Comparative efficacy and safety of β-lactam/β-lactamase inhibitors versus cabapenems for febrile neutropenia empiric therapy: A systematic review and meta analysis

Abstract Background The efficacy and safety of β-lactam/β-lactamase inhibitors (BL/BLIs) versus carbapenems for febrile neutropenia empiric therapy are controversial. Methods PubMed, Embase, Cochrane library databases, Web of Science and Google scholar were searched up to 1 April 2020. Studies were included if they compared BL/BLIs versus carbapenem for febrile neutropenia patients undergoing chemotherapy for either solid tumours or haematological malignancies among adults and children. We pooled the treatment success rate, mortality and adverse events. Results Nine RCTs were included. There was no differences between carbapenems and BL/BLIs were observed in terms of treatment success without modification (RR 1.04, 95% CI 0.93–1.15), no differences were observed in the subgroups of BL/BLIs, adults and children. No significant differences were found in all-cause mortality (RR 1.15, 95% CI 0.64–2.06). Our study shows that gastrointestinal events are the most common adverse effects, nausea/vomiting were significantly more common with carbapenems (RR 2.83, 95% CI 1.35–5.92, P = 0.006), however, diarrhea were more common with BL/BLIs (RR 0.47, 95% CI 0.27–0.80, P = 0.006). Conclusions The efficacy and safety of BL/BLIs with carbapenems were comparable in empiric treatment of febrile neutropenia.

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Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a Bayesian network meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2019-035346 ◽

2020 ◽

Vol 10 (9) ◽

pp. e035346

Author(s):

Yuchen He ◽

Hongyi He ◽

Dong-Xing Xie ◽

Xiaoxiao Li ◽

Yilun Wang

Keyword(s):

Single Dose ◽

Pain Relief ◽

Bayesian Network ◽

Knee Arthroscopy ◽

Meta Analysis ◽

Arthroscopic Surgery ◽

Cochrane Library ◽

Efficacy And Safety ◽

Comparative Efficacy ◽

Number Of Patients

IntroductionMost of the patients who received arthroscopic knee surgery will suffer moderate to severe pain, which can delay the rehabilitation process and increase the risk of postoperative complications. Therefore, seeking a safe and effective postoperative analgesia is necessary for promoting the application of arthroscopic surgery. This protocol aims to detail a planned systematic review and meta-analysis on the comparative efficacy and safety of single-dose intra-articular injection of analgesics for pain relief after knee arthroscopy.Method and analysisPubMed, Embase, Web of Science and Cochrane Library will be searched from inception to 1 June 2020 to retrieve randomised controlled trials (RCTs) that compared the commonly used single-dose intra-articular analgesics (ie, morphine; bupivacaine (including levobupivacaine); ropivacaine and magnesium alone or in combination) with placebo or between each other for postoperative pain relief among patients who had received knee arthroscopy. The primary outcome is pain intensity at 2-hour and 24-hour postoperatively; the secondary outcomes include side effects (eg, knee effusion, nausea, vomiting and flushing), the number of patients requiring supplementary analgesia and the time to first analgesic request. The methodological quality of the included RCTs will be assessed based on the Cochrane risk of bias table. The Bayesian network meta-analysis will be conducted using WinBUGS V.1.4.3.Ethics and disseminationSince no private or confidential patient data will be contained in the reporting, approval from an ethics committee is not required. Our study raises no ethical issue, and the results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019130876.

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Comparative Efficacy and Safety of Sulodexide and Other Extended Anticoagulation Treatments for Prevention of Recurrent Venous Thromboembolism: A Bayesian Network Meta-analysis

TH Open ◽

10.1055/s-0040-1709731 ◽

2020 ◽

Vol 04 (02) ◽

pp. e80-e93 ◽

Cited By ~ 2

Author(s):

Giuseppe Pompilio ◽

Davide Integlia ◽

Joseph Raffetto ◽

Gualtiero Palareti

Keyword(s):

