scholarly journals A Systemic Review of Dupilumab Efficacy and Safety by Phenotypic Variations of Atopic Dermatitis

2021 ◽  
Vol 7 (1) ◽  
pp. 1-5
Author(s):  
Piyu Parth Naik ◽  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Atopic Dermatitis ◽  
Safety Profile ◽  
Signs And Symptoms ◽  
Systemic Review ◽  
Efficacy And Safety ◽  
Current Systematic Review ◽  
Phenotypic Variations ◽  
Chronic Pruritus

Background: The Atopic Dermatitis (AD) is a chronic, pruritus- inflammatory TH2dominant skin disorder characterized by a reaction with complex immunopathogenesis. Dupilumab’s effectiveness and safety profile by phenotypic variations of atopic dermatitis the treatment of atopic dermatitis has been investigated in a variety of large clinical trials in atopic dermatitis for more than 10 years. The goal of the current systematic review was to determine the effectiveness and protection of dupilumab through phenotypic differences in atopic dermatitis. Methods: We systematically searched PubMed, MEDLINE, EMBASE and Google scholar databases to find appropriate articles published between last ten years related to dupilumab efficacy and safety by phenotypic variations of atopic dermatitis with the appropriate key terms (MeSH) including “dupilumab”, “atopic dermatitis”, “eczema”, “phenotypic variations” “phenotypes” etc. Results: Seven studies were included in the current review, which met the inclusion & exclusion criteria of the current study. All the included studies in this review demonstrated that the dupilumab significantly treated the various phenotypes of AD, with the improvement of EASI and DLQI scores. The most commonly occurred side effect during the treatment of duplimab was allergic conjunctivitis followed by allergic rhinitis and asthma. Most of the included studies demonstrated that the dupilumab has been shown to rapidly improving signs and symptoms in the treatment of extreme AD. Conclusion: Dupilumab was first prescribed for adults with atopic dermatitis and has been generally approved since 2018 for adult patients with moderate to extreme atopic dermatitis. The IL-4 and IL-13 cytokines in atopic dermatitis modulate the epidermal barrier and inhibit the production of antimicrobial peptides. Dupilumab’s efficacy and safety profile in the treatment of atopic dermatitis has been investigated in a number of major clinical trials. This current systematic review provides an evidence-based report on dupilumab efficacy and safety by different phenotypic variations of atopic dermatitis, which will help to clinicians for better understanding of the mechanism of dupilumab against AD phenotypes.

Crizotinib Versus Chemotherapy on ALK-positive NSCLC: A Systematic Review of Efficacy and Safety

2018 ◽  
Vol 19 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Mingxia Wang ◽  
Guanqi Wang ◽  
Haiyan Ma ◽  
Baoen Shan
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Objective Response Rate ◽  
Retrospective Studies ◽  
Response Rate ◽  
Objective Response ◽  
Treated Group ◽  
Efficacy And Safety ◽  
Alk Positive

Introduction: Crizotinib was approved to treat anaplastic lymphoma kinase (ALK)- positive non-small cell lung cancer (NSCLC) by the Food and Drug Administration in 2011.We conducted a systematic review of clinical trials and retrospective studies to compare the efficacy and safety of crizotinib with chemotherapy. </P><P> Methods: We searched electronic databases from inception to Dec. 2016. Clinical trials and retrospective studies regarding crizotinib and crizotinib versus chemotherapy in treatment of NSCLC were eligible. The primary outcomes were the objective response rate (ORR) and disease control rate (DCR). Results: Nine studies (five clinical trials and four retrospective studies) including 729 patients met the inclusion criteria. Crizotinib treatment revealed 1-year OS of 77.1% and PFS of 9.17 months. And crizotinib had a better performance than chemotherapy in ORR (OR: 4.97, 95%CI: 3.16 to 7.83, P<0.00001, I2=35%). DCR revealed superiority with crizotinib than chemotherapy (OR: 3.42, 95% CI: 2.33 to 5.01, P<0.00001, I2=0%). PR (partial response) were significant superior to that of chemotherapy through direct systematic review. No statistically significant difference in CR (complete response) was found between crizotinib-treated group and chemotherapy-treated group. Regarding SD (stable disease), chemotherapy-treated group had a better performance than crizotinib-treated group. Common adverse events associated with crizotinib were visual disorder, gastrointestinal side effects, and elevated liver aminotransferase levels, whereas common adverse events with chemotherapy were fatigue, nausea, and hematologic toxicity. This systematic review revealed improved objective response rate and increased disease control rate in crizotinib group comparing with chemotherapy group. Crizotinib treatment would be a favorable treatment option for patients with ALK-positive NSCLC. ALK inhibitors may have future potential applications in other cancers driven by ALK or c-MET gene mutations.

scholarly journals Cardiovascular Toxicities Secondary to Biotherapy and Molecular Targeted Therapies in Neuroendocrine Neoplasms: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2159
Author(s):  
Charalampos Aktypis ◽  
Maria-Eleni Spei ◽  
Maria Yavropoulou ◽  
Göran Wallin ◽  
Anna Koumarianou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Effects ◽  
Targeted Therapies ◽  
Safety Profile ◽  
Meta Analysis ◽  
Mtor Inhibitors ◽  
Risk Of Bias ◽  
Neuroendocrine Neoplasms ◽  
Controlled Trials

