle Income ◽  
Brief Motivational Intervention ◽  
Randomized Controlled

BackgroundHarmful alcohol use leads to a large burden of disease and disability which disportionately impacts LMICs. The World Health Organization and the Lancet have issued calls for this burden to be addressed, but issues remain, primarily due to gaps in information. While a variety of interventions have been shown to be effective at reducing alcohol use in HICs, their efficacy in LMICs have yet to be assessed. This systematic review describes the current published literature on alcohol interventions in LMICs and conducts a meta analysis of clinical trials evaluating interventions to reduce alcohol use and harms in LMICs.MethodsIn accordance with PRISMA guidelines we searched the electronic databases Pubmed, EMBASE, Scopus,Web of Science, Cochrane, and Psych Info. Articles were eligible if they evaluated an intervention targeting alcohol-related harm in LMICs. After a reference and citation analysis, we conducted a quality assessment per PRISMA protocol. A meta-analysis was performed on the 39 randomized controlled trials that evaluated an alcohol-related outcome.ResultsOf the 3,801 articles from the literature search, 87 articles from 25 LMICs fit the eligibility and inclusion criteria. Of these studies, 39 randomized controlled trials were included in the meta-analysis. Nine of these studies focused specifically on medication, while the others focused on brief motivational intervention, brain stimulation, AUDIT-based brief interventions, WHO ASSIST-based interventions, group based education, basic screening and interventions, brief psychological or counseling, dyadic relapse prevention, group counseling, CBT, motivational + PTSD based interview, and health promotion/awareness. Conclusion Issues in determining feasible options specific to LMICs arise from unstandardized interventions, unequal geographic distribution of intervention implementation, and uncertain effectiveness over time. Current research shows that brain stimulation, psychotherapy, and brief motivational interviews have the potential to be effective in LMIC settings, but further feasibility testing and efforts to standardize results are necessary to accurately assess their effectiveness.

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