scholarly journals Updated Review and Meta-Analysis of Probiotics for the Treatment of Clinical Depression: Adjunctive vs. Stand-Alone Treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 647
Author(s):  
Viktoriya L. Nikolova ◽  
Anthony J. Cleare ◽  
Allan H. Young ◽  
James M. Stone
Keyword(s):  
Meta Analysis ◽  
Clinical Depression ◽  
Controlled Clinical Trial ◽  
Reactive Protein ◽  
Treatment Type ◽  
Antidepressant Effects ◽  
Clinical Trial Evidence ◽  
Randomised Controlled ◽  
Trial Evidence ◽  
Insight Into

Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders. The objective of this update review was to evaluate all randomised controlled clinical trial evidence on the efficacy of probiotics for clinical depression. Cochrane guidelines for updated reviews were followed. By searching PubMed and Web of Science databases, we identified 546 new records since our previous review. A total of seven studies met selection criteria, capturing 404 people with depression. A random effects meta-analysis using treatment type (stand-alone vs. adjunctive) as subgroup was performed. The results demonstrated that probiotics are effective in reducing depressive symptoms when administered in addition to antidepressants (SMD = 0.83, 95%CI 0.49–1.17), however, they do not seem to offer significant benefits when used as stand-alone treatment (SMD = −0.02, 95%CI −0.34–0.30). Potential mechanisms of action may be via increases in brain-derived neurotrophic factor (BDNF) and decreases in C-reactive protein (CRP), although limited evidence is available at present. This review offers stronger evidence to support the clinical use of probiotics in depressed populations and provides an insight into the mode of administration more likely to yield antidepressant effects.

Systematic review and meta-analysis of attrition within digital health interventions for people with multiple sclerosis (Preprint)

2021 ◽  
Author(s):  
William Bevens
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Interventions ◽  
Attrition Rates ◽  
Participant Engagement ◽  
Randomised Controlled ◽  
And Control ◽  
Insight Into

BACKGROUND Digital health interventions (DHI) have revolutionised the management of multiple sclerosis (MS). It is now understood that the technological elements that comprise DHIs can influence participant engagement and that people with MS (PwMS) can experience significant barriers to remaining enrolled in DHIs related to the use of these elements. It is essential to explore the influence of technological elements in mitigating attrition after allocation. OBJECTIVE We examined the study design and technological elements of documented DHIs targeted at PwMS and how these correlated with attrition among participants of randomised-controlled trials (RCTs). METHODS We conducted a systematic review and meta-analysis of RCTs (n=17) describing digital technologies for health interventions for PwMS. We analysed attrition of included studies using a random-effects model and meta-regression to measure the association between potential moderators. RESULTS There were no measured differences in attrition between intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 10.6% and 11.2% respectively. CONCLUSIONS Ultimately, this paper provides insight into the technological composition of DHIs and will aid in the design of future studies in this area.

scholarly journals Proteome-wide Mendelian randomization in global biobank meta-analysis reveals multi-ancestry drug targets for common diseases

2022 ◽  
Author(s):  
Huiling Zhao ◽  
humaira Rasheed ◽  
Therese Haugdahl Nost ◽  
Yoonsu Cho ◽  
Yi Liu ◽  
...  
Keyword(s):  
Drug Targets ◽  
Mendelian Randomization ◽  
Meta Analysis ◽  
Drug Repurposing ◽  
Population Data ◽  
Limited Data ◽  
Specific Effects ◽  
Clinical Trial Evidence ◽  
Males And Females ◽  
Trial Evidence

Proteome-wide Mendelian randomization (MR) shows value in prioritizing drug targets in Europeans, but limited data has made identification of causal proteins in other ancestries challenging. Here we present a multi-ancestry proteome-wide MR analysis pipeline based on cross-population data from the Global Biobank Meta-analysis Initiative (GBMI). We estimated the causal effects of 1,545 proteins on eight complex diseases in up to 32,658 individuals of African ancestries and 1.22 million individuals of European ancestries. We identified 45 and seven protein-disease pairs with MR and genetic colocalization evidence in the two ancestries respectively. 15 protein-disease pairs showed evidence of differential effects between males and females. A multi-ancestry MR comparison identified two protein-disease pairs with MR evidence of an effect in both ancestries, seven pairs with European-specific effects and seven with African-specific effects. Integrating these MR signals with observational and clinical trial evidence, we were able to evaluate the efficacy of one existing drug, identify seven drug repurposing opportunities and predict seven novel effects of proteins on diseases. Our results highlight the value of proteome-wide MR in informing the generalisability of drug targets across ancestries and illustrate the value of multi-cohort and biobank meta-analysis of genetic data for drug development.

scholarly journals Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001020 ◽  
Author(s):  
Ana F Águeda ◽  
Sara Monti ◽  
Raashid Ahmed Luqmani ◽  
Frank Buttgereit ◽  
Maria Cid ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Meta Analysis ◽  
Case Series ◽  
Immunosuppressive Drugs ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Inactive Disease ◽  
Controlled Clinical Trial ◽  
Level Of Evidence ◽  
Randomised Controlled