A broad spectrum of novel targeted therapies with prime antitumor activity and/or ample control of hormonal symptoms together with an overall acceptable safety profile have emerged for patients with metastatic neuroendocrine neoplasms (NENs). In this systematic review and quantitative meta-analysis, the PubMed, EMBASE, Cochrane Central Register of Controlled Trials and clinicaltrials.gov databases were searched to assess and compare the safety profile of NEN treatments with special focus on the cardiovascular adverse effects of biotherapy and molecular targeted therapies (MTTs). Quality/risk of bias were assessed using GRADE criteria. Placebo-controlled randomized clinical trials (RCTs) in patients with metastatic NENs, including medullary thyroid cancer (MTC) were included. A total of 3695 articles and 122 clinical trials registered in clinicaltrials.gov were screened. We included sixteen relevant RCTs comprising 3408 unique patients assigned to different treatments compared with placebo. All the included studies had a low risk of bias. We identified four drug therapies for NENs with eligible placebo-controlled RCTs: somatostatin analogs (SSAs), tryptophan hydroxylase (TPH) inhibitors, mTOR inhibitors and tyrosine kinase inhibitors (TKI). Grade 3 and 4 adverse effects (AE) were more often encountered in patients treated with mTOR inhibitors and TKI (odds ratio [OR]: 2.42, 95% CI: 1.87–3.12 and OR: 3.41, 95% CI: 1.46–7.96, respectively) as compared to SSAs (OR:0.77, 95% CI: 0.47–1.27) and TPH inhibitors (OR:0.77, 95% CI: 0.35–1.69). MTOR inhibitors had the highest risk for serious cardiac AE (OR:3.28, 95% CI: 1.66–6.48) followed by TKIs (OR:1.51, 95% CI: 0.59–3.83). Serious vascular AE were more often encountered in NEN patients treated with mTOR inhibitors (OR: 1.72, 95% CI: 0.64–4.64) and TKIs (OR:1.64, 95% CI: 0.35–7.78). Finally, patients on TKIs were at higher risk for new-onset or exacerbation of pre-existing hypertension (OR:3.31, 95% CI: 1.87–5.86). In conclusion, SSAs and TPH inhibitors appear to be safer as compared to mTOR inhibitors and TKIs with regards to their overall toxicity profile, and cardiovascular toxicities in particular. Special consideration should be given to a patient-tailored approach with anticipated toxicities of targeted NEN treatments together with assessment of cardiovascular comorbidities, assisting clinicians in treatment selection and early recognition/management of cardiovascular toxicities. This approach could improve patient compliance and preserve cardiovascular health and overall quality of life.

scholarly journals Therapeutic Strategies for the Treatment of Chronic Hyperuricemia: An Evidence-Based Update

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 58
Author(s):  
Arrigo F. G. Cicero ◽  
Federica Fogacci ◽  
Masanari Kuwabara ◽  
Claudio Borghi
Keyword(s):  
Clinical Trials ◽  
Uric Acid ◽  
Clinical Research ◽  
Safety Profile ◽  
Therapeutic Strategies ◽  
Evidence Based ◽  
Acute Management ◽  
Efficacy And Safety ◽  
Uricosuric Agents ◽  
Xanthine Oxidase Inhibitors

This article aims to critically review the evidence on the available therapeutic strategies for the treatment of hyperuricemia. For this reason, several papers were reviewed. Xanthine oxidase inhibitors are the safest and most effective uric acid lowering drugs for the management of chronic hyperuricemia, while the efficacy of uricosuric agents is strongly modulated by pharmacogenetics. Emergent drugs (lesinurad, peglotidase) were found to be more effective for the acute management of refractory hyperuricemia, but their use is supported by a relatively small number of clinical trials so that further well-designed clinical research is needed to deepen their efficacy and safety profile.

scholarly journals Cyclosporine-A for severe childhood atopic dermatitis: clinical experience on efficacy and safety profile

2018 ◽  
Vol 48 (5) ◽  
pp. 933-938 ◽  
Author(s):  
Hayriye SARICAOĞLU ◽  
Serkan YAZİCİ ◽  
Özge ZORLU ◽  
Emel BÜLBÜL BAŞKAN ◽  
Kenan AYDOĞAN
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Experience ◽  
Cyclosporine A ◽  
Safety Profile ◽  
Efficacy And Safety

scholarly journals The efficacy and safety of interferons for the treatment of patients with COVID-19: protocol for systematic review and meta-analysis of controlled trials

2021 ◽  
Author(s):  
Afsaneh Noormandi ◽  
Mohammad Fathalipour ◽  
Reza Daryabeygi-Khotbehsara ◽  
Soheil Hassanipour
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
World Health ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Global Pandemic ◽  
The World ◽  
Health Organization ◽  
Time Of Administration

Background and objective: COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, their efficacy and safety remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19. Methods: The protocol has been registered in the PROSPERO International Prospective Register (CRD42020200643) on 24 July 2020. This protocol has been arranged according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 checklist. Discussion: Due to lack of approved medication for the covid-19 treatment and also various mutations of this virus, evaluated the efficacy and safety of medications by various studies could help for finding treatments with high effectiveness. IFNs are one of the medications that have been administered in covid-19 infection.  Moreover, the best time of administration and dose of this medication was unknown. Although meta-analysis is a potent source for assessing the accuracy of subjects, heterogeneity of articles is a potent limitation of our work.

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