scholarly journals Efficacy and safety of PDE5 inhibitors in the treatment of diabetes mellitus erectile dysfunction: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Xiao Li ◽  
Qi Zhao ◽  
Jingshang Wang ◽  
Jisheng Wang ◽  
Hengheng Dai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Knowledge Network ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Pde5 Inhibitors ◽  
Data Resource

Abstract ABSTRACT Background: To systematically evaluate the efficacy and safety of the PDE5 inhibitors in patients with diabetes mellitus erectile dysfunction (DMED). Methods:Random control trials (RCTs) in PubMed, EMBASE, Cochrane library, ClinicalTrials, China Knowledge Network (CNKI), Weipu Chinese Science and Technology Journal Full-text Database (VIP), Wanfang Data Resource System (WANFANG) were searched. Two researchers independently screened the literature, extracted the data and checked the results, and used the risk assessment tool to conduct a methodological quality assessment, and finally conducted a meta-analysis. The primary outcome, the erectile function scores of the International Index of Erectile Dysfunction (IIEF-EF), was recorded, while secondary outcomes (IIEF-Q3, IIEF-Q4, SEP 2 and 3, GAQ) and safety outcomes also needed attention. Results: Twelve studies included 3,124 patients and six PDE5 inhibitors were included. Compared with placebo, PDE5 inhibitors significantly improved male erectile function in IIEF-EF (WMD = 5.73; 95% CI: 3.62 to 7.84), IIEF-Q3 (WMD = 1.14; 95% CI: 0.87 to 1.40), IIEF-Q4 (WMD=1.28; 95% CI: 1.04 to 1.51), SEP2 (WMD=21.24; 95% CI: 15.50 to 26.98), SEP3 (WMD=25.77; 95% CI: 18.78 to 32.77), GAQ (RR) =2.98; 95% CI: 2.06 to 4.32), and with the safety (WMD=5.73; 95% CI: 3.62 to 7.84). Conclusions: PDE5 inhibitors can significantly improve the patient's erectile function, but cannot ignore their side effects.

scholarly journals Clinical efficacy on glycemic control and safety of mesenchymal stem cells in patients with diabetes mellitus: Systematic review and meta-analysis of RCT data

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247662
Author(s):  
Jingjing He ◽  
Desheng Kong ◽  
Zhifen Yang ◽  
Ruiyun Guo ◽  
Asiamah Ernest Amponsah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Treatment Group ◽  
Random Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Significant Difference

Background Diabetes mellitus as a chronic metabolic disease is threatening human health seriously. Although numerous clinical trials have been registered for the treatment of diabetes with stem cells, no articles have been published to summarize the efficacy and safety of mesenchymal stem cells (MSCs) in randomized controlled trials (RCTs). Methods and findings The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to provide a reliable numerical summary and the most comprehensive assessment of therapeutic efficacy and safety with MSCs in diabetes. PubMed, Web of Science, Ovid, the Cochrane Library and CNKI were searched. The retrieval time was from establishment of these databases to January 4, 2020. Seven RCTs were eligible for analysis, including 413 participants. Meta-analysis results showed that there were no significant differences in the reduction of fasting plasma glucose (FPG) compared to the baseline [mean difference (MD) = -1.05, 95% confidence interval (CI) (-2.26,0.16), P<0.01, I2 = 94%] and the control group [MD = -0.62, 95%CI (-1.46,0.23), P<0.01, I2 = 87%]. The MSCs treatment group showed a significant decrease in hemoglobin (Hb) A1c [random-effects, MD = -1.32, 95%CI (-2.06, -0.57), P<0.01, I2 = 90%] after treatment. Additionally, HbA1c reduced more significantly in MSC treatment group than in control group [random-effects, MD = -0.87, 95%CI (-1.53, -0.22), P<0.01, I2 = 82%] at the end of follow-up. However, as for fasting C-peptide levels, the estimated pooled MD showed that there was no significant increase [MD = -0.07, 95%CI (-0.30, 0.16), P<0.01, I2 = 94%] in MSCs treatment group compared with that in control group. Notably, there was no significant difference in the incidence of adverse events between MSCs treatment group and control group [relative risk (RR) = 0.98, 95%CI (0.72, 1.32), P = 0.02, I2 = 70%]. The most commonly observed adverse reaction in the MSC treatment group was hypoglycemia (29.95%). Conclusions This meta-analysis revealed MSCs therapy may be an effective and safe intervention in subjects with diabetes. However, due to the limited studies, a number of high-quality as well as large-scale RCTs should be performed to confirm these conclusions.

