scholarly journals HPV vaccines for prevention of cervical pre-cancer in adolescent girls and women

2019 ◽  
Vol 1 (2) ◽  
pp. 112
Author(s):  
Jia Jian Li ◽  
Jessica Stetz
Keyword(s):  
Adverse Events ◽  
Adolescent Girls ◽  
Meta Analysis ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Significant Benefit ◽  
Hpv Vaccines ◽  
Serious Adverse Events

The evidence presented in this Cochrane meta-analysis shows the HPV vaccination confers significant benefit in preventing cervical pre-cancer. NNT of 60 for preventing one cervical pre-cancer (women 15 to 25 years old with or without HPV infection). The effect is higher for lesions associated with HPV16/18. The data also demonstrates an absence of serious adverse events. Therefore, we have assigned a color recommendation of Green (Benefit > Harm) to this vaccine.

scholarly journals Human Papilloma Virus Transmission: Knowledge and Uptake of HPV Vaccine among In-school Adolescent Girls in South-South Nigeria

2020 ◽  
pp. 25-37
Author(s):  
I. N. Ojule ◽  
I. E. Anika
Keyword(s):  
Adolescent Girls ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Virus Transmission ◽  
Hpv Infection ◽  
Cross Sectional Study ◽  
Hpv Vaccines ◽  
Cross Sectional ◽  
Multi Stage ◽  
Rivers State

Background: HPV infection is the most common STI in sexually active adolescents. It has been implicated in majority of cases of cervical cancers. HPV is preventable. Potent Vaccines are available. Objective: This study assessed what adolescents know about HPV infection and HPV vaccination, their attitude and uptake of HPV vaccine. This was also to raise awareness and obtain data that will be useful in identifying where to intervene to improve coverage. Materials and Methods: A descriptive cross-sectional study carried out in Rivers State, Nigeria. Study tool was a semi-structured, self-administered questionnaire. Multi-stage sampling method was used to recruit adolescent girls from secondary schools. Results: 445 in-school adolescent girls aged 9 to 19 years participated. Mean age was 13.4 SD = ±2.2 years. 36.6% and 36.8% had heard of HPV infection and HPV vaccine respectively. Only 3.1% of the participants knew HPV could be prevented through vaccination. 71.7% indicated willingness to obtain the vaccine. Only 3.6% self reported to have received at least one dose of the vaccine at the time of the survey. Uptake of HPV vaccine (P=0.00), willingness to be vaccinated (P=0.005) highest among adolescents that had heard of HPV vaccine and those who perceived themselves to be at risk for HPV infection (P=0.005). Insufficient health information, cost of HPV vaccines identified as key barriers to vaccines utilization. Conclusion: Notwithstanding the low level of knowledge about HPV infection and HPV vaccines willingness to be vaccinated was high. Our study shows that uptake of vaccination is low in our locality.

scholarly journals Improving the Acceptability of Human Papillomavirus Vaccines Among Men Who Have Sex With Men According to the Associated Factors: A Systematic Review and Meta-analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yang Zhao ◽  
Xiaoli Xin ◽  
Huiwen Deng ◽  
Junjie Xu ◽  
Wenjia Weng ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Sexual Behaviors ◽  
Associated Factors ◽  
Meta Analysis ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Hpv Vaccines ◽  
Related Disease ◽  
Time Restrictions ◽  
Sex With Men

