Role of chest MRI for the diagnosis of malignant pulmonary nodules: a systematic review and a meta-analysis

AIM: To evaluate the ability of magnetic resonance imaging (MRI) of the chest to detect malignant pulmonary nodules compared to compute tomography (CT). MATERIALS AND METHODS: We searched the following databases with the final date of search on April 7th, 2021: PubMed, Google Scholar. We selected studies according to the inclusion and exclusion criteria that assessed the detection of malignant lung nodules by MRI and CT and included information about sensitivity and specificity. Method of the analysis and data grouping was chosen with regard to statistical heterogeneity of the studies included in the analysis. We used the 2 test and I2 statistic to evaluate the heterogeneity. RESULTS: We selected 168 articles for the systematic review from the PubMed and Google Scholar databases. We included 21 studies on 1,188 patients in the meta-analysis and revealed statistically significant heterogeneity (р0,00001 for 2 test; I2=99%) for sensitivity and specificity. Hence, we used a random-effect model for further analysis. As a result, values of sensitivity for detection of pulmonary nodules with MRI of 70.4%100%, specificity ― from 60.6% to 100%. CONCLUSIONS: Thus, MRI has sufficient sensitivity and specificity for detecting malignant pulmonary nodules primarily discovered with CT.

Download Full-text

Adjuvant radiotherapy following radical prostatectomy for prostate cancer: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.366 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 366-366

Author(s):

Tobias Engel Ayer Botrel ◽

Otávio Clark ◽

Francisco Flávio Horta Bretas ◽

Marcus V. Sadi ◽

Ubirajara Ferreira ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Radical Prostatectomy ◽

Adjuvant Radiotherapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Expectant Management ◽

Significant Heterogeneity ◽

Free Survival

366 Background: To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) comparing efficacy of adjuvant radiotherapy (AR) versus expectant management (EM) in men who undergo radical prostatectomy for localized prostate cancer (CaP). Methods: To perform this review and meta-analysis,several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. We included all the studies that compared AR versus EM after radical surgery for CaP. The primary endpoints analyzed were biochemical progression-free survival (bPFS), metastasis-free survival (MPFS), prostate cancer-specific survival (CSS), overall survival (OS) and side effects. The data extracted from the studies were combined by using the Hazard Ratio (HR) or Risk Ratio (RR) with their corresponding Confidence Intervals of 95% (CI95%). Results: Overall, 68 studies were identified and screened. The final analysis included 7 trials (EORTC 22911, SWOG 8794, ARO 96-02/AUO AP 09/95, RAVES, FINNISH, GETUG-AFU 17 and RADICALS-RT) comprising 4,221 patients. The bPFS was higher in patients who received AR (fixed effect: HR = 0.58, CI95% = 0.52 to 0.66; p < 0.00001) but with significant heterogeneity (Chi2 = 40.34, df = 6 (P < 0.00001); I2 = 85%). We performed a random-effect model analysis to better explore this heterogeneity: in this analysis, the result remained in favor of AR (random effect: HR = 0.64, CI95% = 0.45 to 0.90; p = 0.01). The MPFS also was higher in patients who received AR (HR = 0.77, CI95% = 0.65 to 0.91; p = 0.002). The CSS and OS were not statistically different in patients with or without adjuvant radiotherapy (HR = 0.79, CI95% = 0.47 to 1.32; p = 0.36 and HR = 0.92, CI95% = 0.77 to 1.11; p = 0.38, respectively). The incidence of adverse events (gastrointestinal and genitourinary) were higher in the AR group. Conclusions: This is the first meta-analysis including the seven available RCTs in the literature (the previous meta-analysis reviewed only three), comparing adjuvant radiotherapy versus expectant management following radical prostatectomy for CaP. Adjuvant radiotherapy statistically increased the bPFS and MPFS, but did not have an impact on the OS or CSS.

Download Full-text

Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15081775 ◽

2018 ◽

Vol 15 (8) ◽

pp. 1775 ◽

Cited By ~ 15

Author(s):

Simone Costa ◽

Carolina Martins ◽

Mânia Pinto ◽

Mara Vasconcelos ◽

Mauro Abreu

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Socioeconomic Indicators ◽

Effect Model ◽

Statistical Heterogeneity ◽

Newcastle Ottawa Scale ◽

Meta Regression ◽

Ottawa Scale

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I2, and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]).

