Efficacy and Safety of Moxibustion for Postherpetic Neuralgia: A Systematic Review and Meta-Analysis

Background: Postherpetic neuralgia (PHN) is one of the most common complications of herpes zoster (HZ), and there is still a lack of effective therapies. An increasing number of studies have found that compared to traditional therapy, moxibustion treatment is beneficial for the treatment of PHN, although current evidence remains inconclusive. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of moxibustion for PHN.Methods: We conducted a broad literature review of a range of databases from inception to December 2020, including the Cochrane Library, PubMed, EMBASE, Web of Science, Clinical Trails, China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), China Biomedical Network Information, and Wanfang databases. We included RCTs that compared moxibustion to pharmacological therapies, herbal medicine, or no treatment for treating PHN. The main outcome measure was efficacy rate and Visual Analog Scale (VAS); the secondary outcome measure was adverse events. Data accumulation and synthesis included meta-analysis, publication bias, sensitivity analysis, risk-of-bias assessment, and adverse events.Results: We included 13 RCTs involving 798 patients. Compared with the controls (pharmacological therapies, herbal medicine, or no treatment), moxibustion achieved a significantly higher efficacy rate (odds ratio [OR]: 3.65; 95% [confidence interval]: [2.32, 5.72]; P < 0.00001). Subgroup analysis of the distinct moxibustion modalities showed that both Zhuang medicine medicated thread and thunder-fire moxibustions obtained higher clinical efficacy than the control group. Compared with the controls, moxibustion resulted in significantly lower scores on the VAS (Weighted Mean Difference (MD) = −1.79; 95% CI: [−2.26, −1.33]; P < 0.00001). However, there was no significant difference in terms of safety between moxibustion and the controls (OR = 0.33; 95% CI [0.06, 1.77]; P = 0.19).Conclusion: Due to the lack of methodological quality as well as the significant heterogeneity of the included studies, it remains difficult to draw a firm conclusion on the efficacy and safety of moxibustion for the treatment of PHN. Future high-quality studies are urgently needed.

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Efficacy and safety of omalizumab in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2020-047344 ◽

2021 ◽

Vol 11 (9) ◽

pp. e047344

Author(s):

Qingwu Wu ◽

Lianxiong Yuan ◽

Huijun Qiu ◽

Xinyue Wang ◽

Xuekun Huang ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Chronic Rhinosinusitis ◽

Randomised Controlled Trials ◽

Nasal Polyps ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomised Controlled

ObjectivesTo assess the efficacy and safety of omalizumab for chronic rhinosinusitis with nasal polyps (CRSwNP) and to identify evidence gaps that will guide future research on omalizumab for CRSwNP.DesignSystematic review and meta-analysis.Data sourcesA comprehensive search was performed in PubMed, Embase, Web of Science and the Cochrane Library on 13 October 2020.Eligibility criteriaRandomised controlled trials (RCTs) comparing omalizumab with placebo, given for at least 16 weeks in adult patients with CRSwNP.Data extraction and synthesisTwo independent authors screened search results, extracted data and assessed studies using the Cochrane risk of bias tool. Data were pooled using the inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the χ2 test and the I2 statistic.ResultsA total of four RCTs involving 303 participants were identified. When comparing omalizumab to placebo, there was a significant difference in Nasal Polyps Score (MD=−1.20; 95% CI −1.48 to −0.92), Nasal Congestion Score (MD=−0.67; 95% CI −0.86 to −0.48), Sino-Nasal Outcome Test-22 (MD=−15.62; 95% CI −19.79 to −11.45), Total Nasal Symptom Score (MD=−1.84; 95% CI −2.43 to −1.25) and reduced need for surgery (risk ratio (RR)=5.61; 95% CI 1.99 to 15.81). Furthermore, there was no difference in the risk of serious adverse events ((RR=1.40; 95% CI 0.29 to 6.80), adverse events (RR=0.83; 95% CI 0.60 to 1.15) and rescue systemic corticosteroid (RR=0.52; 95% CI 0.17 to 1.61).ConclusionsThis was the first meta-analysis that identified omalizumab significantly improved endoscopic, clinical and patient-reported outcomes in adults with moderate to severe CRSwNP and it was safe and well tolerated.PROSPERO registration numberCRD42020207639.