Objectives: To investigate the acceptability of human papillomavirus (HPV) vaccination among men who have sex with men (MSM) and its associated factors.Methods: We searched studies written in English in PubMed, EMBASE, and Web of Science with no geographical or time restrictions. We evaluated the quality of the included literature. We calculated the pooled acceptability and performed meta-analysis of selected studies, including factors associated with the acceptability among MSM, using Review Manager (v5.3).Results: The acceptability among the 15 studies (n = 8,658) was 50% (95% CI: 0.27–0.72). The meta-analysis of seven articles (n = 4,200) indicated that having a college or higher degree (OR = 1.62, 95% CI: 1.35–1.95), disclosure of sexual orientation to healthcare professionals (HCPs; OR = 2.38, 95% CI: 1.47–3.86), vaccination with at least one dose for hepatitis A or B (OR = 2.10, 95% CI: 1.42–3.10), awareness of HPV (OR = 1.85, 95% CI: 1.21–2.83), knowledge of HPV (SMD = 0.28, 95% CI: 0.16–0.39), perceived susceptibility to HPV infection (SMD = 0.31, 95% CI: 0.11–0.50), and perceived severity of HPV-related disease (SMD = 0.40, 95% CI: 0.28–0.51) can promote acceptance of HPV vaccines. Meanwhile, people who have had unprotected anal sex or have more sex partners tend to have low acceptance of HPV vaccines.Conclusions: HPV education should be actively promoted according to the factors that influence the acceptability of HPV vaccines among the MSM population. HPV education should be especially aimed at people with low academic qualifications and people with risky sexual behaviors, and should emphasize the aspects of susceptibility to and severity of HPV-related disease. More intervention trials should be conducted to increase the credibility of the results.

scholarly journals Association between human papillomavirus vaccination and serious adverse events in South Korean adolescent girls: nationwide cohort study

BMJ ◽  
2021 ◽  
pp. m4931 ◽  
Author(s):  
Dongwon Yoon ◽  
Ji-Ho Lee ◽  
Hyesung Lee ◽  
Ju-Young Shin
Keyword(s):  
Cohort Study ◽  
Adverse Events ◽  
Incidence Rate ◽  
Adolescent Girls ◽  
Cohort Analysis ◽  
Hpv Vaccination ◽  
Secondary Analysis ◽  
Primary Analysis ◽  
Serious Adverse Events ◽  
Adjusted Rate

Abstract Objective To evaluate the association between human papillomavirus (HPV) vaccination and serious adverse events in adolescent girls in South Korea. Design Cohort study. Setting A large linked database created by linking the Korea Immunization Registry Information System and the National Health Information Database, between January 2017 and December 2019. Participants 441 399 girls aged 11-14 years who had been vaccinated in 2017: 382 020 had been vaccinated against HPV and 59 379 had not been vaccinated against HPV. Main outcome measures Outcomes were 33 serious adverse events, including endocrine, gastrointestinal, cardiovascular, musculoskeletal, haematological, dermatological, and neurological diseases. A cohort design was used for the primary analysis and a self-controlled risk interval design for the secondary analysis; both analyses used a risk period of one year after HPV vaccination for each outcome. Incidence rate and adjusted rate ratios were estimated using Poisson regression in the primary analysis, comparing the HPV vaccinated group with the HPV unvaccinated group, and adjusted relative risks were estimated using conditional logistic regression in the secondary analysis. Results Among the 33 predefined serious adverse events, no associations were found with HPV vaccination in the cohort analysis, including Hashimoto’s thyroiditis (incidence rate per 100 000 person years: 52.7 v 36.3 for the vaccinated and unvaccinated groups; adjusted rate ratio 1.24, 95% confidence interval 0.78 to 1.94) and rheumatoid arthritis (incidence rate per 100 000 person years: 168.1 v 145.4 for the vaccinated and unvaccinated groups; 0.99, 0.79 to 1.25), with the exception of an increased risk observed for migraine (incidence rate per 100 000 person years: 1235.0 v 920.9 for the vaccinated and unvaccinated groups; 1.11, 1.02 to 1.22). Secondary analysis using self-controlled risk intervals confirmed no associations between HPV vaccination and serious adverse events, including migraine (adjusted relative risk 0.67, 95% confidence interval 0.58 to 0.78). Results were robust to varying follow-up periods and for vaccine subtypes. Conclusions In this nationwide cohort study, with more than 500 000 doses of HPV vaccines, no evidence was found to support an association between HPV vaccination and serious adverse events using both cohort analysis and self-controlled risk interval analysis. Inconsistent findings for migraine should be interpreted with caution considering its pathophysiology and the population of interest.