Download Full-text

Newly Reported Studies on the Increase in Gastrointestinal Symptom Prevalence with COVID-19 Infection: A Comprehensive Systematic Review and Meta-Analysis

Diseases ◽

10.3390/diseases8040041 ◽

2020 ◽

Vol 8 (4) ◽

pp. 41

Author(s):

Hakan Akin ◽

Ramazan Kurt ◽

Fatih Tufan ◽

Ahmed Swi ◽

Resat Ozaras ◽

...

Keyword(s):

Systematic Review ◽

Abdominal Pain ◽

Respiratory Symptoms ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Significant Heterogeneity ◽

Gi Tract ◽

Chinese Studies ◽

Gi Symptoms

Background and Aim: Although constitutional and respiratory symptoms such as cough and fever are the most common symptoms in patients infected with COVID-19, gastrointestinal (GI) tract involvement has been observed by endoscopic biopsies. Multiple GI symptoms, including diarrhea, nausea or vomiting and abdominal pain, have also been reported. This review aims to present the currently available data regarding the GI symptoms of COVID-19 patients, and to compare the frequency of GI symptoms in early stage (Eastern) mostly Chinese data to the current stage (Western) non-Chinese data. Methods: We performed a systematic literature search to identify both published studies by using PubMed, Google Scholar, and CNKI (Chinese medical search engine), and yet unpublished studies through medRxiv and bioRxiv. We also reviewed the cross references of the detected articles. We conducted a Medical Subject Headings (MeSH) search up until 20 September 2020. We pooled the prevalence of symptoms of diarrhea, anorexia, nausea, vomiting, and abdominal pain by using the Freeman–Tukey’s transforming random effect model. Results: A total of 118 studies were included in the systematic review and 44 of them were included in the meta-analysis. There was a significant heterogeneity between the studies; therefore, the random effects model was used. The pooled prevalence estimate of any GI symptoms reported was found to be 0.21 (95%CI, 0.16–0.27). Anorexia was the most commonly reported GI symptom at 18% (95%CI, 0.10–0.27) followed by diarrhea at 15% (95%CI, 0.12–0.19). Diarrhea, abdominal pain, nausea/vomiting, and respiratory symptoms were more common in non-Chinese studies. The prevalence of abdominal pain was lower in the “inpatient-only” studies when compared with studies that included outpatients only and those including both inpatients and outpatients. Conclusions: In this comprehensive systematic review and meta-analysis study, we observed higher rates of diarrhea, nausea/vomiting, and abdominal pain in COVID-19 infected patients among non-Chinese studies compared to Chinese studies. We also observed a higher prevalence of GI symptoms in Chinese studies than was reported previously. Non-respiratory symptoms, including GI tract symptoms, should be more thoroughly and carefully evaluated and reported in future studies.

Download Full-text

MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.685 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 1

Author(s):

Juan Qu ◽

Jizhi Yang ◽

Ming Chen ◽

Lihong Cui ◽

Tianxi Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Sensitivity And Specificity ◽

Diagnostic Marker ◽

Meta Analysis ◽

Characteristic Curve ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic

Background: MicroRNA-21 (miR-21) is one of the oncogenic miRNAs which may be a potential diagnostic biomarker for hepatocellular carcinoma (HCC). Methods: We systematically searched Medline, Embase, the Cochrane Library, ISI Web of Knowledge, Scopus from inception to August 15, 2018, and reference lists of identified primary studies. Two independent investigators extracted patient and study characteristics. The sensitivity and specificity of microRNA-21 for HCC detection and were analyzed with a random effect model. The area under summary receiver operating characteristic curve (AUC) was used to estimate overall test performance. Results: A total of 515 HCC patients, and 338 healthy or chronic hepatitis controls from six published studies were enrolled in this meta-analysis. All articles were published in English with moderate-to-high quality. The overall pooled sensitivity and specificity were 85.2% (73.3% to 88.4%) and 79.2% (68.4% to 87.0%), respectively. The AUC area was 0.89 (95% CI: 0.85-0.91). The studies had moderate heterogeneity (I2=70.11%). None of the subgroups investigated-ethnicity, controls, sample source-could account for the heterogeneity. Conclusion: MiR-21 is a helpful biomarker for early diagnosis of HCC. Nevertheless, the results of the test must be interpreted carefully in the context of medical history, erological tests and imaging examinations for HCC surveillance. doi: https://doi.org/10.12669/pjms.35.5.685 How to cite this:Qu J, Yang J, Chen M, Cui L, Wang T, Gao W, et al. MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.685 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

Effect of anticholinergic medications on the risk of dementia: a Protocol of systematic review and meta-analysis

