Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

Abstract Background: Acromegaly is a rare, chronic and severe disease. Drug therapy including somatostatin analogues, dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not respond to surgery. The use of combination therapy with PEG and SAs has become more common over the last decade. We performed this study to accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, ClinicalTrials.gov, Scopus, Web of Science, Chinese Biomedical Literature Database and Trip database were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1 . Sensitivity analysis was conducted to explore heterogeneity. Results : Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 66% (95% CI: 52%–78%; I 2 =62.59%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L -1 ; 95% CI: −0.374 to 0.397 mmol*L -1 ; P=0.954) or glycosylated haemoglobin (ES: -0.074%; 95% CI: −0.166% to 0.315%; P=0.544) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 8% to 21%) of the patients. There was no significant difference for serious adverse events and treatment discontinuation due to adverse event between SAs monotherapy group and combination therapy group. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The therapy also decreased significantly FPI levels with a neutral effect on glucose parameters in acromegaly patients. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

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Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

10.21203/rs.2.14260/v2 ◽

2020 ◽

Author(s):

Lingyun Ma ◽

Daohuang Luo ◽

Ting Yang ◽

Songtao Wu ◽

Min Li ◽

...

Keyword(s):

Combination Therapy ◽

Liver Enzyme ◽

Combined Therapy ◽

Meta Analysis ◽

Somatostatin Analogues ◽

Biomedical Literature ◽

Cochrane Library ◽

Fasting Plasma ◽

Number Of Patients ◽

Significant Difference

Abstract Background: Acromegaly is a rare, chronic and severe disease. Drug therapy including somatostatin analogues, dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not respond to surgery. The use of combination therapy with PEG and SAs has become more common over the last decade. We performed this study to accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, ClinicalTrials.gov, Scopus, Web of Science, Chinese Biomedical Literature Database and Trip database were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1. Sensitivity analysis was conducted to explore heterogeneity. Results: Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 66% (95% CI: 52%–78%; I2=62.59%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L-1; 95% CI: −0.374 to 0.397 mmol*L-1; P=0.954) or glycosylated haemoglobin (ES: -0.074%; 95% CI: −0.166% to 0.315%; P=0.544) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 8% to 21%) of the patients. There was no significant difference for serious adverse events and treatment discontinuation due to adverse event between SAs monotherapy group and combination therapy group. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The therapy also decreased significantly FPI levels with a neutral effect on glucose parameters in acromegaly patients. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

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Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

10.21203/rs.2.14260/v1 ◽

2019 ◽

Author(s):

Lingyun Ma ◽

Daohuang Luo ◽

Ting Yang ◽

Songtao Wu ◽

Min Li ◽

...

Keyword(s):

Combination Therapy ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Plasma Insulin ◽

Combined Therapy ◽

Meta Analysis ◽

Somatostatin Analogues ◽

Glycosylated Haemoglobin ◽

Fasting Plasma ◽

Fasting Plasma Insulin

Abstract Background: Acromegaly is a rare, chronic and severe disease . Drug therapy including somatostatin analogues , dopamine receptor agonists and growth hormone receptor antagonists are commonly used to treat patients who do not responde to surgery. T he use of combination therapy with PEG and SAs has become more common over the last decade . We performed this study t o accurately evaluate the effect of combination therapy of somatostatin analogues (SAs) with pegvisomant (PEG) on acromegalic patients. Methods: PubMed, EMBASE, The Cochrane Library, and ClinicalTrials.gov were searched for relevant studies. Prospective clinical trials treating acromegaly with the co-administration of SAs and PEG were included. We performed a meta-analysis by using Stata 12.1 . Sensitivity analysis was conducted to explore heterogeneity. Results: Eight studies were included in this meta-analysis. The overall rate of serum insulin-like growth factor 1 (IGF-1) normalization was 75% (95% CI: 50%–93%; I 2 =93.60%). The combination therapy did not significantly change patients’ fasting plasma glucose (ES: 0.011 mmol*L -1 ; 95% CI: − 0.374 to 0.397 mmol*L -1 ; P=0.954) or glycosylated haemoglobin (ES: -0.106%; 95% CI: − 0.302% to 0.089%; P=0.285) while decreasing the fasting plasma insulin (ES: −21.487 pmol*L-1; 95% CI: −35.713 to -7.260 pmol*L-1; P=0.003). Elevation of liver enzyme levels was found in 14% (95% CI: 10% to 19%) of the patients. Conclusions: Combined therapy of SAs and PEG effectively normalized IGF-1 levels in most of the patients whose IGF-1 level was greater than the upper limit of normal after high dose SAs monotherapy. The combination therapy significantly decreased patients’ fasting plasma insulin. However, improved fasting plasma glucose or glycosylated haemoglobin was not found during the combination therapy. Moreover, elevated liver enzyme levels were observed in a small number of patients, which suggests a need for liver function monitoring. Trial registration We have our protocol registered in PROSPERO. (Registration number: CRD42019115549)