scholarly journals Beneficial and harmful effects of antidepressants versus placebo, ‘active placebo’, or no intervention for adults with major depressive disorder: a protocol for a systematic review of published and unpublished data with meta-analyses and trial sequential analyses

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sophie Juul ◽  
Faiza Siddiqui ◽  
Marija Barbateskovic ◽  
Caroline Kamp Jørgensen ◽  
Michael Pascal Hengartner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Adverse Events ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Major Depressive ◽  
Serious Adverse Events ◽  
Harmful Effects

Abstract Background Major depressive disorder is one of the most common, burdensome, and costly psychiatric disorders worldwide. Antidepressants are frequently used to treat major depressive disorder. It has been shown repeatedly that antidepressants seem to reduce depressive symptoms with a statistically significant effect, but the clinical importance of the effect sizes seems questionable. Both beneficial and harmful effects of antidepressants have not previously been sufficiently assessed. The main objective of this review will be to evaluate the beneficial and harmful effects of antidepressants versus placebo, ‘active placebo’, or no intervention for adults with major depressive disorder. Methods/design A systematic review with meta-analysis will be reported as recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), bias will be assessed with the Cochrane Risk of Bias tool-version 2 (ROB2), our eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, Trial Sequential Analysis will be conducted to control for random errors, and the certainty of the evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. To identify relevant trials, we will search both for published and unpublished trials in major medical databases from their inception to the present. Clinical study reports will be obtained from regulatory authorities and pharmaceutical companies. Two review authors will independently screen the results of the literature searches, extract data, and perform risk of bias assessment. We will include any published or unpublished randomised clinical trial comparing one or more antidepressants with placebo, ‘active placebo’, or no intervention for adults with major depressive disorder. The following active agents will be included: agomelatine, amineptine, amitriptyline, bupropion, butriptyline, cianopramine, citalopram, clomipramine, dapoxetine, demexiptiline, desipramine, desvenlafaxine, dibenzepin, dosulepin, dothiepin, doxepin, duloxetine, escitalopram, fluoxetine, fluvoxamine, imipramine, iprindole, levomilnacipran, lofepramine, maprotiline, melitracen, metapramine, milnacipran, mirtazapine, nefazodone, nortriptyline, noxiptiline, opipramol, paroxetine, protriptyline, quinupramine, reboxetine, sertraline, trazodone, tianeptine, trimipramine, venlafaxine, vilazodone, and vortioxetine. Primary outcomes will be depressive symptoms, serious adverse events, and quality of life. Secondary outcomes will be suicide or suicide attempt, suicidal ideation, and non-serious adverse events. Discussion As antidepressants are commonly used to treat major depressive disorder in adults, a systematic review evaluating their beneficial and harmful effects is urgently needed. This review will inform best practice in treatment and clinical research of this highly prevalent and burdensome disorder. Systematic review registration PROSPERO CRD42020220279

Prevalence of human papillomavirus by geographical regions, sexual orientation and HIV status in China: a systematic review and meta-analysis

2018 ◽  
Vol 94 (6) ◽  
pp. 434-442 ◽  
Author(s):  
Xiaomeng Ma ◽  
Qian Wang ◽  
Jason J Ong ◽  
Christopher K Fairley ◽  
Shu Su ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Meta Analysis ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Central China ◽  
Hiv Positive ◽  
Heterosexual Men ◽  
Hpv Prevalence