Venous Thromboembolism ◽

Hierarchical Models ◽

Observational Studies ◽

Therapeutic Option ◽

Meta Analysis ◽

Oral Anticoagulants ◽

Cochrane Library ◽

Efficacy And Safety ◽

Comparative Efficacy ◽

Direct Acting

Abstract Objective This network meta-analysis (NMA) assesses the clinical comparative efficacy and safety of sulodexide versus direct-acting oral anticoagulants (DOACs), vitamin K antagonist (VKA), and aspirin in patients with an unprovoked venous thromboembolism (VTE). Methods We conducted a literature search in MEDLINE, Embase, and Cochrane Library using both randomized controlled trials (RCTs) and observational studies. Reduction in recurrent deep venous thrombosis (r-DVT), pulmonary embolism (PE), major bleeding (MB), clinically relevant nonmajor bleeding (CRNMB) were the primary efficacy and safety outcomes. Other secondary end points were also included. We performed a fixed, random effects, and hierarchical models Bayesian NMA for each outcome. Results We identified 18 RCTs and seven observational studies. Random models showed sulodexide is the best treatment compared with DOACs, VKA, and aspirin at reducing the risk of CRNMB, for preventing death from any cause, and VTE/PE/myocardial infarction (MI)/stroke with 0.47, 0.81, and 0.65 probabilities, respectively. In the random model sulodexide was the best treatment for reducing the risk of MB with a 0.50 probability and hierarchical model that confirmed favorable results. Random and hierarchical models showed sulodexide and DOACs to be the best treatments for reducing PE risk. Sulodexide was more effective than aspirin for reducing r-DVT with 0.12 and less of 0.0001 probabilities, respectively. Conclusion Sulodexide is more effective for reducing MB and CRNMB, for preventing deaths from any cause, and from VTE/PE/MI/stroke, than other treatments, for both random and hierarchical models. Sulodexide showed to be more effective than aspirin in reducing the risk of r-DVT and PE. Sulodexide's reduction in bleeding while protecting from recurrent DVT risk makes this therapeutic option an important alternative for extended anticoagulation treatment.

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Efficacy of four hollow nail rhombic fixation for the treatment of patients with femoral neck fractures: A protocol of systematic review and meta-analysis

10.21203/rs.3.rs-27662/v1 ◽

2020 ◽

Author(s):

Qing-hui Ji ◽

Yu Xue ◽

Jie Miao ◽

Zhi-xin Reng ◽

Yu-fei Yuan ◽

...

Keyword(s):

Systematic Review ◽

Femoral Neck ◽

Web Of Science ◽

Meta Analysis ◽

Femoral Neck Fractures ◽

Cochrane Library ◽

Publication Date ◽

Study Quality ◽

Efficacy And Safety ◽

Randomized Controlled

Abstract Background : This study aims to assess the efficacy of four hollow nail rhombic fixation (FHNRF) for the treatment of patients with femoral neck fractures (FNF). Methods : A literature search in MEDLINE, Scopus, Web of Science, EMBASE, Cochrane Library, ProQuest, Thesis and Dissertation Catalog, Cumulative Index to Nursing and Allied Health Literature, and China National Knowledge Infrastructure will be performed from inception through February 29, 2020. This study will not apply limitations to the language and publication date. All potential randomized controlled trials (RCTs) that identify the efficacy and safety of FHNRF for the treatment of patients with FNF. Two contributors will separately examine searched records, extract essential data, and assess study quality using Cochrane risk of bias tool. Any opposition between two authors will be settled by a third contributor. We will employ RevMan 5.3 software for statistical analysis. Discussion : This study will summarize high quality RCTs to assess the efficacy and safety of FHNRF for the treatment of patients with FNF. It will help to determine whether or not FHNRF is effective and safety for the treatment of patients with FNF. Systematic review registration CRD42020168378.

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The efficacy and safety of bamlanivimab treatment against COVID-19: A meta-analysis

10.1101/2021.08.24.21262580 ◽

2021 ◽

Author(s):

Huairong Xiang ◽

Bei He ◽

Yun Li ◽

Xuan Cheng ◽

Qizhi Zhang ◽

...

