Meta-analysis of the prognostic and clinical value of serum 25-hydroxyvitamin D levels in previously untreated lymphoma

2021 ◽  
Author(s):  
Yunxia Tao ◽  
Haizhu Chen ◽  
Yu Zhou ◽  
Yuankai Shi
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Central Register ◽  
Clinical Value ◽  
Low Level ◽  
Hydroxyvitamin D ◽  
Central Register ◽  
Summary Effect ◽  
25 Hydroxyvitamin D

Background: This meta-analysis explored the prognostic and clinical value of serum 25-hydroxyvitamin D, 25(OH)D, levels in previously untreated lymphoma. Materials & methods: PubMed, Web of Science, Embase and the Cochrane Central Register of Controlled Trials databases were searched for eligible studies. Summary effect estimates and 95% CIs were pooled using random-effects or fixed-effects models. Results: Twelve studies with 4139 patients were included. Low level of serum 25(OH)D was associated with inferior progression-free survival (hazard ratio [HR]: 2.06; 95% CI: 1.82–2.32) and overall survival (HR: 1.94; 95% CI: 1.71–2.19), advanced disease (odds ratio [OR]: 1.52; 95% CI: 1.09–2.13) and elevated lactate dehydrogenase (OR: 1.84; 95% CI: 1.08–3.15). Conclusions: Low level of serum 25(OH)D is a prognostic risk factor for newly diagnosed lymphoma.

scholarly journals Stereotactic Radiosurgery for Intracranial Noncavernous Sinus Benign Meningioma: International Stereotactic Radiosurgery Society Systematic Review, Meta-Analysis and Practice Guideline

Neurosurgery ◽  
2020 ◽  
Vol 87 (5) ◽  
pp. 879-890 ◽  
Author(s):  
Marcello Marchetti ◽  
Arjun Sahgal ◽  
Antonio A F De Salles ◽  
Marc Levivier ◽  
Lijun Ma ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Intracranial Meningioma ◽  
Evidence Based ◽  
Cochrane Central Register ◽  
Benign Meningioma ◽  
Central Register ◽  
Prescription Dose ◽  
Level I

Abstract BACKGROUND Stereotactic radiosurgery (SRS) for benign intracranial meningiomas is an established treatment. OBJECTIVE To summarize the literature and provide evidence-based practice guidelines on behalf of the International Stereotactic Radiosurgery Society (ISRS). METHODS Articles in English specific to SRS for benign intracranial meningioma, published from January 1964 to April 2018, were systematically reviewed. Three electronic databases, PubMed, EMBASE, and the Cochrane Central Register, were searched. RESULTS Out of the 2844 studies identified, 305 had a full text evaluation and 27 studies met the criteria to be included in this analysis. All but one were retrospective studies. The 10-yr local control (LC) rate ranged from 71% to 100%. The 10-yr progression-free-survival rate ranged from 55% to 97%. The prescription dose ranged typically between 12 and 15 Gy, delivered in a single fraction. Toxicity rate was generally low. CONCLUSION The current literature supporting SRS for benign intracranial meningioma lacks level I and II evidence. However, when summarizing the large number of level III studies, it is clear that SRS can be recommended as an effective evidence-based treatment option (recommendation level II) for grade 1 meningioma.

scholarly journals Efficacy and safety of daptomycin: systematic review and meta-analysis

2019 ◽  
Vol 6 ◽  
pp. 204993611988646
Author(s):  
María Teresa Rosanova ◽  
David Bes ◽  
Pedro Serrano-Aguilar ◽  
Norma Sberna ◽  
Estefania Herrera-Ramos ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Failure Rates ◽  
Efficacy And Safety ◽  
Fixed Effects Model ◽  
Intention To Treat ◽  
Central Register

Background: The aim of this study was to assess whether daptomycin is safer and more efficacious than comparators for the treatment of serious infection caused by gram-positive microorganisms. Methods: Electronic databases (Medline, EMBASE, the Cochrane Central Register of Controlled Trials and clinical registered trials) were searched to identify randomized controlled trials (RCTs) that assessed the efficacy and safety of daptomycin versus therapy with any other antibiotic comparator. Two reviewers independently applied selection criteria, performed a quality assessment and extracted the data. Heterogeneity was assessed, and a random-effects or fixed-effects model, when appropriate, was used for estimates of risk ratio (RR). The primary outcome assessed was the risk of clinical treatment failure among the intention-to-treat population and the presence of any treatment related adverse event (AEs). Results: A total of seven trials fulfilled the inclusion criteria. Daptomycin treatment failure rates were no different to comparator regimens (RR = 0.96; CI 95% 0.86–1.06). No significantly different treatment related AEs were identified when comparing groups (RR = 0.91; CI 95% 0.83–1.01). Conclusions: No significant differences in treatment failure rates and safety were found using daptomycin or any of the comparators treatment.