ObjectiveHuman papillomavirus (HPV) infection causes multiple cancers in both women and men. In China, both HPV vaccination and cervical cancer screening coverages are low. We aim to investigate the temporal and geographical trends of HPV DNA prevalence in heterosexual men, women, men who have sex with men (MSM) and people living with HIV (PLHIV) in China.MethodsWe conducted a systematic review, collecting publications in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Data from January 2000 to May 2017. A total of 247 studies were selected for this meta-analysis to estimate pooled HPV prevalence, incidence of cervical cancer and risk of infection for subgroups. Meta-regression was applied to identify contributing factors to prevalence heterogeneities.ResultsThe national HPV prevalence was 15.6% (95% CI (14.4% to 16.9%)) in women with normal cervical cytology, and Central China had the highest prevalence (20.5% (15.2% to 25.8%)). HPV prevalence in heterosexual men (14.5% (11.3% to 17.7%)) was comparable with that of women (OR=1.09 (0.98 to 1.17)), but HPV prevalence in MSM (59.9% (52.2% to 67.6%)) was significantly higher than that in heterosexual men (OR=8.81 (8.01 to 9.69)). HIV-positive women (45.0% (38.4% to 51.6%)) and HIV-positive MSM (87.5% (82.3% to 90.9%)) had 4.67 (3.61 to 6.03) and 6.46 (5.20 to 8.02) times higher risk of HPV infection than their HIV negative counterparts.ConclusionHPV infection is prevalent in China, particularly in Central China, in comparison with the global level and neighbouring countries. Targeted HPV vaccination for women, MSM and PLHIV and scale-up of cervical screening for women are priorities in curbing the HPV epidemic in China.

Efficacy and Safety of PEGPH20 in Pancreatic Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Vinod Solipuram ◽  
Harish Gopalakrishna ◽  
Gayatri Naira ◽  
Akhila Mohan
Keyword(s):  
Pancreatic Cancer ◽  
Placebo Group ◽  
Febrile Neutropenia ◽  
Adverse Events ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Thromboembolic Events ◽  
Serious Adverse Events ◽  
Significant Difference

Introduction: Pancreatic cancer is an aggressive tumor that had an estimated 57,600 new cases and 47,050 deaths in 2020 in the US alone. Recent studies have targeted tumor microenvironment (TME) for better delivery of systemic chemotherapy like PEGPH20, which degrades hyaluronic acid in the extracellular matrix (ECM). A meta-analysis of these Randomized controlled trials (RCTs) to test the efficacy of PEGPH20 was performed. Methods: A systematic search was performed using PubMed, Embase, and Cochrane library without language limitations from inception to July 30, 2020. A total of 59 articles was identified, and 3 RCTs were included in the final analysis. The primary outcome was progression-free survival (PFS), and secondary outcomes were overall survival (OS), deaths from adverse events, thromboembolic events, serious adverse events (SAE), and febrile neutropenia. Results: There was no statistically significant improvement in PFS (HR= 0.94; 95%CI (0.79, 1.11)) in the PEGPH20 group when compared to the standard treatment/placebo group. There was no significant difference among OS (HR= 0.99, 95%CI (0.83, 1.17), deaths from adverse events (RR=0.97; 95%CI (0.54, 1.73)), thromboembolic events (RR= 1.49; 95%CI (0.92, 2.44)), and febrile neutropenia (RR= 0.88; 95%CI (0.45, 1.72), however, there was statistically significant increase in SAE (RR = 1.59; 95%CI (1.01, 2.52) in the PEGPH20 group compared to the placebo group. Conclusion: This meta-analysis showed that PEGPH20 did not improve the PFS or OS. Moreover, there is an increased incidence of serious adverse events with the use of PEGPH20 compared to standard therapies.

Safety and Efficacy of Fremanezumab for the Prevention of Migraine: a Meta-analysis from Random Clinical Trails

2020 ◽  
Author(s):  
Bixi Gao ◽  
Nan Sun ◽  
Yanbo Yang ◽  
Yue Sun ◽  
Mingjia Chen ◽  
...  
Keyword(s):  
Adverse Events ◽  
Neurological Diseases ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Serious Adverse Events ◽  
Safety And Efficacy ◽  
Therapeutic Drugs ◽  
Primary Endpoints ◽  
Calcitonin Gene ◽  
Clinical Trails