scholarly journals Efficacy and safety of PDE5 inhibitors in the treatment of diabetes mellitus erectile dysfunction

Medicine ◽  
2018 ◽  
Vol 97 (40) ◽  
pp. e12559 ◽  
Author(s):  
Xiao Li ◽  
Qi Zhao ◽  
Jingshang Wang ◽  
Jisheng Wang ◽  
Hengheng Dai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Efficacy And Safety ◽  
Pde5 Inhibitors ◽  
Treatment Of Diabetes

scholarly journals Efficacy and Safety of Banxia Formulae for Insomnia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Yan-Hua Lin ◽  
Cong Chen ◽  
Xiu Zhao ◽  
Yi-Fei Mao ◽  
Guang-Xin Xiang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Effective Rate ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled ◽  
Bias Risk

Objective. To systematically evaluate the efficacy and safety of Banxia (Pinellia Tuber) formulae in the treatment of insomnia compared with those of conventional western medicines. Methods. Randomized controlled trials (RCTs) evaluating the efficacy and safety of Banxia formulae in the treatment of insomnia were searched from the following databases: PubMed, Cochrane Library, EMBASE, the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang database. The literature collected was from the time when the databases were established to April 2020. Quality assessment and meta-analysis were conducted by using Cochrane bias risk assessment tool and RevMan 5.2, respectively. Publication bias was assessed by Egger’s test. Results. Fourteen RCTs with 910 participants were identified. A total of 46 traditional Chinese medicines involving 2 different dosage forms were used in the included studies. Meta-analysis indicated that Banxia formulae had more significant effects on improving the total effective rate (RR = 1.23, 95% CI 1.16 to 1.31), Pittsburgh Sleep Quality Index (PSQI, MD = −1.05, 95% CI −1.63 to −0.47), and the TCM syndrome score (SMD = −0.78, 95% CI −1.18 to −0.39). Meanwhile, on reducing adverse events, Banxia formulae also showed an advantage (RR = 0.48, 95% CI 0.24 to 0.93). Conclusion. According to the current studies, the efficacy of Banxia formulae in the treatment of insomnia is better than that of the conventional western medicines, and its safety is relatively stable. However, due to the limitations of this study, further research and evaluation are needed.

scholarly journals Prevalence of erectile dysfunction patients with diabetes mellitus and its association with body mass index and glycated hemoglobin in Africa: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Erectile Dysfunction ◽  
Body Mass ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Vascular Complications ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
Patients With Diabetes

AbstractBackgroundMortality and morbidity in patients with diabetes mellitus (DM) is attributed to both the micro-vascular and macro-vascular complications. Variation among primary studies was seen on the prevalence of erectile dysfunction in Africa. Therefore, this study was aimed to estimate the pooled prevalence of erectile dysfunction patients with diabetes mellitus and its association with body mass index and glycated hemoglobin in Africa.MethodsPubMed, Web of Science, Cochrane library, Scopus, Psyinfo, Africa online journal and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was used to check heterogeneity of studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and Meta regression analysis were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of single study on the overall estimation. STATA version 14 statistical software was used for meta-analysis.ResultA total of 20 studies with 5,177 study participants were included to estimate the pooled prevalence. The pooled prevalence of erectile dysfunction patients with diabetes mellitus was 61.62% (95% CI: 48.35–74.9). BMI ≥ 30kg/m2 (AOR = 1.26; 95% CI: 0.73 –2.16), and glycated hemoglobin ≥ 7% (AOR = 0.93; 95% CI: 0.5–5.9), were identified factors though not statistically significant associated with erectile dysfunction.ConclusionsThe prevalence of erectile dysfunction in Africa remains high. Therefore, situation based interventions and country context specific preventive strategies could be developed to reduce the magnitude of erectile dysfunction among patients with diabetes mellitus.

scholarly journals Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Erectile Dysfunction ◽  
Body Mass ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Pooled Prevalence ◽  
Patients With Diabetes

Background. Mortality and morbidity in patients with diabetes mellitus (DM) are attributed to both microvascular and macrovascular complications. However, there is a significant amount of variation in the primary studies on DM regarding the prevalence of erectile dysfunction (ED) in Africa. Therefore, this study was aimed to estimate the pooled prevalence of ED patients with DM and its association with body mass index (BMI) and glycated hemoglobin in Africa. Methods. PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were searched for studies that looked at ED in DM patients. A funnel plot and Egger’s regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and meta-regression analyses were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for the meta-analysis. Result. A total of 13 studies with 3,501 study participants were included in this study. We estimated that the pooled prevalence of ED in patients with DM in Africa was 71.45% (95% CI: 60.22–82.69). Diabetic patients whose BMI was ≥30 kg/m2 were 1.26 times more likely to develop ED (AOR = 1.26; 95% CI: 0.73–2.16) and whose glycated hemoglobin was <7% were 7% less likely to develop ED (AOR = 0.93; 95% CI: 0.5–5.9), although they were not significantly associated with ED. Conclusions. The prevalence of ED in DM patients in Africa remains high. Therefore, situation-based interventions and country context-specific preventive strategies should be developed to reduce the prevalence of ED among patients with DM.