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The VAD Scheme versus Thalidomide plus VAD for Reduction of Vascular Endothelial Growth Factor in Multiple Myeloma: A Meta-Analysis

BioMed Research International ◽

10.1155/2018/3936706 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Gan-Lin He ◽

Duo-Rong Xu ◽

Wai-Yi Zou ◽

Sui-Zhi He ◽

Juan Li

Keyword(s):

Multiple Myeloma ◽

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Vascular Endothelial ◽

China National Knowledge Infrastructure ◽

Significant Difference ◽

Endothelial Growth Factor

The VAD (vincristine-doxorubicin-dexamethasone) regimen has been used for decades to treat multiple myeloma (MM). Based on reports that vascular endothelial growth factor- (VEGF-) mediated angiogenesis is critical for MM pathogenesis, the antiangiogenic compound thalidomide has been added to VAD (T-VAD). However, it remains unclear whether T-VAD is more efficacious than VAD for serum VEGF reduction or if the difference influences clinical outcome. Pubmed, Cochrane library, China Biomedical Literature (CBM) database, China National Knowledge Infrastructure (CNKI) database, Vip database, and Wanfang database were searched for relevant studies published up to June 2017. RevMan5.2 was used for methodological quality evaluation and data extraction. Thirteen trials (five randomized, seven nonrandomized, and one historically controlled) involving 815 cases were included. Serum VEGF was significantly higher in MM cases than non-MM controls (MD=353.01, [95%CI 187.52–518.51], P<0.01), and the overall efficacy of T-VAD was higher than that of VAD (RR=1.36, [1.21–1.53], P <0.01). Further, T-VAD reduced VEGF to a greater extent than VAD does ([MD=-49.85, [-66.28− -33.42], P<0.01). The T-VAD regimen also reduced VEGF to a greater extent in newly diagnosed MM patients than it did in recurrent patients ([MD=-120.20, [-164.60–-39.80], P<0.01). There was no significant difference in VEGF between T-VAD patients (2 courses) and nontumor controls (MD=175.94, [-26.08–377.95], P=0.09). Greater serum VEGF reduction may be responsible for the superior efficacy of T-VAD compared to VAD.

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Effects of Different Integrase Inhibitors on Body Weight in Patients with HIV/AIDS: A Network Meta-Analysis

10.21203/rs.3.rs-136545/v1 ◽

2020 ◽

Author(s):

Ruojing Bai ◽

Shiyun Lv ◽

Hao Wu ◽

Lili Dai

Keyword(s):

Body Weight ◽

Weight Gain ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Weight Changes ◽

Aids Patients ◽

First Choice ◽

Significant Difference ◽

Hiv Aids

Abstract Background: Global antiretroviral therapy has entered the era of integrase strand transfer inhibitor (INSTI). Because INSTIs have the advantages of high antiviral efficacy, rapid virus inhibition, and good tolerance, they have become the first choice in international acquired immunodeficiency syndrome (AIDS) treatment guidelines. However, they may also increase the risk of obesity. There are differences in the effects of different INSTIs on weight gain in Human immunodeficiency virus (HIV) infection / AIDS patients, but there is no evidence-based medical evidence. This study aimed to assess the effect of different INSTIs on body weight in HIV/AIDS patients.Methods: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database, and Wanfang databases were searched by computer to screen the relevant literature on INSTI treatment of HIV/AIDS patients, extract the data on weight changes in the literature, and perform network meta-analysis using Stata16.0 software.Results: Eight articles reported weight changes in HIV/AIDS patients, and weight gain was higher after treatment with dolutegravir (DTG) than with elvitegravir (EVG) in HIV/AIDS patients, and the difference was statistically significant [MD = 1.13, (0.18, 2.07)]. The network meta-analysis's consistency test results showed no overall and local inconsistency, and there was no significant difference in the results of the direct and indirect comparison (P > 0.05). The rank order of probability was DTG (79.2%) > Bictegravir (BIC) (77.9%) > Raltegravir (RAL) (33.2%) > EVG (9.7%), suggesting that DTG may be the INSTI drug that causes the most significant weight gain in HIV/AIDS patients.Conclusion: According to the literature data analysis, among the existing INSTIs, DTG may be the drug that causes the highest weight gain in HIV/AIDS patients, followed by BIC.

