scholarly journals THE EFFICACY COMPARISON OF MIRABEGRON AS A MONOTHERAPY VERSUS ITS COMBINATION WITH SOLIFENACIN IN OVERACTIVE BLADDER: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 28 (2) ◽  
pp. 202-210
Author(s):  
Hasan Madani ◽  
Soetojo ◽  
Wahjoe Djatisoesanto
Keyword(s):  
Overactive Bladder ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Forest Plot ◽  
Controlled Trials ◽  
Monotherapy Group ◽  
Randomized Controlled ◽  
Micturition Frequency ◽  
Micturition Volume

Objective: This review aimed to evaluate the efficacy and safety of mirabegron as monotherapy and its combination with solifenacin for patients with overactive bladder (OAB). Material & Methods: A systematic search was conducted in PubMed, Google Scholar, and Science Direct using the keywords Overactive bladder or OAB and mirabegron or beta-3 agonist or β3 adrenoreceptor agonist and solifenacin or antimuscarinic based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline to include relevant randomized controlled trials (RCT)s. The included studies were assessed for their risks of bias using the Cochrane risk of bias tool for randomized controlled trials. Quantitative analysis using forest plot was performed in Review Manager 5.4. Results: A total of 4 RCTs were included from 227 studies. A fixed-effects model was chosen due to the low level of heterogeneity between the studies (I2 = 0%). The average micturition volume of patients in the combination group is higher compared to the monotherapy group (MD 17.13, 95% CI 12.78 - 21.48, p < 0.00001). The mean micturition frequency (MD - 0.54, 95% CI - 0.73 - -0.34, p < 0.00001) and incontinence incidence (MD -0.30, 95% CI -0.48 - -0.12, p = 0.001) in the combined group are significantly lower compared to the monotherapy group. Conclusion: The combination of mirabegron and solifenacin has better efficacy compared to mirabegron as monotherapy for OAB patients with a therapy duration of less than 12 weeks based on the micturition volume, micturition frequency, and incontinence incidence. The administration of combination therapy would not increase adverse event incidence compared to monotherapy.

scholarly journals Poly(ADP-Ribose) Polymerase Inhibitors (PARPi) for Patients With Advanced Breast Cancer: a Meta-analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
YongCheng Su ◽  
XiaoGang Zheng
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Parp Inhibitors ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Grade 3

Abstract BACKGROUND: Poly(ADP–ribose) polymerase (PARP) inhibitors are new class of drugs that are currently being studied in several malignancies. However, datas about the efficacy and safety of the PARP inhibitors are limited. Therefore, we conducted a meta-analysis of randomized controlled trials (RCT) in patients with breast cancer.METHODS: Pubmed/Medline, Embase, Cochrane Library, and abstracts presented at the annual meeting of the American Society of Clinical Oncology (ASCO) were searched for articles published from 2000 to June 2018.Summary incidences and the RR, HR with 95% confidence intervals, were calculated by using a random-effects or fixed-effects model.RESULTS: The summary HR indicated PARPi was not associated with OS (HR=0.83, 95%CI 0.66–1.06, Z=1.49, P=0.14), while it could significantly improve PFS ande time to deterioration (TTD) of global health status/quality of life(GHS/QoL) as compared with traditional standard therapy, the HR was 0.60(95%CI 0.50-0.72; Z=5.52, P＜0.00001) and 0.4 (95%CI 0.29–0.54,z=5.80 ,p=0.000),respectively.The RR of grade 3 or more anemia ,fatigue and headache was 3.02 (95% CI, 0.69–13.17;p = 0.14,,I2=90%),0.77 (95%CI, 0.34–1.73;p=0.52,I2=7%) and 1.13 (95% CI,0.30–4.18;p=0.86,I2=0%),respectively.CONCLUSION: The findings of this meta-analysis showed that PARPi has no significant effect on OS, while it could significantly improve in PFS and TTD of GHS/QoL for patients with advanced or metastatic breast cancer.Furthermore,our findings also demonstrated that the PARPi treatment is connected with an increased risk of grade 3 or more anemia adverse events.

Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 204748732093058 ◽  
Author(s):  
Lei Dai ◽  
Yuyue Zuo ◽  
Qiqi You ◽  
Hesong Zeng ◽  
Shiyi Cao
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Lipid Lowering ◽  
Oral Drug ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled

Aim Bempedoic acid is a novel oral drug, which has been increasingly researched to play an important role in the treatment of hypercholesterolemia recently. However, results from original studies were inconsistent and inconclusive. We aimed to conduct a meta-analysis to quantitatively appraise the efficacy and safety of bempedoic acid. Methods PubMed, Embase, Web of Science and Scopus were searched from inception to 30 January 2020. We included randomized controlled trials that compared the efficacy and safety of bempedoic acid with placebo in patients with hypercholesterolemia. Results from trials were presented as mean differences or odds ratios (ORs) with 95% confidence intervals (CIs) and were pooled by random or fixed effects model. The risk of bias and heterogeneity among trials were also assessed and analyzed. Results Pooled analysis of 10 eligible trials showed that bempedoic acid treatment resulted in greater lowering of the low-density lipoprotein cholesterol level than the placebo group (mean difference –23.16%, 95% CI –26.92% to –19.04%). We also found that improvements in lipid parameters and biomarkers were still maintained at weeks 24 and 52 from the long-term trials. As for safety, bempedoic acid did not increase the risk of overall adverse events (OR 1.02, 95% CI 0.88 to 1.18). However, the incidence of adverse events leading to discontinuation was higher in the bempedoic acid group (OR 1.44, 95% CI 1.14 to 1.82). Conclusions Available evidence from randomized controlled trials suggests that bempedoic acid provides a well-tolerated and effective therapeutic option for lipid lowering in patients with hyperlipidemia

scholarly journals Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials

2017 ◽  
Vol 30 (3) ◽  
pp. 285-293 ◽  
Author(s):  
Egemen Savaskan ◽  
Heiko Mueller ◽  
Robert Hoerr ◽  
Armin von Gunten ◽  
Serge Gauthier
Keyword(s):  
Randomized Controlled Trials ◽  
Ginkgo Biloba ◽  
Fixed Effects ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Caregiver Distress ◽  
Egb 761 ◽  
Randomized Controlled ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:In randomized controlled trials, Ginkgo biloba extract EGb 761® has been found to be effective in the treatment of behavioral and psychological symptoms of dementia (BPSD).Methods:To assess the effects of EGb 761® on specific BPSD, we analyzed data from all randomized, placebo-controlled, at least 20-week, trials of EGb 761® enrolling patients with dementia (probable Alzheimer's disease (AD), probable vascular dementia or probable AD with cerebrovascular disease) who had clinically significant BPSD (Neuropsychiatric Inventory (NPI) total score at least 6). Data were pooled and joint analyses of NPI single item composite and caregiver distress scores were performed by meta-analysis with a fixed effects model.Results:Four trials involving 1628 patients (EGb 761®, 814; placebo, 814) were identified; treatment duration was 22 or 24 weeks; the daily dose of EGb 761® was 240 mg in all trials. Pooled analyses including data from the full analysis sets of all trials (EGb 761®, 796 patients; placebo, 802 patients) revealed significant superiority of EGb 761® over placebo in total scores and 10 single symptom scores. Regarding caregiver distress scores, EGb 761®-treated patients improved significantly more than those receiving placebo in all symptoms except delusions, hallucinations, and elation/euphoria. The benefit of EGb 761® mainly consists of improvement in symptoms present at baseline, but the incidence of some symptoms was also decreased.Conclusions:Twenty two- to twenty four-week treatment with Ginkgo biloba extract EGb 761® improved BPSD (except psychotic-like features) and caregiver distress caused by such symptoms.

scholarly journals Incidence of Adverse Psychiatric Events During Treatment of Inflammatory Bowel Disease With Biologic Therapies: A Systematic Review

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Avni Jain ◽  
Ruth Ann Marrie ◽  
Leigh Anne Shafer ◽  
Lesley A Graff ◽  
Scott B Patten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Biologic Therapy ◽  
Meta Analysis ◽  
Risk Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Inflammatory Bowel ◽  
Biologic Medication

Abstract We conducted a systematic review and a fixed-effects meta-analysis to determine whether incident adverse psychiatric events (APE) including depression, anxiety, psychosis, or suicide were associated with biologic therapy in IBD. Six randomized controlled trials and a cohort study met criteria, reporting an incidence of APE in 4,882 patients. The risk difference per 100 person-months of any APE with a biologic medication was 0.01 (95% confidence interval = 0.00–0.02). There was insufficient evidence available in randomized controlled trials to conclude that biologic therapy in IBD is associated with an increased incidence of APE.