scholarly journals Qingre Yiqi Method along with Oral Hypoglycemic Drugs in Treating Adults with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Li Jiang ◽  
Shidong Wang ◽  
Jinxi Zhao ◽  
Weijun Huang ◽  
Jiayue Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Meta Analysis ◽  
Knowledge Network ◽  
Quality Data ◽  
Cochrane Library ◽  
Oral Hypoglycemic Drugs

Objective. To evaluate the efficacy of the Qingre Yiqi method in the treatment of type 2 diabetes mellitus (T2DM) with meta-analysis. Method. The randomized controlled trials (RCTs) of the Qingre Yiqi method in the treatment of T2DM in the PubMed, Medline, EMBase, Cochrane Library, Web of Science, Weipu Journal, China Knowledge Network (CNKI), and Wanfang database were conducted. Three reviewers independently conducted the screening, extracted the data, and assessed methodological quality. Data analysis was performed using Rev Man 5.3 software for statistical analysis. Results. A total of 15 RCTs, including 1440 patients, were included. The results showed that compared with oral hypoglycemic drugs alone, the add-on treatment of the Qingre Yiqi method could significantly improve Chinese medicine syndrome (OR (95%CI) = 3.66 [2.47,5.42], P < 0.00001 ) and lower the level of HbA1c (MD (95%CI) = −0.68 [0.91, −0.45], P < 0.00001 ), triglyceride (TG) (MD (95%CI) = −0.38 [−0.58,-0.17], P = 0.0004 ), low-density lipoprotein cholesterol (LDL-C) (MD (95%CI) = −0.25 [−0.37, −0.13], P < 0.0001 ), and total cholesterol(TC) (MD(95%CI) = −0.40[−0.67, −0.13], P = 0.003 ). In terms of fasting blood glucose (FBG) and postprandial blood sugar (PBG), subgroup analysis showed that the baseline of FBG and the number of combined oral hypoglycemic drugs of PBG were the major sources of heterogeneity. Conclusion. Compared with the standard treatment, the Qingre Yiqi method along with oral hypoglycemic drugs showed the more beneficial effects for T2DM on improving TCM syndromes and reducing the blood glucose and partial lipid parameter.

scholarly journals Comparative Efficacy and Safety of Metformin, Glyburide, and Insulin in Treating Gestational Diabetes Mellitus: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-29 ◽  
Author(s):  
Lanlan Guo ◽  
Jing Ma ◽  
Jia Tang ◽  
Dingyao Hu ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Neonatal Hypoglycemia ◽  
Gestational Age At Delivery ◽  
Nicu Admission

To compare the efficacy and safety of metformin, glyburide, and insulin in treating gestational diabetes mellitus (GDM), a meta-analysis of randomized controlled trials (RCTs) was conducted. PubMed, Embase, CINAHL, Web of Science, and Cochrane Library to November 13, 2018, were searched for RCT adjusted estimates of the efficacy and safety of metformin, glyburide, and insulin treatments in GDM patients. There were 41 studies involving 7703 GDM patients which were included in this meta-analysis; 12 primary outcomes and 24 secondary outcomes were detected and analyzed. Compared with metformin, insulin had a significant increase in the risk of preeclampsia (RR, 0.57; 95% CI, 0.45 to 0.72; P<0.001), NICU admission (RR, 0.75; 95% CI, 0.64 to 0.87; P<0.001), neonatal hypoglycemia (RR, 0.57; 95% CI, 0.49 to 0.66; P<0.001), and macrosomia (RR, 0.68; 95% CI, 0.55 to 0.86; P<0.05). To the outcomes of birth weight and gestational age at delivery, insulin had a significant increase when compared with metformin (MD, 114.48; 95% CI, 37.32 to 191.64; P<0.01; MD, 0.23; 95% CI, 0.12 to 0.34; P<0.001; respectively). Of the two groups between glyburide and metformin, metformin had lower gestational weight gain compared with glyburide (MD, 1.67; 95% CI, 0.26 to 3.07; P<0.05). Glyburide had a higher risk of neonatal hypoglycemia compared with insulin (RR, 1.76; 95% CI, 1.32 to 2.36; P<0.001). This meta-analysis found that metformin could be a safe and effective treatment for GDM. However, clinicians should pay attention on the long-term offspring outcomes of the relative data with GDM patients treated with metformin. Compared with insulin, glyburide had a higher increase of neonatal hypoglycemia. The use of glyburide in pregnancy for GDM women appears to be unclear.