ObjectiveTo collect available evidence on management of large vessel vasculitis to inform the 2018 update of the EULAR management recommendations.MethodsTwo independent systematic literature reviews were performed, one on diagnosis and monitoring and the other on drugs and surgical treatments. Using a predefined PICO (population, intervention, comparator and outcome) strategy, Medline, Embase and Cochrane databases were accessed. Eligible papers were reviewed and results condensed into a summary of findings table. This paper reports the main results for Takayasu arteritis (TAK).ResultsA total of 287 articles were selected. Relevant heterogeneity precluded meta-analysis. Males appear to have more complications than females. The presence of major complications, older age, a progressive disease course and a weaker inflammatory response are associated with a more unfavourable prognosis. Evidence for details on the best disease monitoring scheme was not found. High-quality evidence to guide the treatment of TAK was not found. Glucocorticoids are widely accepted as first-line treatment. Conventional immunosuppressive drugs and tumour necrosis factor inhibitors were beneficial in case series and uncontrolled studies. Tocilizumab failed the primary endpoint (time to relapse) in a randomised controlled clinical trial; however, results still favoured tocilizumab over placebo. Vascular procedures may be required, and outcome is better when performed during inactive disease.ConclusionsEvidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence. Therefore, higher-quality studies are needed in the future.

scholarly journals Effect of purified anthocyanins or anthocyanin-rich extracts on C-reactive protein levels: a systematic review and meta-analysis of randomised clinical trials

2018 ◽  
Vol 120 (12) ◽  
pp. 1406-1414 ◽  
Author(s):  
Zohreh Sadat Sangsefidi ◽  
Shirin Hasanizadeh ◽  
Mahdieh Hosseinzadeh
Keyword(s):  
Clinical Trials ◽  
Significant Relationship ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Quality Score ◽  
C Reactive Protein ◽  
Trial Duration ◽  
Protein Levels ◽  
Reactive Protein ◽  
Randomised Controlled

AbstractAs the results of clinical trials are inconsistent, we conducted this research to assess the effect of purified anthocyanins or anthocyanin-rich extract supplementation on C-reactive protein (CRP) levels. We searched several databases to identify and extract data on characteristics, methods and outcomes of the eligible randomised controlled trials (RCT). A random-effects model, weighted mean difference (WMD) and 95 % CI were applied for data analysis. To investigate the effects of the study quality score or design on our results, we performed the same analysis by excluding the studies of Karlsen et al., with the lowest quality score, and Hassellund et al., with a cross-over design. Meta-analysis showed that anthocyanins had no significant impact on CRP levels (WMD=0·018; 95 % CI –0·44, 0·47; P=0·94). Although the effect of anthocyanins was independent of supplementation duration (slope: 0·01; 95 % CI –0·002, 0·03; P=0·08), their effect depended on the dose of anthocyanins (slope: 0·001; 95 % CI 0·0007, 0·002; P<0·001). However, no significant relationship was found between the anthocyanin dosage and CRP levels after excluding the studies of Karlsen et al. and Hassellund et al. Finally, anthocyanins had no effect on CRP levels regarding healthy participants, patients and types of anthocyanins. Although changes in CRP concentrations had no association with trial duration, a significant relationship was found between anthocyanin dosage and CRP level. No significant result was observed between the anthocyanin dosage and CRP levels after excluding the mentioned studies. Further well-designed RCT are needed to validate these findings.

scholarly journals When to start antiretroviral treatment? A history and analysis of a scientific controversy

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Nathan Geffen ◽  
Marcus O. Low
Keyword(s):  
Clinical Trials ◽  
Antiretroviral Treatment ◽  
Hiv Transmission ◽  
Scientific Controversy ◽  
Optimal Point ◽  
Clinical Trial Evidence ◽  
History Of ◽  
The Individual ◽  
Randomised Controlled ◽  
Trial Evidence

Background: Since 1987 HIV scientists and activists have debated the optimal point to start antiretroviral treatment. Positions have varied between treating people with HIV as soon as they are diagnosed, based on biological, modelling and observational evidence, versus delaying treatment until points in disease progression at which clinical trial evidence has shown unequivocally that treatment is beneficial.Objectives: Examining the conduct and resolution of this debate may provide insight into how science works in practice. It also documents an important part of the history of the HIV epidemic.Method: We describe clinical trials, observational studies, models and various documents that have advanced the debate from 1987 to 2015.Results and conclusion: Evidence accumulated over the past decade, especially from randomised controlled clinical trials, has shown that immediate treatment both reduces the mortality and the risk of HIV transmission; it benefits both public health and the individual patient. By mid-2015, the debate was resolved in favour of immediate treatment.

scholarly journals Start as you mean to carry on: The emerging evidence base for the treatment of conflict-related mental health difficulties in children and adolescents

2017 ◽  
Vol 210 (4) ◽  
pp. 243-244
Author(s):  
Richard Meiser-Stedman ◽  
Leila R. Allen
Keyword(s):  
Traumatic Stress ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Evidence Base ◽  
Post Traumatic Stress ◽  
Psychological Therapies ◽  
Mental Health Difficulties ◽  
Post Traumatic ◽  
Randomised Controlled ◽  
Trial Evidence

SummaryIn this editorial, we discuss Morina and colleagues' meta-analysis of psychological therapies for youth with post-traumatic stress disorder (PTSD) and depression following conflict. Recent years have seen significantly more randomised controlled trial evidence addressing the needs of this population. More work is needed to understand post-traumatic depression, dissemination, timing of intervention and whether trauma-focused interventions are essential.

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