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Efficacy and Safety of Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.677694 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jin Xu ◽

Chunyu Zhong ◽

Shu Huang ◽

Xinyi Zeng ◽

Shali Tan ◽

...

Keyword(s):

Adverse Events ◽

Fixed Effects ◽

Clinical Success ◽

Meta Analysis ◽

Peroral Endoscopic Myotomy ◽

Therapeutic Modality ◽

Current Evidence ◽

Cochrane Library ◽

Efficacy And Safety ◽

Endoscopic Myotomy

Background: The efficacy and safety of peroral endoscopic myotomy (POEM) in the treatment of sigmoid-type achalasia is unknown. This meta-analysis aims to explore the clinical outcomes of POEM for sigmoid-type achalasia.Method: We searched all relevant studies published up to September 2020 in PubMed, Embase, and Cochrane library databases. Meta-analyses for clinical success, Eckardt score, angle of esophageal tortuosity, diameter of esophagus, lower esophageal sphincter (LES) pressure, integrated relaxation pressure (IRP), adverse events, and gastroesophageal reflux diseases were performed based on random or fixed-effects models as needed.Results: We found a total of eight studies that provided data on 248 patients. Overall, the pooled clinical success was achieved in 211 sigmoid-type achalasia patients [90.4%; 95% confidence interval (CI), 85.5%−93.8%]. The pre- and post-POEM Eckardt scores, angle of esophageal tortuosity, diameter of esophageal, LES pressure, and IRP were significantly improved (All p < 0.05). The pooled adverse events rate was 13.0% (95% CI, 3.6%−37.4%). The pooled objective confirmation of reflux rate was 41.5% (95% CI, 26.5%−58.3%), and symptomatic reflux rate was 12.5% (95% CI, 8.3%−18.4%).Conclusions: Our current evidence indicated that POEM is an effective and safe therapeutic modality for the treatment of sigmoid-type achalasia.

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Efficacy and Safety of Mucopolysaccharide Polysulfate Cream for Non-Exudative Eczema: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.788324 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ming Li ◽

Yan Li ◽

Lujing Xiang ◽

Linfeng Li

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Recurrence Rate ◽

Meta Analysis ◽

Good Effect ◽

Efficacy Rate ◽

Efficacy And Safety ◽

Tacrolimus Ointment ◽

Randomized Controlled

Background: Mucopolysaccharide polysulfate (MPS) cream as a moisturizer is widely applied to treat eczema, and a lot of clinical trials have demonstrated its efficacy and safety. However, there is no further research to collect and analyze these studies.Objective: This meta-analysis aimed to assess the efficacy and safety of MPS cream as monotherapy or add-on therapy for non-exudative eczema.Methods: Ten databases were searched to identify the eligible randomized controlled trials (RCTs) from their inception to July 31, 2021. Revman 5.3 software was used for the meta-analysis.Results: A total of eligible 20 studies were included. Among the 20 studies, 2 studies compared MPS cream with other moisturizers, 14 compared MPS cream plus topical corticosteroids (TCS) with TCS alone, and 4 compared with MPS cream plus tacrolimus ointment with tacrolimus ointment alone. The pooled results demonstrated that MPS cream had a higher total efficacy rate [Risk ratio (RR) 1.21, 95% CI: 1.12 to 1.30, P < 0.00001], a lower recurrence rate (RR 0.44, 95% CI: 0.26 to 0.74, P = 0.002) and a lower pruritus score [mean difference (MD) −1.78, 95% CI: −2.16 to −1.40, P < 0.00001] than urea cream or vaseline ointment. Moreover, in comparison with TCS or tacrolimus ointment alone, the combination treatment performed better in terms of total efficacy rate, total symptom score, recurrence rate, and pruritus score. For safety, the skin adverse events were mild, and MPS cream as monotherapy or add-on therapy did not increase the risk of skin adverse events.Conclusions: MPS cream as monotherapy or add-on therapy could provide a good effect for treating non-exudative eczema with mild and tolerable skin adverse events. However, due to the suboptimal quality of the included studies, high-quality and large-sample RCTs are needed in the future for update or validation.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/PROSPERO/), identifier: CRD42021265735.

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Therapeutic Efficacy of Kangfuxin Liquid Combined with PPIs in Gastric Ulcer

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/1324969 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Jun-Bo Zou ◽

Xiao-Fei Zhang ◽

Ya-Jun Shi ◽

Jia Tai ◽

Yu Wang ◽

...