10.21203/rs.3.rs-271086/v1 ◽

2021 ◽

Author(s):

Elham Maraghi ◽

Ali Reza Safarpour ◽

Maryam Hajmohammadi ◽

Ali Akbar Oroojan ◽

Amal Saki Malehi ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Grey Literature ◽

Random Effect ◽

Random Effect Model ◽

Forest Plot ◽

Anticholinergic Drugs ◽

Effect Model ◽

Statistical Heterogeneity

Abstract Introduction: The most kind of dementia is Alzheimer's disease. Alzheimer’s is a type of degenerative cerebrovascular disorder which exacerbates over time. Meanwhile, anticholinergic drugs can potentially modify the risk factors. As different studies have achieved different results and the clinical findings of these interventions have not been conclusive, the objective of this research will be to evaluate the effect of anticholinergic drugs on the risk of dementia.Materials& Methods: This systematic review and meta-analysis with no language limitation between 1988.12.15 and 2020.12.15 will search WoS, EMBASE, MEDLINE/PubMed, Scopus, ProQuest electronic databases and grey literature. Our search strategy with suitability criteria evaluating the effect of anticholinergic drugs on the risk of dementia. Two authors will independently implement the selection phases, data extraction, and quality assessment. Any discrepancies between reviewers will be resolved by consensus; otherwise, the viewpoint of a third specialist person will be applied. The reviewers will evaluate the risk of bias using NOS. We will conduct a meta-analysis with Random Effect Model or Fixed Effect Model according to severity of methodological heterogeneity. The results will be presented via the forest plot for the composition of final studies’ data, to demonstrate the separated and combined frequency and their corresponding 95% CIs and summary tables and narrative summaries. Using I2 statistics and the Q-statistic test, the statistical heterogeneity will be evaluated. For evaluating the possible reporting bias, the Funnel plot will be used; also Begg's and Egger's tests will be applied for significant results of the publication bias, and the Fill & Trim method for reformed publication bias. Ethical and dissemination: The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.PROSPRO Registration: CRD42020219612

Download Full-text

Patients with psoriasis have a higher risk of dementia: A systematic review and meta-analysis

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_732_19 ◽

2021 ◽

Vol 0 ◽

pp. 1-8

Author(s):

Nipith Charoenngam ◽

Thanitsara Rittiphairoj ◽

Ben Ponvilawan ◽

Patompong Ungprasert

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Risk Ratio ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Epidemiological Studies ◽

Eligibility Criteria ◽

Inverse Variance ◽

Statistical Heterogeneity

Background: Patients with psoriasis may have a higher risk of dementia because of the higher inflammatory burden, although results from previous epidemiological studies have been inconsistent. Aims: To determine the association between psoriasis and risk of dementia by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from Medline and EMBASE databases from inception to July 2019 using a search that comprised terms for “psoriasis” and “dementia.” Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic patients and individuals without psoriasis and followed them for incident dementia. Studies were also required to report standardized incidence ratio, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of dementia between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 8,861 articles were identified. After two rounds of independent review by three investigators, we included six cohort studies that met the eligibility criteria in the meta-analysis. The risk of dementia was significantly higher among psoriatic patients than in those without psoriasis with a pooled risk ratio of 1.16 (95% CI, 1.04–1.30; I2 95%). A funnel plot was relatively symmetric and was not suggestive of the presence of publication bias. Limitations: Limited accuracy of diagnosis of psoriasis and dementia as four included studies were coding-based studies, and high statistical heterogeneity among studies. Conclusion: This systematic review and meta-analysis indicates that psoriatic patients have a significantly elevated risk of developing dementia.

Download Full-text

The Association of Metabolic Syndrome and Psoriasis: A Systematic Review and Meta-Analysis of Observational Study

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666191008170409 ◽

2020 ◽

Vol 20 (5) ◽

pp. 703-717 ◽

Cited By ~ 3

Author(s):

Saumya Choudhary ◽

Dibyabhaba Pradhan ◽

Anamika Pandey ◽

Mohd. Kamran Khan ◽

Rohit Lall ◽

...