Abstract Background Fremanezumab (TEV-48125) is a fully humanized immunoglobulin G isotype 2a selective monoclonal antibody that potently binds to calcitonin gene-related peptide (CGRP). It is one of novel therapeutic drugs for the prevention of migraine, which is one of the most common neurological diseases worldwide. Several clinical trails have been conducted to investigate the safety and efficacy of fremanezumab, but there is no systematic review of existing literature has been performed. Hence, we performed a meta-analysis to investigate the efficacy and safety of fremanezumab for prevention of migraine. Method Pubmed (MEDLINE), Embase, and Cochrane Library were searched from January 2001 to August 2019 for randomized controlled trials (RCTs). Five RCTs with 3379 patients were finally included in our study. Result We pooled 3379 patients from 5 RCTs, the primary endpoints were mean monthly migraine and headache days, baseline to week 12. We found that fremanezumab led to a significant reduction in migraine days (P < 0.0001) and headache days (P < 0.0001) during 12 weeks compared with placebo. In addition, after using fremanezumab, the risk of at least one adverse event (P=0.001) or related to the trail regimen (P=0.0005) significantly increase compared with placebo. Conclusions Fremanezumab has good efficacy for the prevention of migraine. The administration of fremanezumab can cause some mild adverse events but not serious adverse events.

Dual– Versus Mono–Bronchodilator Therapy in Moderate to Severe COPD: A Meta-analysis

2020 ◽  
Vol 54 (12) ◽  
pp. 1232-1242
Author(s):  
Melissa Lipari ◽  
Pramodini B. Kale-Pradhan ◽  
Sheila M. Wilhelm
Keyword(s):  
Adverse Events ◽  
English Language ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Jadad Score ◽  
Serious Adverse Events ◽  
Bronchodilator Therapy ◽  
Long Acting

Background: Chronic obstructive pulmonary disease (COPD) guidelines recommend both long-acting and dual bronchodilator therapy. It is unclear if there are differences in efficacy and safety. Objective: This meta-analysis evaluates the efficacy of dual therapy with long-acting β-agonist (LABA) + long acting muscarinic antagonist (LAMA) compared with monotherapy with LAMA for COPD. Methods: We searched PubMed, CINAHL, and Web of Science databases from inception through March 2020 to identify English-language, prospective randomized controlled trials (RCTs) that compared dual therapy with monotherapy in adult patients with COPD. Risk of bias was assessed using the Jadad score. Overall analysis was performed using Review Manager 5.3. Treatment effect was determined with the random-effects model using the Mantel-Haenszel method and was reported as mean difference (MD) with 95% CI. Results: A total of 18 RCTs were included (n = 6086; median Jadad score 5/5) that compared LAMA + LABA with LAMA. There was a greater improvement in forced expiratory volume at 1 s (FEV1) with dual therapy compared with LAMA: MD = 0.08; 95% CI = [0.05, 0.11]. There was no difference in St George Respiratory Questionnaire (SGRQ) scores between groups: OR = −0.85; 95% CI = [−1.83, 0.13]. There were no differences in overall adverse events (OR = 1.00; 95% CI = 0.92, 1.09), serious adverse events (OR = 1.01; 95% CI = 0.86, 1.18), or cardiovascular events (OR = 0.88; 95% CI = 0.58, 1.34). Conclusion and Relevance: Dual therapy improves FEV1 and is as safe as LAMA. Dual therapy does not improve SGRQ scores more than LAMA.

scholarly journals Incidence of Ipilimumab-Related Serious Adverse Events in Patients with Advanced Cancer: A Meta-Analysis

2019 ◽  
Vol 10 (1) ◽  
pp. 120-130
Author(s):  
Chang-Ying Guo ◽  
Si-Cong Jiang ◽  
Yu-Kang Kuang ◽  
Hao Hu
Keyword(s):  
Adverse Events ◽  
Advanced Cancer ◽  
Meta Analysis ◽  
Serious Adverse Events
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