Keyword(s):

Clinical Trials ◽

Observational Studies ◽

Randomized Clinical Trials ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Efficacy And Safety ◽

Positive Treatment ◽

The Cochrane Library

Background: Bamlanivimab is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in worldwide. We performed a meta-analysis to investigate the efficacy and safety of bamlanivimab treatment in patients with COVID-19. Methods: We searched articles from Web of Science, PubMed, Embase, the Cochrane Library and MedRxiv between 30 January 2020 and August 5, 2021. We selected randomized clinical trials (RCTs) and observational studies with a control group to assess the efficiency of bamlanivimab in treating patients with COVID-19. Results: Our meta-analysis retrieved 3 RCTs and 7 cohort studies including 14461 patients. Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease. The combination of bamlanivimab and etesevimab may had a greater potential for positive treatment outcome. Conclusion: Bamlanivimab has demonstrated clinical efficacy on mild or moderate ill patients with COVID-19 to prevent hospitalization, reduce severity and mortality from the disease. Combinations of two or more monoclonal antibody increase the effect. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients'population that could benefit from bamlanivimab are warranted in the future.

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Efficacy and safety of ledipasvir/sofosbuvir for hepatitis C among drug users: a systematic review and meta-analysis

Virology Journal ◽

10.1186/s12985-021-01625-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Xue Yang ◽

Yang Tang ◽

Di Xu ◽

Guang Zhang ◽

Peng Xu ◽

...

Keyword(s):

Hepatitis C ◽

Drug Users ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Limited Data ◽

Svr12 Rate ◽

Funnel Plots ◽

Direct Acting

Abstract Background and aims Limited data is available on the efficacy of direct acting anti-viral drugs on hepatitis C in drug users. The aim of this meta-analysis was to comprehensively analyze the efficacy and safety of LDV/SOF in drug users infected with the hepatitis C virus (HCV). Methods The PubMed, Cochrane library, Embase and Web of Science databases were searched for articles published till April 2021 on HCV-positive drug users who were treated with ledipasvir/sofosbuvir (LDV/SOF). The primary endpoint was pooled sustained virological response at 12 weeks (SVR12) with 95% confidence interval (95% CI). Funnel plots and Egger’s test were used to assess the publication bias. Results A total of 12 studies and 711 subjects treated with LDV/SOF-based regimen for HCV were included, and the pooled SVR12 rate was 89.8% (95% CI 85.9–92.7). The pooled SVR12 rate of genotype 1 drug users was 92.4% (95% CI 88.6–95.0). Subgroup analysis showed that pooled SVR12 rates of patients treated with LDV/SOF and LDV/SOF ± RBV were 89.2% (95% CI 83.4–93.1), 90.4% (95% CI 83.6–94.5) respectively. In addition, the SVR12 rates were 88% (95% CI 70.7–95.7) for 8 weeks, 89.9% (95% CI 81.0–94.9) for 12 weeks and 82.2% (95% CI 24.9–98.5) for 24 weeks of treatment. Conclusion LDV/SOF is a safe and relatively effective treatment for hepatitis C in drug users.

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Efficacy of ondansetron for spinal anesthesia during cesarean section: a meta-analysis of randomized trials

Journal of International Medical Research ◽

10.1177/0300060517716502 ◽

2017 ◽

Vol 46 (2) ◽

pp. 654-662 ◽

Cited By ~ 4

Author(s):

Chengmao Zhou ◽

Yu Zhu ◽

Zeqing Bao ◽

Xianxue Wang ◽

Qili Liu

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Randomized Trials ◽

Web Of Science ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

The Cochrane Library

Objective To investigate the efficacy and safety of ondansetron during cesarean section under spinal anesthesia. Methods We sought randomized controlled trials (RCTs) on ondansetron during spinal anesthesia for cesarean section in The Cochrane Library, PubMed, MEDLINE, and Web of Science from their inception to September 2016. Results Altogether, 21 RCTs were included in this study. Meta-analysis showed that the ondansetron group had a lower incidence of nausea/vomiting and bradycardia than the placebo group during cesarean section under spinal anesthesia [relative risk (RR) = 0.43, 95% confidence interval (CI) (0.36, 0.51) and RR = 0.45, 95% CI (0.26, 0.80), respectively]. There were no significant differences in the incidences of pruritus, hypotension, or shivering during cesarean section under spinal anesthesia [RR = 0.92, 95% CI (0.83, 1.02); RR = 0.72 (0.50, 1.06), 95% CI (0.50, 1.06); and RR = 0.89, 95% CI (0.71, 1.11), respectively]. Conclusion Ondansetron effectively reduces the incidences of nausea/vomiting and bradycardia under spinal anesthesia during cesarean section.