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

Plasma Glucose ◽

Observational Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Significant Heterogeneity ◽

Statistical Heterogeneity

Background: Metabolic syndrome worsens complications in psoriasis patients by predisposing them to cardiovascular diseases. Psoriasis has been widely associated with metabolic syndrome; however, it has still not been proven owing to a limited number of studies and some of those reporting conflicting results. Objective: Psoriasis has reportedly been associated with metabolic syndrome; however, it has yet not been established beyond doubt owing to conflicting literature. The present meta-analysis of observational studies aims to evaluate the prevalence of metabolic syndrome in psoriasis patients and establish an inferring point that psoriasis patients are certainly susceptible to metabolic syndrome. The study will benefit clinicians to assess and monitor psoriasis patients for several associated comorbid conditions and in its treatment. Methods: A systematic web search for ‘Psoriasis’, ‘Metabolic Syndrome’, ‘Hypertension’, ‘Plasma Glucose’, ‘Dyslipidaemia’, ‘Waist Circumference’ was performed, collecting all original observational studies on humans up to April 30, 2018. Depending on the inclusion and exclusion criteria, articles were screened for eligibility. Due to the presence of significant heterogeneity, the Odds Ratio (OR) was calculated using a random-effect model with Der-Simonian and Laird method. The statistical heterogeneity was determined using I2 statistics. Comprehensive Meta-Analysis Software, Version 3 was used to perform all the analysis. Results: Sixty-three studies encompassing 15,939 psoriasis patients and 103,984 controls were included in this meta-analysis. Among them, 30.29 % of psoriasis patients were reported with metabolic syndrome in comparison to 21.70 % of subjects in the control group. The present study clearly indicates an increased prevalence of metabolic syndrome among psoriasis patients (OR: 2.077 [95% CI, 1.84 - 2.34]). Conclusions: The findings support the fact that psoriasis patients have a higher incidence of metabolic syndrome. Our study also recommends that psoriasis patients should be regularly monitored for metabolic syndrome complications and its associated risk factors such as hypertension, raised triglyceride, lowered HDL Cholesterol, increased fasting plasma glucose, and waist circumference.

Download Full-text

Prevalence and associated factors of cervical cancer among women in Ethiopia: A systematic review and meta-analysis

10.21203/rs.2.19627/v1 ◽

2019 ◽

Author(s):

Dereje Zena Asrat ◽

Berhanu Elfu Feleke ◽

Kebadnew Mulatu Mihretie

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Associated Factors ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Life Time ◽

Prevalence Estimate ◽

Significant Heterogeneity ◽

Pooled Prevalence

Abstract Background: cervical cancer is the second commonest disease of women in Ethiopia. Even though, some studies were conducted to assess the prevalence and associated factors of cervical cancer among women in Ethiopia, a variation in reported prevalence across the studies were observed. The aim of this study was to determine the pooled prevalence estimate and associated factors of cervical cancer among women in Ethiopia. Methodology: A systematic review and meta-analysis was performed based on published and gray literatures between 2010 and 2019. Articles were evaluated using Joanna Briggs Institute database guidelines by two independent authors. The pooled prevalence estimate was calculated using MedCalc software-version 19.0.7 and the pooled odd ratios for predictors was calculated using RevMan software version 5.3. A meta-analysis using a mantel Hansen variance random-effects model was performed to assess the amount of variation in between studies. The report was depicted descriptively using pooled estimated prevalence and odd ratios using tables and plots. Result: From 124 retrieved data, 10 full text articles were eligible for the review. The pooled prevalence estimates of cervical cancer among women in Ethiopia using random-effect model was 15.7%, 95%CI (10.8, 21.3%). Statistically significant heterogeneity between studies was detected (I 2 =94.35% (p<0.0001). Among all associated factors measured: numbers of life time sexual partners >1, OR=0.40, 95% Cl (0.21,0.27), being HIV positive, OR=0.41,95%CI(0.21,0.75), having history of STI,OR=1.99,95% CI (1.02,3.87), women getting widowed, separated or divorced), OR=0.32, 95% CI(0.14,0.75),income <1000birr, OR=1.78, 95% CI (1.19,2.65) and women had experience of contraceptive use, OR=2.32, 95% CI (1.75,3.43) were had statistical significant association with cervical cancer among women in Ethiopia Conclusion: The pooled prevalence estimate of cervical cancer among women in Ethiopia was high. There was a variation of cervical cancer reports across studies. Reporting of this information in a consistent manner is important for researchers to enhance future studies and also useful for policymakers and practitioners for better understanding of the burden of cervical cancer in Ethiopia for prevention, diagnosis, and early treatment of the disease. Trial registration: This systematic review for registration in PROSPERO was retrospectively registered on June 20,2019.