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Efficacy of Brucea javanica Oil Emulsion Injection Combined with the Chemotherapy for Treating Gastric Cancer: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/6350782 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Jia-Rui Wu ◽

Shu-Yu Liu ◽

Jia-Lian Zhu ◽

Dan Zhang ◽

Kai-Huan Wang

Keyword(s):

Gastric Cancer ◽

Total Effective Rate ◽

Meta Analysis ◽

Performance Status ◽

Effective Rate ◽

Biomedical Literature ◽

Cochrane Library ◽

Oil Emulsion ◽

Brucea Javanica ◽

Significant Difference

Objective. This meta-analysis sought to assess the efficacy and safety of Brucea javanica oil emulsion injection (BJOEI) combined with chemotherapy for treating gastric cancer (GC). Method. Randomized controlled trials (RCTs) regarding BJOEI to treat GC were searched in PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure Database (CNKI), the Wan-Fang Database, China Science and Technology Journal Database (VIP), and the Chinese Biomedical Literature Database (SinoMed) up to January 9, 2017. The clinical total effective rate, performance status, adverse drug reactions (ADRs), and other outcomes were analyzed with Review Manager 5.3 and Stata12.0 software. Results. 13 RCTs involving 912 patients were included in the present meta-analysis. The results demonstrated that, compared with receiving chemotherapy alone, BJOEI combined with chemotherapy was more effective in improving clinical total effective rate (RR = 1.38, 95% CI: 1.22~1.56, P<0.00001), performance status (RR = 1.63, 95% CI: 1.30~2.04, P<0.00001), and relieving ADRs such as myelosuppression, neutropenia, thrombopenia, and liver damage. Statistically significant difference was observed between the experimental group and control group. Conclusion. The pooled analysis showed that using BJOEI on the basis of the chemotherapy had a remarkable therapeutic effect for patients with GC, whereas more evidence-based medical researches were required to further support our study.

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Systematic Review and Meta-Analysis of Rituximab for Steroid-Dependent or Frequently Relapsing Nephrotic Syndrome in Children

Frontiers in Pediatrics ◽

10.3389/fped.2021.626323 ◽

2021 ◽

Vol 9 ◽

Author(s):

Xia Gao ◽

Yan Wang ◽

Zichuan Xu ◽

Huiying Deng ◽

Huabin Yang ◽

...

Keyword(s):

Systematic Review ◽

Nephrotic Syndrome ◽

Assessment Tool ◽

Meta Analysis ◽

Biomedical Literature ◽

Cochrane Library ◽

Control Group ◽

Frequently Relapsing Nephrotic Syndrome ◽

Steroid Dependent ◽

Number Of Patients

Objective: To explore the effectiveness and safety of rituximab (RTX) for steroid-dependent or frequently relapsing nephrotic syndrome via a systematic review and meta-analysis.Methods: All the literature about RTX therapy for childhood nephrotic syndrome (NS) on PubMed, Web of Science, Cochrane Library, EMBASE, and Chinese biomedical literature database published before November 1, 2019, were conducted and selected according to the preset criteria. The Cochrane bias risk assessment tool was used to evaluate the quality of the literature included. The outcome data were analyzed by RevMan 5.3 software.Results: There were six RCT studies that met the inclusion criteria with a moderate quality after evaluation. At the end of the treatment, the relapse rate of NS in the RTX group reduced significantly when compared with that in the control group [odds ratio (OR) = 0.11, 95% confidence interval (CI) (0.03, 0.43), p = 0.001]. The number of patients in the RTX group used less steroid or/and calcineurin inhibitors significantly than that in the control group [OR = 0.05, 95% CI (0.01, 0.28), p = 0.0007]. For children who were steroid-dependent, RTX treatment significantly reduced the dosage of the steroid, compared with that in control [standardized mean difference (SMD) = −1.49, 95% CI (−2.00, −0.99), p < 0.00001]. There was no significant reduction in protein excretion between the two groups [SMD = −0.33, 95% CI (−0.71, 0.04), p = 0.08]. Fewer serious adverse reactions of RTX in the six studies were reported and most adverse events were mild.Conclusion: RTX is effective and safe for children with steroid-dependent or frequently relapsing nephrotic syndrome.Systematic Review Registration: Identifier: CRD 42020150933. https://www.crd.york.ac.uk/prospero/. This review has been registered to the PROSPERO on 27 Feb 2020.