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Efficacy and Safety of Intravenous Thrombolysis in Patients with Unknown Onset Stroke: A Meta-Analysis

Behavioural Neurology ◽

10.1155/2019/5406923 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11

Author(s):

Di Luan ◽

Yuanxiang Zhang ◽

Qian Yang ◽

Zhiming Zhou ◽

Xianjun Huang ◽

...

Keyword(s):

Thrombolytic Therapy ◽

Conservative Therapy ◽

Web Of Science ◽

Meta Analysis ◽

Onset Time ◽

Intravenous Thrombolysis ◽

Cochrane Library ◽

Clinical Use ◽

Efficacy And Safety ◽

Good Outcome

Objectives. Unknown onset stroke (UOS) is usually excluded from intravenous thrombolysis concerning the unclear symptom onset time. Attempts have been done to use thrombolytic therapy in these patients. The current meta-analysis was done to examine the efficacy and safety of intravenous thrombolysis in UOS. Methods. PubMed, Web of Science, and Cochrane Library were searched for studies comparing thrombolysis with conservative therapy among UOSs. Data of good outcome (mRS, 0-2), mortality, and intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) were extracted and analyzed using the Revman 5.2 software. Results. In total, 8 studies with 1271 subjects (542 with thrombolysis and 729 with conservative therapy) were included in this meta-analysis. The data showed that patients receiving thrombolysis had a higher incidence of 90-day good outcome (P=0.0005) than conservative therapy. The comparison of discharge (P=0.89) and 90-day mortality (P=0.10) in both groups did not find any significances. The incidences of ICH (P=0.42) and sICH (P=0.06) were relatively comparable between the two therapies. Conclusions. Intravenous thrombolysis is a better choice for UOS patients for its efficacy and safety. In addition, pretreatment imaging assessment is beneficial for improving the efficacy of thrombolytic therapy. However, it needs more supporting evidences for clinical use in the future.

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Bracketless Invisible Orthosis in the Treatment of Children With Malocclusion : A Protocol of Systematic Review

10.21203/rs.3.rs-190842/v1 ◽

2021 ◽

Author(s):

Shi-chen Liu ◽

Xiao-guang Li ◽

Yu-li Xi ◽

Wei Zhao

Keyword(s):

Clinical Efficacy ◽

Web Of Science ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Assessment Development ◽

Randomized Controlled ◽

Study Quality Assessment ◽

Grade Approach

Abstract BackgroundMalocclusion is a common oral disorder. Childhood is a critical period for the development of malocclusion. This protocol will explore the clinical efficacy and safety of bracketless invisible orthosis (BIO) in the treatment of children with malocclusion.MethodsThis study will search MEDLINE, PUBMED, Cochrane Library, Web of Science, WANGFANG, VIP, CNKI, and CBM from inception to the present. We will not apply any limitations to the language and publication status. All potential randomized controlled trials (RCTs) on the efficacy of BIO for the treatment of children with malocclusion will be considered for inclusion. Two authors will independently carry out study identification, data extraction, and study quality assessment in each study. Any disagreement will be resolved through discussion with a third author. When a number of included studies are sufficient, we will conduct meta-analysis, as well as subgroup analysis and sensitivity analysis. The certainty of evidence will be appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Outcome of interest will be presented in summary of findings tables, and statistical analysis will be performed utilizing RevMan 5.4 software. DiscussionThis systematic study will summarize all available studies to investigate the clinical efficacy of BIO in treating children with malocclusion. Findings of this study will highlight efficacy and safety of BIO for the treatment of children with malocclusion for both clinical practice and future strategies. Study registrationOSF (https://osf.io/avpmx).

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Efficacy and safety of thromboprophylaxis in cancer patients: a systematic review and meta-analysis

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920907540 ◽

2020 ◽

Vol 12 ◽

pp. 175883592090754

Author(s):

Miao Liu ◽

Guiyue Wang ◽

Yuhang Li ◽

Hongliang Wang ◽

Haitao Liu ◽

...