scholarly journals Platelet inhibition and clinical outcomes of low dose ticagrelor in patients with coronary artery disease: a meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Cheng Xie ◽  
Xiaoliang Ding ◽  
Qiong Qin ◽  
Jia Lin ◽  
Yuzhen Zhang
Keyword(s):  
Randomized Controlled Trials ◽  
Clinical Outcomes ◽  
Fixed Effects ◽  
Low Dose ◽  
Platelet Reactivity ◽  
Standard Dose ◽  
Meta Analysis ◽  
Platelet Inhibition ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Background Although current guidelines recommend ticagrelor 90 mg twice daily in ACS patients for 12 months and 60 mg twice daily in stable patients 1 to 3 years after MI with additional high-risk features, the bleeding complication was actually higher than clopidogrel. This meta-analysis was performed to assess the platelet inhibition and clinical outcomes of low dose ticagrelor in patients with CAD. Methods Medline, EMBASE and Cochrane Databases were systematically searched from inception to March, 2021 for randomized controlled trials (RCTs) comparing low dose ticagrelor with standard dose clopidogrel or standard dose ticagrelor in patients with CAD. Pooled estimates were calculated using fixed-effects or random-effects model as appropriate. Results 15 RCTs that included 15357 patients were identified. Low dose ticagrelor had no statistical differences of the risks of MACE and major bleeding compared with standard dose ticagrelor and standard dose clopidogrel (RR 0.98, 95%CI 0.87 − 1.11, P = 0.80; RR 1.35, 95%CI 0.46 − 4.00, P = 0.59; RR 0.86, 95%CI 0.68 − 1.10, P = 0.23; RR 1.46, 95%CI 0.45 − 4.76, P = 0.53, respectively). Compared with standard dose clopidogrel, low dose ticagrelor showed significantly lower platelet reaction units (PRU) (MD -118.48, 95%CI -144.33−-92.63, P ༜0.00001), rates of high on-treatment platelet reactivity (HTPR) (RR 0.10, 95%CI 0.04 − 0.21, P ༜ 0.00001) and minor or minimal bleeding (RR 0.73, 95%CI 0.55 − 0.96, P = 0.03), but increased the incidence of dyspnea (RR 6.48, 95%CI 1.78 − 23.54, P = 0.005). Compared with standard dose ticagrelor, low dose ticagrelor showed significantly higher PRU (MD 15.45, 95%CI 5.45 − 25.44, P = 0.002) and risk of dyspnea (RR 0.81, 95%CI 0.75 − 0.88, P ༜ 0.00001), but similar rates of HTPR (RR 1.63, 95%CI 0.40 − 6.70, P = 0.50) and minor or minimal bleeding (RR 1.36, 95%CI 0.78 − 2.38, P = 0.28). Conclusion Low dose ticagrelor may provide an additional choice for secondary prevention in CAD patients. However, the specific dose of ticagrelor should be selected according to the patients’ clinical characteristics.

Forest plot: An indispensable segment of meta-analysis

2021 ◽  
Vol 3 (1) ◽  
pp. 3-8
Author(s):  
Vipin Ahuja ◽  
Annapurna Ahuja
Keyword(s):  
Medical Research ◽  
Randomized Controlled Trials ◽  
Graphical Representation ◽  
Meta Analysis ◽  
Review Article ◽  
Forest Plot ◽  
Controlled Trials ◽  
Graphical Display ◽  
Randomized Controlled ◽  
The Individual

Forest plot is the graphical display of estimated results from a number of scientific studies included in Meta-Analysis. The name refers to the forest of lines produced. It is also known as a blobbogram and is a graphical representation of data from studies addressing the same question, along with the overall results. It was developed for use in medical research as a means of graphically representing a meta-analysis of the results of randomized controlled trials. One of the foremost advantages of these plots is that one can see and interpret the information from the individual studies that went into meta-analysis at a glance. It also highlights the amount of variation between the studies and an estimate of the overall result. This review article throws a light on the importance of forest plots and their interpretation in the field of dental research.

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