Effects of TACE and preventive antiviral therapy on HBV reactivation and subsequent hepatitis in hepatocellular carcinoma: a meta-analysis

2019 ◽  
Vol 49 (7) ◽  
pp. 646-655 ◽  
Author(s):  
Su-Su Zhang ◽  
Jin-Xia Liu ◽  
Jing Zhu ◽  
Ming-Bing Xiao ◽  
Cui-Hua Lu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Antiviral Therapy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Hbv Reactivation ◽  
Cochrane Central Register ◽  
Fixed Effects Model ◽  
Central Register ◽  
Significant Difference ◽  
The Impact

Abstract Background and aim The impact of transarterial chemoembolization (TACE) and preventive antiviral therapy on the occurrence of hepatitis B virus (HBV) reactivation and subsequent hepatitis remains controversial. This meta-analysis aimed to evaluate the effect of TACE and preventive antiviral therapy on the risk of HBV reactivation and subsequent hepatitis. Meanwhile, we explored the role of HBeAg status in HBV reactivation after TACE. Methods We performed this meta-analysis with 11 included studies to assess the effect of TACE and preventive antiviral therapy on predicting clinical outcomes in HBV-related hepatocellular carcinoma (HCC). The pooled odds ratios (OR) were calculated using a random or fixed effects model. PUBMED, MEDLINE, EMBASE and the Cochrane Central Register of Controlled were searched for the included articles (from 2000 to December 2017). Results Our results showed that TACE significantly increased the risk of HBV reactivation (OR: 3.70; 95% CI 1.45–9.42; P < 0.01) and subsequent hepatitis (OR: 4.30; 95% CI 2.28–8.13; P < 0.01) in HCC patients. There was no significant difference in HBV reactivation after TACE between HBeAg positive and negative patients (OR: 1.28; 95% CI 0.31–5.34; P = 0.73). Preventive antiviral therapy could statistically reduce the rate of HBV reactivation (OR: 0.08; 95% CI 0.02–0.32; P < 0.01) and hepatitis (OR: 0.22; 95% CI 0.06–0.80; P = 0.02) in those with TACE treatment. Conclusions The present study suggested that TACE was associated with a higher possibility of HBV reactivation and subsequent hepatitis. Preventive antiviral therapy is significantly in favor of a protective effect.

scholarly journals Hypovitaminosis D is Associated with Psoriasis: A Systematic Review and Meta- Analysis

2019 ◽  
Vol 12 (4) ◽  
pp. 103-108 ◽  
Author(s):  
Siwadon Pitukweerakul ◽  
Subhanudh Thavaraputta ◽  
Sittichoke Prachuapthunyachart ◽  
Rudruidee Karnchanasorn
Keyword(s):  
Vitamin D ◽  
Meta Analysis ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
P Value ◽  
Hydroxyvitamin D ◽  
Central Register ◽  
Study Heterogeneity ◽  
Comprehensive Search ◽  
25 Hydroxyvitamin D

Introduction Psoriasis is a chronic inflammatory and immunemediatedskin disease that affects over 7.2 million U.S. adults. Currenttreatment has improved clinical outcomes. Vitamin D is believed toaffect the proliferation and regeneration of keratinocytes; therefore,its deficiency is a possible risk factor; however, there is still no definiteevidence. The objective of this study was to synthesize existing dataon the relationship between hypovitaminosis D and psoriasis. Methods. A meta-analysis of relevant studies was conducted bydoing a comprehensive search in the MEDLINE, EMBASE, and theCochrane Central Register through July 2018 to identify relevantcohort studies and to assess serum 25-hydroxyvitamin D (25(OH)D) levels in adults with psoriasis. The primary outcome was the meandifference in serum 25(OH)D level between psoriatic patients andcontrols. Results The initial search identified 107 articles. Only ten studiesmet the criteria for full-paper review. Meta-analysis was conductedfrom ten prospective cohort studies involving 6,217 controls and 693cases. The pooled mean difference in serum 25(OH)D level betweenpsoriatic patients and controls was -6.13 ng/ml (95% CI, -10.93 to-1.32, p-value = 0.01). The between-study heterogeneity (I2) was98%, p < 0.00001. Conclusion Our meta-analysis was the first study to establish therelation between vitamin D and psoriasis. The result found a significantrelationship between low 25(OH) D levels and psoriasis, but didnot establish a causal relationship. Further studies will be requiredto establish whether vitamin D supplementation benefits patientswith psoriasis.