Keyword(s):

Systematic Review ◽

Major Bleeding ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Bleeding Events ◽

Patients With Cancer ◽

Significant Difference ◽

All Cause Mortality ◽

The Cochrane Library

Background: Thrombosis is a common complication in patients with cancer. Whether thromboprophylaxis could benefit patients with cancer is unclear. The aim of this systematic review was to determine the efficacy and safety of thromboprophylaxis in patients with cancer undergoing surgery or chemotherapy. Methods: We searched the Cochrane Library, EMBASE, MEDLINE, EBSCOhost, and Web of Science for studies published before May 2018 to investigate whether thromboprophylaxis measures were more effective than a placebo in patients with cancer. Results: In total, 33 trials with 11,942 patients with cancer were identified. In patients with cancer undergoing surgery, the administration of thromboprophylaxis was associated with decreasing trends in venous thromboembolism (VTE) [relative risk (RR) 0.51, 95% confidence interval (CI) 0.32–0.81] and DVT (RR 0.53, 95% CI 0.33–0.87). In patients with cancer undergoing chemotherapy, the administration of thromboprophylaxis reduced the incidences of VTE, DVT, and pulmonary embolism compared with no thromboprophylaxis (RR 0.54, 95% CI 0.40–0.73; RR 0.47, 95% CI 0.31–0.73; RR 0.51, 95% CI 0.32–0.81, respectively). The pooled results regarding major bleeding showed no significant difference between prophylaxis and no prophylaxis in either the surgical or the chemotherapy groups (RR 2.35, 95% CI 0.74–7.52, p = 0.1482, I2 = 0%; RR 1.30, 95% CI 0.93–1.83, p = 0.1274, I2 = 0%, respectively). Conclusion: Thromboprophylaxis did not increase major bleeding events or the incidence of thrombocytopenia. All-cause mortality was not significantly different between those who received thromboprophylaxis and those who did not. This meta-analysis provides evidence that thromboprophylaxis can reduce the number of VTE and DVT events, with no apparent increase in the incidence of major bleeding in patients with cancer.

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The prognostic value of soluble Klotho in patients with haemodialysis: a systematic review and meta-analysis

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622320940176 ◽

2020 ◽

Vol 11 ◽

pp. 204062232094017

Author(s):

Qi-Feng Liu ◽

Sha-Sha Li ◽

Li-Xia Yu ◽

Jian-Hua Feng ◽

Li-Li Xue ◽

...

Keyword(s):

Clinical Outcomes ◽

Fixed Effects ◽

Web Of Science ◽

Meta Analysis ◽

Adverse Outcomes ◽

Cochrane Library ◽

Maintenance Haemodialysis ◽

Hazard Ratios ◽

Subgroup Analyses ◽

All Cause Mortality

Aim: The correlation between soluble Klotho (sKlotho) levels and clinical outcomes remains inconclusive for patients undergoing maintenance haemodialysis (MHD). We aimed to evaluate the potential predictive significance of sKlotho in this population by conducting a meta-analysis. Methods: PubMed, Embase, Web of Science and Cochrane Library were comprehensively searched for studies concerning the association between sKlotho level and clinical outcomes including cardiovascular (CV) events and all-cause mortality. The pooled hazard ratios (HR) and 95% confidence intervals (CI) were generated using either random or fixed effects models. Sensitivity and subgroup analyses were used to explore heterogeneity sources. Results: Eight prospective studies with 992 MHD participants were included and reduced sKlotho levels predicted more adverse outcomes in this meta-analysis. The pooled HRs and 95% CIs related to CV events, mortality, or composite outcomes were 1.73 (95% CI 1.08–2.76, p = 0.02), 2.34 (95% CI 1.34–2.07, p = 0.003) or 1.75 (95% CI 1.19–2.57, p = 0.005). Moderate heterogeneity was observed in the composite adverse outcomes ( I2 = 57%, p = 0.05). Age and sKlotho level were the main sources of heterogeneities in the subgroup analysis. Conclusion: Lower sKlotho levels were associated with more CV events and all-cause mortality, suggesting that sKlotho may have predictive value in CKD patients receiving haemodialysis.

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