Keyword(s):

Gastric Ulcer ◽

Adverse Events ◽

Recurrence Rate ◽

T Lymphocyte ◽

Lymphocyte Subsets ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy Rate ◽

Efficacy And Safety ◽

T Lymphocyte Subsets

Objective. To evaluate the clinical efficacy and safety of Kangfuxin liquid (KFX) combined with proton pump inhibitors (PPIs) in the treatment of gastric ulcer (GU). Materials and Methods. Electronic databases including PubMed, Wanfang, CNKI, VIP, Embase, Cochrane Library, and CBM were examined for appropriate articles without language limitations on key words before March 10, 2019. RevMan 5.3 software was applied to execute outcome assessment and finish the meta-analysis. Results. 22 articles involving 2,024 patients with a gastric ulcer were selected. Total efficacy rate and efficacy rate of gastroscopy were significantly enhanced for the combination of KFX with PPIs compared to those of PPI treatment alone (OR = 6.95, 95% CI: 4.87, 9.91, P<0.00001; OR = 2.96, 95% CI: 1.98, 4.42, P<0.00001, respectively). Same results were found for different PPIs in combination on total efficacy rate, respectively. The combination also significantly reduced the adverse events (OR = 0.39, 95% CI: 0.22, 0.70, P=0.002). In addition, KFX combined with PPI could suppress the inflammation (MD = −6.11, 95% CI: −7.45, −4.77, P<0.00001), reduce the recurrence rate (OR = 0.31, 95% CI: 0.14, 0.70, P=0.005), and enhance the clearance rate of Helicobacter pylori (HP, OR = 3.76, 95% CI: 1.80, 7.87, P=0.0004). It seemed like the combination would influence immune function by increasing levels of T-lymphocyte subsets CD4 and CD8 but not CD3 (MD = 2.40, 95% CI: 1.25, 3.55, P<0.0001); MD = 25.72, 95% CI: 14.55, 36.90, P<0.00001; MD = 0.72, 95% CI: −0.66, 2.09, P=0.31, respectively). Conclusion. KFX combined with PPIs in treatment of patients with GU could improve the total efficacy rate and efficacy rate of gastroscopy and reduce adverse events and the recurrence rate. However, the results of this study should be handled with care due to the limitations. Several rigorous RCTs are in need to confirm these findings.

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Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of primary liver cancer: A protocol for systematic review and meta-analysis

10.37766/inplasy2021.8.0103 ◽

2021 ◽

Author(s):

Dong Shen ◽

◽

Zhuang Xiong ◽

Yangyang Liu ◽

Yan Leng ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Liver Cancer ◽

Chinese Herbal Medicine ◽

Primary Liver Cancer ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Chinese Herbal ◽

Treatment Information

Review question / Objective: The aim of this systematic review is to valuate the efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of primary liver cancer inform clinical practice. To this end, the proposed systematic review will address the following question: Which is the best choice to effective in improving The short-term curative effect is effective, the quality of life is stable, and the survival rate of patients is six months/one year in patients with primary liver cancer, acupuncture combined with Chinese herbal medicine or the best supportive treatment? Information sources: We will search the following databases: PubMed, Web of Science, Embase, AMED, Cochrane Library, CNKI, VIP, CBM, and Wanfang. Additionally, we will manually search all reference lists from relevant systematic reviews to find other eligible studies. We will exclude all conference records, reviews, meta-analyses, newspapers, guides, letters and other documents. When the full text or the required information in the analysis process was missing, the author of the studies was contacted for data.

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Efficacy and safety of Chinese herbal medicine combined with Sorafenib in the treatment of primary liver cancer: A protocol for systematic review and meta-analysis

10.37766/inplasy2021.9.0024 ◽

2021 ◽

Author(s):