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Combined Therapy of Hypertensive Nephropathy with Breviscapine Injection and Antihypertensive Drugs: A Systematic Review and a Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/2958717 ◽

2018 ◽

Vol 2018 ◽

pp. 1-17 ◽

Cited By ~ 8

Author(s):

Lihua Wu ◽

Ming Liu ◽

Zhuyuan Fang

Keyword(s):

Clinical Efficacy ◽

Antihypertensive Drugs ◽

Combined Therapy ◽

Meta Analysis ◽

Relevant Literature ◽

Cochrane Library ◽

Lower Systolic Blood Pressure ◽

Hypertensive Nephropathy ◽

Chinese Populations ◽

Significant Difference

Objective. To evaluate the beneficial and adverse effects of breviscapine injection in combination with antihypertensive drugs for treating hypertensive nephropathy in clinical practice. Methods. We searched PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data for relevant literature. The timeframe of retrieval was set from the founding date of each database to September 28, 2018. Results. Fourteen papers were included in this study. The quality of all the studies included was determined to be low. All studies were conducted with Chinese populations. Meta-analysis showed that, compared with single-use antihypertensive drugs, using breviscapine injection in combination with antihypertensive drugs to treat hypertensive nephropathy can reduce serum creatinine (Scr) [WMD = –35.16, 95% CI(–50.01, –20.31), P ≤ 0.001], blood urea nitrogen (BUN) [WMD = –2.00, 95% CI(–3.07, –0.94), P ≤ 0.001], 24-hour urinary total protein (24 h UTP) [WMD = –0.04, 95% CI(–0.05, –0.02), P ≤ 0.001], and the beta-2-microglobulin (B2M) [WMD = –0.09, 95% CI(–0.11, –0.07), P ≤ 0.001], improve creatinine clearance rate (Ccr) [WMD = 7.84, 95% CI(5.20, 10.49), P ≤ 0.001], and increase the clinical efficacy [RR = 1.27, 95% CI(1.05, 1.53), P = 0.014], but does not lower systolic blood pressure (SBP) [WMD = –1.02, 95% CI(–2.88, 0.84), P = 0.281]. There was no significant difference in adverse events between experimental groups and control groups. Conclusion. Breviscapine injection in combination with antihypertensive drugs can improve clinical efficacy and Ccr and reduce Scr, BUN, 24 h UTP, and B2M in patients with hypertensive nephropathy. The present meta-analysis indicated that breviscapine injection can serve as a renal protective effect to patients with hypertensive nephropathy. However, the evidence of methodological quality and sample sizes is weak, and thus, further standardized research is required.

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Kuntai Capsule Combined With Letrozole on Gonadal Hormone Levels and Ovarian Function in Patients With PCOS: A Systematic Review and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.789909 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xing Tang ◽

Qinwan Huang ◽

Chengcheng Wang ◽

Da Zhang ◽

Shoujin Dong ◽

...

Keyword(s):

Ovarian Function ◽

Combined Therapy ◽

Meta Analysis ◽

Sex Hormone ◽

Biomedical Literature ◽

Cochrane Library ◽

Gonadal Hormone ◽

Control Group ◽

Hormone Levels ◽

Better Than

BackgroundThe efficacy of Kuntai capsule combined with letrozole (LE) in improving ovarian function of polycystic ovary syndrome (PCOS) has been evaluated before, but there is still a lack of evidence-based support for the regulation of sex hormone levels. In recent years, new randomized clinical trials (RCTs) have been reported on the effect of combined therapy on regulating sex hormone levels.ObjectiveWe aimed to systematically evaluate the efficacy of Kuntai capsule combined with LE in the treatment of PCOS.MethodsA search across the China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang database, PubMed, Web of Science, The Cochrane Library, and Embase was conducted on Kuntai capsule combined with LE in the treatment of PCOS. The time of the self-built database was up to April 30, 2021. RCTs of LE in the control group and LE combined with Kuntai capsule in the experimental group were selected. RevMan5.3 software was used for data analysis.ResultsA total of 17 studies were gathered, which included 1,684 patients. The meta-analysis results showed that the total effective rate of the combined group was 93.36% and that of the LE group was 78.15%. The improvement in the ovulation rate, pregnancy rate, number of mature follicles, endometrial thickness, cervical mucus score, and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL) in the combined group was consistent with the results of a previous meta-analysis and was better than that in the LE group (p < 0.05). In addition, the combination group was better than the LE group in regulating the levels of estradiol (E2) and testosterone (T) (p < 0.05). There were no adverse drug reactions in the two groups during treatment.ConclusionAs a type of pure traditional Chinese medicine preparation, Kuntai capsule combined with LE had a better effect than LE alone in the treatment of PCOS, with advantages mainly reflected in enhancing ovarian function and regulating the levels of sex hormones in vivo, among others, but the value of combined therapy still needs to be verified by more high-quality RCTs.