scholarly journals Assessment of Hydroxychloroquine and Chloroquine Safety Profiles – A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Lu Ren ◽  
Wilson Xu ◽  
James L Overton ◽  
Shandong Yu ◽  
Nipavan Chiamvimonvat ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Regression Analyses ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Central Register ◽  
Precautionary Measures ◽  
Meta Analyses

AbstractBackgroundRecently, chloroquine (CQ) and its derivative hydroxychloroquine (HCQ) have emerged as potential antiviral and immunomodulatory options for the treatment of 2019 coronavirus disease (COVID-19). To examine the safety profiles of these medications, we systematically evaluated the adverse events (AEs) of these medications from published randomized controlled trials (RCTs).MethodsWe systematically searched PubMed, MEDLINE, Cochrane, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and the ClinicalTrials.gov for all the RCTs comparing CQ or HCQ with placebo or other active agents, published before March 31, 2020. The random-effects or fixed-effects models were used to pool the risk estimates relative ratio (RR) with 95% confidence interval (CI) for the outcomes.ResultsThe literature search yielded 23 and 17 studies for CQ and HCQ, respectively, that satisfied our inclusion criteria. Of these studies, we performed meta-analysis on the ones that were placebo-controlled, which included 6 studies for CQ and 14 studies for HCQ. We did not limit our analysis to published reports involving viral treatment alone; data also included the usage of either CQ or HCQ for the treatment of other diseases. The trials for the CQ consisted of a total of 2,137 participants (n=1,077 CQ, n=1,060 placebo), while the trials for HCQ involved 1,096 participants (n=558 HCQ and n=538 placebo). The overall mild or total AEs were statistically higher comparing CQ or HCQ to placebo. The AEs were further categorized into four groups and analyses revealed that neurologic, gastrointestinal, dermatologic, and ophthalmic AEs were higher in participants taking CQ compared to placebo. Although this was not evident in HCQ treated groups, further analyses suggested that there were more AEs attributed to other organ system that were not included in the categorized meta-analyses. Additionally, meta-regression analyses revealed that total AEs was affected by dosage for the CQ group.ConclusionsTaken together, we found that participants taking either CQ or HCQ have more AEs than participants taking placebo. Precautionary measures should be taken when using these drugs to treat COVID-19.

scholarly journals Pancreatogastrostomy versus Pancreatojejunostomy: An Up-to-Date Meta-Analysis of RCTs

2017 ◽  
Vol 2017 ◽  
pp. 1-18 ◽  
Author(s):  
Konstantinos Perivoliotis ◽  
Eleni Sioka ◽  
Athina Tatsioni ◽  
Ioannis Stefanidis ◽  
Elias Zintzaras ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Large Scale ◽  
Delayed Gastric Emptying ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Cochrane Central Register ◽  
Random Effects Model ◽  
Controlled Clinical Trials ◽  
Central Register ◽  
Clinically Significant

Background. A meta-analysis was conducted in order to provide an up-to-date comparison of pancreatogastrostomy (PG) and pancreatojejunostomy (PJ), after pancreatoduodenectomy (PD), in terms of clinically significant postoperative pancreatic fistula (POPF) and other postoperative complications. Methods. This meta-analysis was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in MEDLINE and Cochrane Central Register of Controlled Clinical Trials was performed. Fixed Effects or Random Effects model was used, based on the Cochran Q test. Results. In total, 10 studies (1629 patients) were included. There was no statistical significance between PG and PJ regarding the rate of clinically significant POPF (OR: 0.70, 95%CI: 0.46–1.06). PG was associated with a higher rate of postpancreatoduodenectomy haemorrhage (PPH) (OR: 1.52, 95%CI: 1.08–2.14). There was no difference between the two techniques in terms of clinically significant PPH (OR: 1.35, 95%CI: 0.95–1.93) and clinically significant postoperative delayed gastric emptying (DGE) (OR: 0.98, 95%CI: 0.59–1.63). Discussion. There is no difference between the two anastomotic techniques regarding the rate of clinically significant POPF. Given several limitations, more large scale high quality RCTs are required.