Dong Shen ◽

◽

Zhuang Xiong ◽

Yangyang Liu ◽

Yan Leng ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Liver Cancer ◽

Chinese Herbal Medicine ◽

Primary Liver Cancer ◽

Meta Analysis ◽

Cochrane Library ◽

Publication Date ◽

Efficacy And Safety ◽

Chinese Herbal

The aim of this systematic review is to compare Chinese herbal medicine combined with Sorafenib in terms of efficacy and acceptability in the primary liver cancer to better inform clinical practice. To this end, the proposed systematic review will address the following question: Which is the best choice to reduce Efficacy and safety in Patients with primary liver cancer, Chinese herbal medicine combined with Sorafenib or Sorafenib.this systematic review and meta-analysis will evaluate the efficacy and Sorafenib combined with Chinese herbal medicine in the treatment of PLC. Information sources: We will search the following databases from inception up to September 8, 2021: PubMed, Web of Science, Embase, AMED, Cochrane Library, CNKI, VIP, CBM, and Wanfang. There will be no restrictions regarding publication date or language. We will apply a combination of medical keywords and words, including "Sorafenib", "Chinese herbal medicine" and "primary liver cancer". Additionally, we will manually search all reference lists from relevant systematic reviews to find other eligible studies.

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A Systematic Review about the Efficacy and Safety ofTripterygium wilfordiiHook.f. Preparations Used for the Management of Rheumatoid Arthritis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/1567463 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 4

Author(s):

Jing Wang ◽

Na Chen ◽

Liang Fang ◽

Zhe Feng ◽

Guochun Li ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Chinese Herb ◽

Current Evidence ◽

Control Group ◽

Efficacy And Safety ◽

Tripterygium Wilfordii ◽

Reactive Protein

Tripterygium wilfordiiHook.f. (TWHF) is a traditional Chinese herb long used for rheumatoid arthritis (RA) treatment, in modern times, often in the form of variousTripterygium wilfordiiHook.f. preparations (TWPs). This systematic review and meta-analysis focuses on analyzing the clinical efficacy and safety of TWPs in the treatment of RA. Databases were searched to collect the randomized controlled trials (RCTs) on TWPs treating RA published on or before April 10, 2017. Data from 11 studies were included in this meta-analysis. Compared with the control group, TWPs can increase effectiveness, while decreasing erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), and risk of adverse events. TWPs treatment was also more effective than treatment by conventional western medicine (CWM) and Chinese patent medicine or placebo (COP). TWPs significantly decreased the risk of adverse events compared with the CWM group, but not compared with the COP group. Current evidence shows that TWPs are more effective than other western or Chinese medicines we included in this meta-analysis for RA treatment with relatively lower toxicity.

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Efficacy and Safety of Immunotherapies in Refractory Myasthenia Gravis: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.725700 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xuelin Feng ◽

Zubiao Song ◽

Mengli Wu ◽

Yanmei Liu ◽

Sushan Luo ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Myasthenia Gravis ◽

Daily Living ◽

Primary Outcome ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Disease Exacerbation ◽

Post Intervention

Introduction: Approximately 10–20% of patients WITH myasthenia gravis (MG) are refractory to conventional immunotherapies. The purpose of this study was to conduct a systematic review and meta-analysis to explore the optimal therapies for refractory MG.Method: Correlative studies were performed through a search in PubMed, Cochrane Library, and Embase databases. The primary outcome was defined by changes in the quantitative myasthenia gravis score (QMG). Secondary outcomes were defined by the Myasthenia Gravis Activities of Daily Living Scale (MG-ADL), Myasthenia Gravis Foundation of America (MGFA) post intervention status, adverse events, and disease exacerbation after treatment.Result: A total of 16 studies were included with 403 patients with refractory MG on therapies with rituximab, eculizumab, tacrolimus, and cladribine. Therapeutic efficacy of rituximab and eculizumab was identified with an estimated reduction in QMG score (4.158 vs. 6.928) and MG-ADL (4.400 vs. 4.344), respectively. No significant changes were revealed in efficacy or exacerbation density between the two independent therapeutic cohorts. The estimated adverse event density of eculizumab was more significant than that in the rituximab group (1.195 vs. 0.134 per patient-year), while the estimated serious event density was similar.Conclusion: The efficacy and safety of rituximab and eculizumab have been approved in patients with refractory MG. Rituximab had a superior safety profile than eculizumab with a lower incidence of adverse events.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021236818, identifier CRD42021236818.