scholarly journals Avanafil for the Treatment of men With Erectile Dysfunction: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2019 ◽  
Vol 13 (5) ◽  
pp. 155798831988076
Author(s):  
Jinze Li ◽  
Lei Peng ◽  
Dehong Cao ◽  
Lujia He ◽  
Yunxiang Li ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Present Evidence ◽  
Randomized Controlled ◽  
Drug Of Choice ◽  
Function Domain ◽  
Larger Sample

Previous studies have reported the clinical efficacy of avanafil for erectile dysfunction (ED), but these findings are controversial. This study aims to investigate the safety and efficacy of avanafil for ED. EMBASE, PubMed, and Cochrane Library were searched extensively to obtain eligible studies. Clinical outcomes including successful vaginal penetration (SVP), successful intercourse (SI), International Index of Erectile Function-Erectile Function domain (IIEF-EF) score and treatment adverse events (TAEs) were compared using RevMan v.5.3. Eight RCTs involving 3,709 patients were included. The analysis demonstrated that compared with placebo, the SVP (RR = 3.20, 95% CI [2.60, 3.95], p < .001), SI (RR = 2.53, 95% CI [2.19, 2.92], p < .001), change in IIEF-EF score (MD = 4.57, 95% CI [3.68, 5.46], p < .001) and TAEs (RR = 1.78, 95% CI [1.38, 2.31], p < .0001) were significantly higher in the avanafil. In addition, avanafil 200 mg were higher than avanafil 100 mg in SI (RR = 0.86, 95% CI [0.75, 0.99], p = .03) and change in IIEF-EF score (MD = −1.34, 95% CI [−1.67, −1.01], p < .001), but there were no obvious differences in SVP (RR = 0.89; 95% CI [0.74, 1.08], p = .23) and TAEs (RR = 0.97, 95% CI [0.83, 1.14], p = .74) between the two doses. The present evidence suggests that avanafil (especially 200 mg) has the potential to be the drug of choice for ED, but more strict and larger sample size RCTs are need to validate the findings.

A Meta-Analysis of the Effects and Safety of Pulmonary Surfactants Combined with Budesonide in Bronchopulmonary Dysplasia

2020 ◽  
Vol 22 (6) ◽  
Author(s):  
Bing-Bin He ◽  
Guo-Sheng Liu ◽  
Jia-Yong Zhuang ◽  
Bo-Ran Ye
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Ductus Arteriosus ◽  
Intratracheal Instillation ◽  
Knowledge Network ◽  
Cochrane Library ◽  
Pulmonary Surfactants ◽  
Increased Risk ◽  
Related Mortality

Context: The purpose of this analysis was to explore the effects and safety of Pulmonary Surfactants (PS) combined with budesonide in Bronchopulmonary Dysplasia (BPD) by a meta-analysis of Randomized Controlled Trials (RCTs). Evidence acquisition: Literature searches were performed in PubMed, the Cochrane Library, EMBASE, the China Knowledge Network, and the Wanfang database to collect data from RCTs. The primary outcomes were BPD incidence and BPD-related mortality, while the secondary outcomes were BPD-related complications. Bias was evaluated by the Cochrane risk assessment tool. The RevMan 5.3 software was used for the meta-analysis, and the Egger’s test was used for publication bias assessment. Results: A total of 720 subjects were enrolled from six RCTs, including 352 in the experimental group and 368 in the observation group. The BPD incidence (RR = 0. 42, 95% CI [0. 37, 0. 89], P < 0.001) and BPD-related mortality (RR = 0.54, 95% CI [0.38, 0.89], P < 0.05) differed significantly between the two groups. Significant differences were also found in intraventricular hemorrhage, infection/sepsis, Retinopathy of Prematurity (ROP), and Patent Ductus Arteriosus (PDA). There were no significant differences in the incidence of PDA, Neonatal Necrotizing Enterocolitis (NEC), hyperglycemia, and hypertension. Conclusions: The intratracheal instillation of pulmonary surfactants with budesonide can reduce the incidence of BPD and BPD-related mortality with no increased risk of short-term complications.

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