A Bayesian network meta-analysis of systemic regimens for advanced pancreatic cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4015-4015
Author(s):  
Kelvin K. Chan ◽  
Doug Coyle ◽  
Chris Cameron ◽  
Kelly Lien ◽  
Yoo-Joung Ko
Keyword(s):  
Pancreatic Cancer ◽  
Bayesian Network ◽  
Meta Analysis ◽  
Advanced Pancreatic Cancer ◽  
Progression Free Survival ◽  
Cochrane Central Register ◽  
Free Survival ◽  
Central Register ◽  
Credible Region ◽  
Asco Meeting

4015 Background: For advanced pancreatic cancer, many regimens have been compared with gemcitabine (G) in randomized control trials (RCTs). Few have been compared with each other directly in RCTs and the relative efficacy and safety among them are unclear. Methods: A systematic review was performed through MEDLINE, EMBASE, Cochrane Central Register of Contorlled Trials and ASCO meeting abstracts up to Jan 2013 to identify RCTs that included metastatic pancreatic cancer comparing the following regimens: G, G+5-flourouracil (GF), G+capecitabine (GCap), G+S1 (GS), G+cisplatin (GCis), G+oxaliplatin (GOx), G+erlotinib (GE), G+Abraxane (GA) and FOLFIRINOX. Studies were reviewed by two authors and discrepancies were resolved by consensus or by a third author. Data including overall survival (OS), progression-free survival (PFS), response rate (RR), and side-effects were extracted. A Bayesian network meta-analysis with random effects was performed using WinBUGS to compare all regimens simultaneously. Results: Twenty-two studies involving 6,252 patients were identified, with 21 RCTs involving G, 4 with GF, 3 with GCap, 2 with GS, 6 with GCis, 3 with GOx, 1 with GE, 1 with GA and 1 with FOLFIRINOX. Median OS, PFS and RR for G arms from all trials were similar, suggesting the absence of significant clinical heterogeneity among RCTs. For OS, the results of the Bayesian network meta-analysis found that the probability that FOLFIRINOX was the best regimen was 71%, while it was 19% for GS, 7% for GA and 2% for GE respectively. The OS hazard ratio (HR) for FOLFIRINOX vs. GS was 0.82 (95% credible region (CR): 0.53-1.35), the OS HR for FOLFIRINOX vs. GA was 0.77 (95% CR: 0.51-1.23), and the OS HR for FOLFIRINOX vs. GE was 0.67 (95% CR: 0.45-1.08). Similar ranking and probabilities were observed for the best regimen for PFS. Conclusions: FOLFIRINOX appeared to be the best regimen for advanced pancreatic cancer probabilistically, with a trend towards improvement in OS and PFS when compared with GS, GA, or GE by indirect comparisons. In the absence of direct pairwise comparisons of these regimens from RCTs, network meta-analysis helps synthesize evidence and inform decision making.

scholarly journals Microvessel Density in Patients with Cutaneous Melanoma: An Up-to-Date Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Konstantinos Perivoliotis ◽  
Panagiotis Ntellas ◽  
Katerina Dadouli ◽  
Prodromos Koutoukoglou ◽  
Maria Ioannou ◽  
...  
Keyword(s):  
Overall Survival ◽  
Microvessel Density ◽  
Cutaneous Melanoma ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Disease Free Survival ◽  
Cochrane Central Register ◽  
Free Survival ◽  
Central Register

Background. We conducted a meta-analysis, in order to appraise the effect of microvessel density (MVD) on the survival of patients with cutaneous melanoma. Methods. This study was conducted according to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature search in electronic databases (MEDLINE, Web of Science, and Cochrane Central Register of Controlled Clinical Trials) was performed. Fixed Effects or Random Effects model was used, based on the Cochran Q test. Results. In total 9 studies (903 patients) were included. Pooled HR for overall survival (OS) and disease-free survival (DFS) were 2.62 (95% CI: 0.71–9.60, p=0.15) and 2.64 (95% CI: 0.82–8.47, p=0.10), respectively. Odds ratios of overall survival between high and low MVD groups, at 12 (1.45, 95% CI: 0.16–13.24), 36 (2.93, 95% CI: 0.63–13.59), and 60 (4.09, 95% CI: 0.85–19.77) months did not reach statistical significance. Significant superiority of low MVD group, in terms of DFS, at all time intervals (OR: 4.69, p<0.0001; OR: 2.18, p=0.004; OR: 7.46, p=0.01, resp.) was documented. Discussion. MVD does not affect the HR of OS and DFS. A strong correlation with DFS rates at 12, 36, and 60 months was recorded.

scholarly journals Association Between the Circulating Level of 25-Hydroxyvitamin D and Clinical Results After Cardiac Surgery: A Meta-Analysis and Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Yulin Zhang ◽  
Jiawen Li ◽  
Yu Qiu ◽  
Xue Gong ◽  
Yunru He ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Sensitivity Analyses ◽  
Cochrane Central Register ◽  
Severe Condition ◽  
Hydroxyvitamin D ◽  
Organ Systems ◽  
25 Hydroxyvitamin D