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Systematic review and meta-analysis of second-generation antidepressants for the treatment of older adults with depression: questionable benefit and considerations for frailty

BMC Geriatrics ◽

10.1186/s12877-019-1327-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Laurie Mallery ◽

Tanya MacLeod ◽

Michael Allen ◽

Pamela McLean-Veysey ◽

Natasha Rodney-Cail ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Adverse Events ◽

Second Generation ◽

Meta Analysis ◽

Cochrane Library ◽

Efficacy And Safety ◽

Double Blind ◽

Frail Older Adults ◽

Significant Difference

Abstract Background Frail older adults are commonly prescribed antidepressants. Yet, there is little evidence to determine the efficacy and safety of antidepressants to treat depression with concomitant frailty. To better understand this issue, we examined the efficacy and safety of second-generation antidepressants for the treatment of older adults with depression and then considered implications for frailty. Methods Due to the absence of therapeutic studies of frail older adults with depression, we conducted a systematic review and meta-analysis of double-blind, randomized controlled trials that compared antidepressants versus placebo for adults with depression, age 65 years or older. We searched PubMed/MEDLINE, Cochrane Library, reference lists from meta-analyses/studies, hand searches of publication lists, and related articles on PubMed. Outcomes included rates of response, remission, and adverse events. After evaluating the data, we applied a frailty-informed framework to consider how the evidence could be applied to frailty. Results Nine trials were included in the meta-analysis (n = 2704). Subjects had moderate to severe depression. For older adults with depression, there was no statistically significant difference in response or remission to second-generation antidepressants compared to placebo. Response occurred in 45.3% of subjects receiving an antidepressant compared to 40.5% receiving placebo (RR 1.15, 95% CI: 0.96 – 1.37, p = 0.12, I2 = 71%). Remission occurred in 33.1% with antidepressant versus 31.3% with placebo (RR 1.10, 95% CI: 0.92 – 1.31, p = 0.30, I2 = 56%) (Figure 2 and 3). There were more withdrawals due to adverse events with antidepressants, 13% versus 5.8% (RR 2.30, 95% CI: 1.45–3.63; p < 0.001; I2 = 61%; NNH 14, 95% CI:10–28). Implications for frailty Subjects in the meta-analysis did not have obvious characteristics of frailty. Using framework questions to consider the implications of frailty, we hypothesize that, like older adults, frail individuals with depression may not respond to antidepressants. Further, observational studies suggest that those who are frail may be less responsive to antidepressants compared to the non-frail. Given the vulnerability of frailty, adverse events may be more burdensome. Conclusions Second-generation antidepressants have uncertain benefit for older adults with depression and cause more adverse events compared to placebo. Until further research clarifies benefit, careful consideration of antidepressant prescribing with frailty is warranted.

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Efficacy and safety of Chinese herbal footbaths for the treatment of dysmenorrhea: Protocol for a systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0250685 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250685

Author(s):

Min Xiao ◽

Lizhou Liu ◽

Steve Tumilty ◽

Dan Liu ◽

Yanyan You ◽

...

Keyword(s):

Systematic Review ◽

Evaluation System ◽

Rating Scale ◽

Data Extraction ◽

Meta Analysis ◽

Biomedical Literature ◽

Current Evidence ◽

Cochrane Library ◽

Efficacy And Safety ◽

Chinese Herbal

Background Chinese herbal footbaths are an external therapy of traditional Chinese medicine that has been widely used to treat dysmenorrhea. This review aims to systematically evaluate its efficacy and safety for the treatment of dysmenorrhea. Methods Databases of PubMed, EMBASE, Cochrane Library, CIHAHL, Web of Science, Chinese National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Database (VIP), Wanfang Database, China Biomedical Literature Database(CBM), and Chinese Biomedical Literature Service System (SinoMed) will be searched from the inception to September 30, 2020. The eligible randomized controlled trials (RCTs) will be identified and included. The primary outcomes include pain intensity measured by validated scales of visual analog scale, numeric rating scale, and response rate of symptom reduction. The secondary outcomes are scores on validated pain questionnaires, quality of life measured by SF-36 or other validated scales, and adverse events. Study selection, data extraction, and assessment of bias risk will be conducted by two reviewers independently. RevMan software (V.5.3.5) will be utilized to perform data synthesis. Subgroup and sensitivity analysis will be performed when necessary. The strength of the evidence will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation System. Results A high-quality synthesis of current evidence of Chinese herbal footbaths for patients with dysmenorrhea will be provided in this study. Conclusion This systematic review will provide evidence of whether Chinese herbal footbaths are an effective and safe intervention for the treatment of dysmenorrhea. Systematic review registration PROSPERO CRD42020188256.

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