Download Full-text

Dundee Ready Educational Environment Measure Tool for Evaluating the Educational Environment: A Systematic Review and Meta-analysis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4280 ◽

2020 ◽

Vol 8 (F) ◽

pp. 108-116

Author(s):

Faraz Ahmed Farooqi ◽

Soban Qadir Khan ◽

Abdul Khabeer ◽

Saqib Ali ◽

Asim Al-Ansari

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Educational Environment ◽

Significant Heterogeneity ◽

Medical College ◽

Positive Side ◽

Group 2

OBJECTIVE: The purpose of this systematic review was to study the literature evaluating the educational environment by using DREEM tool and compute overall mean DREEM score by using Meta-analysis. Further, variation in DREEM score was also studied by distributing studies into different time periods. MATERIALS AND METHODS: A systematic literature search was performed using PubMed and Web of Science databases, followed by review and analysis. All the studies which used DREEM as a tool, published from 1997 to December 2015 were included. Heterogeneity between the studies was assessed by I2-coefficient and Q-statistics. Where significant heterogeneity existed random effect, model was used. Egger’s symmetric test and Begg’s funnel plot was used to study possibility of publication bias. The PRISMA Guideline for systematics review was used. RESULTS: Out of 128 published DREEM studies, 43 passed the criteria and included in analysis. Overall mean DREEM score through Meta-analysis was 2.426 (95% confidence interval [CI]: 2.34-2.52). Studies were divided into two groups for analyzing the time effect. Mean score of the studies published during 1997 to 2009 (group 1) was 2.5 (95% confidence interval [CI]: 2.35-2.64) and for the studies from 2010 to 2015 (group 2) was 2.39 (95% confidence interval [CI]: 2.29-2.5). CONCLUSION: Overall DREEM score was more towards positive side than negative. Current review revealed that DREEM has not been used as predictor for achievement of any medical college instead it can be used to predict high and low achievers in a medical school. This review can signify DREEM to be suitable and consistent tool showing learning environment of institute and student’s prerequisites.

Download Full-text

The Clinical Efficacy and Adverse Effects of Entecavir plus Thymosin alpha-1 Combination Therapy versus Entecavir Monotherapy in HBV-related Cirrhosis: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-17344/v1 ◽

2020 ◽

Author(s):

Dan Peng ◽

Hai-Yan Xing ◽

Chen Li ◽

Xian-Feng Wang ◽

Min Hou ◽

...

Keyword(s):

Systematic Review ◽

Combination Therapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Large Sample Size ◽

Significant Heterogeneity ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Thymosin Alpha 1

Abstract Background Previous studies have demonstrated the benefits of thymosin alpha-1 (Tα1) in anti-virus, immunological enhancement and anti-inflammation. However, it is controversial about the efficacy and safety of entecavir (ETV) plus Tα1 combination therapy versus ETV monotherapy in cirrhosis patients with hepatitis B virus (HBV) infection. Objective The systematic review and meta-analysis of randomized clincal trials (RCTs) were performed to evaluate the efficacy and safety of ETV plus Tα1 compared with ETV monotherapy in HBV-related cirrhosis. Methods A systematic search was performed via PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journals Database (VIP), and Chinese Biological Medicine database (CBM). Relative risk (RR) and standardized mean difference (SMD) with a fixed- or random- effect model were calculated. Heterogeneity were assessed with the Cochrane Q-test and I 2 values. Results Seven RCTs involving 1144 subjects were included in the systematic review and meta-analysis. Compared with ETV monotherapy, ETV plus Tα1 combination therapy led to a higher complete response (RR = 1.18; 95% CI, 1.07 - 1.30). The HBV DNA undetectable rate and HBeAg loss rate of ETV plus Tα1 therapy for 24 weeks was higher than the ETV alone (RR = 1.91; 95% CI, 1.56 - 2.35; RR = 2.05; 95% CI, 1.62 - 2.60). However, after treatment for 48 and 52 weeks, there was no significantly different between the combination therapy and ETV monotherapy (RR = 1.07; 95% CI, 0.96 - 1.18; RR = 1.17; 95% CI, 0.89 - 1.55). In comparison with ETV alone, ETV plus Tα1 improved part of biochemical parameters and liver fibrosis. There was significant heterogeneity. In addition, The ETV plus Tα1 significantly reduced adverse events compared to ETV monotherapy (RR = 0.48; 95% CI, 0.24 - 0.95). Conclusions ETV plus Tα1 combination therapy might have a higher clinical response and a lower comprehensive adverse reaction rate in HBV-related cirrhosis patients compared with ETV monotherapy. Meanwhile, the whole patients included in this meta-analysis were from chinese mainland, so that more worldwide RCTs with a large sample size are needed to verify the current findings.

Download Full-text