Background: Vitamin D (VitD) is an important pleiotropic hormone for organ systems. Studies have focused on the level of VitD, especially that of 25-hydroxyvitamin D (25-(OH)-VitD), in patients after cardiac surgery and the relationship between VitD deficiency and adverse outcomes, but the results have been inconsistent. We carried out a meta-analysis to evaluate differences in the 25-(OH)-VitD level before and after cardiac surgery, and evaluated the predictive value of 25-(OH)-VitD level in the clinical outcomes of patients undergoing cardiac surgery.Methods: Studies related to VitD level and cardiac surgery were searched from PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases from inception to October 2020. We applied the Newcastle–Ottawa Scale to assess the risk of a bias in individual studies. We examined the heterogeneity and publication bias and performed subgroup analyses and sensitivity analyses.Results: Fifteen studies were included in our analysis. The 25-(OH)-VitD level was significantly lower immediately after surgery [stand mean difference (SMD), 0.69; 95%CI (0.1, 1.28), P = 0.023] and 24-h after surgery [0.84; (0.47, 1.21), 0.000] compared with that before surgery. A higher prevalence of 25-(OH)-VitD deficiency was recorded 24 h after surgery [RR, 0.59; 95%CI (0.47, 0.73), P = 0.00]. Pooled results demonstrated a significant relationship between the preoperative 25-(OH)-VitD level and vasoactive-inotropic score (VIS) [SMD, −3.71; 95%CI (−6.32, −1.10); P = 0.005], and patients with 25-(OH)-VitD deficiency revealed a comparatively poor prognosis and severe condition after cardiac surgery [−0.80; (−1.41, −0.19), 0.01]. However, 25-(OH)-VitD deficiency was not associated with the duration of stay in the intensive care unit.Conclusions: Cardiac surgery would leads to deficiency of 25-(OH)-VitD. And the preoperative and postoperative levels of 25-(OH)-VitD are associated with adverse events, which is eligible to work as an indicator to demonstrate clinical outcomes.

Efficacy of PD-1/PD-L1 inhibitor-based therapies in refractory microsatellite instability (MSI)-unselected metastatic colorectal cancer (mCRC): A network meta-analysis (NMA) of randomized controlled trials (RCTs).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15048-e15048
Author(s):  
Zi-xian Wang ◽  
Yu-tong Chen ◽  
Yi-xin Zhou ◽  
Hao-xiang Wu ◽  
Zhan-Hong Chen ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Best Supportive Care ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Cochrane Central Register ◽  
Fixed Effects Model ◽  
Hazard Ratios ◽  
Central Register ◽  
Treatment Comparisons

e15048 Background: PD-1/PD-L1 inhibitor-based monotherapies and combination therapies are being investigated to challenge microsatellite stable (MSS) mCRC. This NMA aimed to assess the efficacy of anti-PD-1/PD-L1-based therapies against active comparators (regorafenib, trifiuridine+tipiracil, and fruquintinib [R/T/F]) and negative controls (placebo and best supportive care [P/BSC]) in patients with refractory MSI-unselected mCRC, which are predominantly MSS. Methods: We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and major oncology websites for relevant RCTs comparing the above therapies with each other up to Feb 15, 2019. We used the frequentist NMA to evaluate hazard ratios (HRs) for pairwise treatment comparisons in terms of overall survival (OS). Results: Seven RCTs were included, totaling nine comparisons between five therapies (durvalumab+tremelimumab [anti-PD-L1+Tre] vs. P/BSC [n = 1], atezolizumab+cobimetinib [anti-PD-L1+Cobi] vs. R/T/F [n = 1], atezolizumab [anti-PD-L1-only] vs. R/T/F [n = 1], anti-PD-L1+Cobi vs. anti-PD-L1-only [n = 1], and R/T/F vs. P/BSC [n = 5]). No significant heterogeneity was detected in the NMA (P = 0.340 in Q test; I2= 11.6%). Compared to P/BSC, OS was significantly improved with anti-PD-L1+Tre (fixed-effects model HR, 0.72 [95% confidence interval, 0.54-0.96]; P = 0.014) and anti-PD-L1+Cobi (HR, 0.70 [0.50-0.98]; P = 0.018), but not with anti-PD-L1-only (HR, 0.83 [0.57-1.21]; P = 0.172). OS with anti-PD-L1+Tre and anti-PD-L1+Cobi did not significantly differ from that with R/T/F (P = 0.565 and P = 0.500, respectively). Conclusions: In refractory MSI-unselected mCRC, anti-PD-L1 monotherapy was ineffective but anti-PD-L1+Tre and anti-PD-L1+Cobi therapies exhibited efficacies comparable to that of R/T/F.

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