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The Effectiveness and Safety of Heat Sensitive Moxibustion for Anaphylactic Rhinitis: A PRISMA Compliance Systematic Review and Meta-Analysis of Randomized Clinical Trials

10.21203/rs.3.rs-129187/v1 ◽

2020 ◽

Author(s):

Jun Yang ◽

Jun Xiong ◽

Ting Yuan ◽

Xue Wang ◽

Yun Feng Yunfeng ◽

...

Keyword(s):

Total Effective Rate ◽

Meta Analysis ◽

Effective Rate ◽

Biomedical Literature ◽

Cochrane Library ◽

Control Group ◽

Inflammatory Disorder ◽

Life Questionnaire ◽

Significant Difference

Abstract BackgroundAnaphylactic rhinitis (AR) is an IgE antibody-mediated, inflammatory disorder. Heat- sensitive moxibustion (HSM) has been accepted for AR in clinically. Our study was conducted to evaluate the effectiveness and safety of HSM for AR. MethodsWe conducted a comprehensive literature review of the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Science and Technology Periodical Database (VIP) and Chinese Biomedical Literature Database (CBM) from their inception to April 2020 for RCTs that compared HSM with other active intervention for AR. The primary outcome measure was the total nasal symptom and sign score, and secondary outcomes include total effective rate, Rhinoconjunctivitis quality of life questionnaire (RQLQ) and adverse events. More than two authors independently conducted the process of data collection and analysis by Review Manager (Version 5.3). ResultsA total of 15 RCTs of 1087 participants were included in our study. The overall meta-analysis demonstrated that HSM were superior in relieving the symptoms and signs of AR in treatment (SMD = -1.46, 95%CI (-1.81, -1.10); P < 0.00001) or during the follow-up period (SMD = -2.87, 95%CI (-5.11, -0.63); P < 0.0001). The results also applied to the total effective rate (OR = 2.96, 95%CI (2.19, 4.00); P < 0.00001) and RQLQ (SMD = -7.80, 95%CI (-13.92, -1.68); P < 0.00001) in treatment. Subgroup analysis indicated that there was a significant difference between the HSM group and control group. There were two studies referred to the adverse effects. The overall level of evidence was low with low methodology quality. ConclusionThis meta-analysis suggests that the effectiveness of HSM on AR were statistically significant in treatment or during the follow-up period. However, the included studies have relatively poor quality; further high-quality trials should be conducted to confirm our finding.Systematic review registrationPROSPERO CRD42019140723

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Efficacy of magnesium sulfate as an adjuvant to rocuronium in general anaesthesia: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211027736 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110277

Author(s):

Haiyan Sun ◽

Tao Jin ◽

Xiping Wu ◽

Lei Yang ◽

Yunxia Zuo ◽

...

Keyword(s):

Magnesium Sulfate ◽

General Anaesthesia ◽

Neuromuscular Block ◽

Meta Analysis ◽

Onset Time ◽

Biomedical Literature ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Significant Difference

Objective Magnesium sulfate is considered to be an effective adjuvant to rocuronium in general anaesthesia. We conducted a meta-analysis to clarify its efficacy. Methods We searched the PubMed, Embase, Web of Science, Cochrane Library, WanFang, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases for randomized controlled trials (RCTs) of magnesium sulfate as an adjuvant to rocuronium from the start of the database establishment until May 2020. Results Eleven RCTs were analysed. The pooled meta-analysis showed that using magnesium sulfate as an adjuvant significantly shortened the onset time and prolonged the clinical duration of neuromuscular blockade by rocuronium compared with the control group without magnesium sulfate. However, there was no significant difference in recovery index of neuromuscular block between the magnesium and control groups. Furthermore, magnesium sulfate significantly increased the rates of excellent and clinically acceptable intubation conditions. Conclusion Adding magnesium sulfate to rocuronium during general anaesthesia can alter the neuromuscular parameters, including shortening the anaesthesia-onset time and prolonging the clinical duration, without significantly increasing the recovery time. Pretreatment with magnesium sulfate may also improve intubation conditions during general anaesthesia.

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