scholarly journals Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4221
Author(s):  
Katja A. Schönenberger ◽  
Anne-Catherine Schüpfer ◽  
Viktoria L. Gloy ◽  
Paul Hasler ◽  
Zeno Stanga ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Health Assessment ◽  
Study Data ◽  
Risk Of Bias ◽  
Protein Levels ◽  
Lower Pain ◽  
Anti Inflammatory ◽  
Mean Differences

Various nutritional therapies have been proposed in rheumatoid arthritis, particularly diets rich in ω-3 fatty acids, which may lead to eicosanoid reduction. Our aim was to investigate the effect of potentially anti-inflammatory diets (Mediterranean, vegetarian, vegan, ketogenic) on pain. The primary outcome was pain on a 10 cm visual analogue scale. Secondary outcomes were C-reactive protein levels, erythrocyte sedimentation rate, health assessment questionnaire, disease activity score 28, tender/swollen joint counts, weight, and body mass index. We searched MEDLINE (OVID), Embase (Elsevier), and CINAHL for studies published from database inception to 12 November 2021. Two authors independently assessed studies for inclusion, extracted study data, and assessed the risk of bias. We performed a meta-analysis with all eligible randomized controlled trials using RevMan 5. We used mean differences or standardized mean differences and the inverse variance method of pooling using a random-effects model. The search retrieved 564 unique publications, of which we included 12 in the systematic review and 7 in the meta-analysis. All studies had a high risk of bias and the evidence was very low. The main conclusion is that anti-inflammatory diets resulted in significantly lower pain than ordinary diets (−9.22 mm; 95% CI −14.15 to −4.29; p = 0.0002; 7 RCTs, 326 participants).

scholarly journals Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Haonan Tian ◽  
Congman Xie ◽  
Min Lin ◽  
Hongmei Yang ◽  
Aishu Ren
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Canine Retraction ◽  
Temporary Anchorage Devices ◽  
The Mean ◽  
Mean Differences ◽  
Implant Anchorage

Abstract Background Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03). Conclusions There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.

The effect of anti-inflammatory diets on pain in rheumatoid arthritis: a systematic review and meta-analysis

2021 ◽  
Vol 46 ◽  
pp. S682-S683
Author(s):  
K.A. Schönenberger ◽  
A.-C. Schüpfer ◽  
V.L. Gloy ◽  
Z. Stanga ◽  
N. Kägi-Braun ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Anti Inflammatory

scholarly journals The Derivative of Tripterygium wilfordii Hook F—Kunxian Capsule, Attenuated Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ya-Fei Liu ◽  
Zhe Zhang ◽  
Jun-Jun Zhang ◽  
Zhe Chen ◽  
Sheng-Hao Tu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Tender Joint ◽  
Tripterygium Wilfordii Hook F ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Tripterygium Wilfordii Hook ◽  
Mean Differences ◽  
Review Manager

The study aimed to explore the efficacy and safety of Kunxian Capsule (KXC) in the treatment of rheumatoid arthritis (RA). The randomized controlled trials (RCTs) comparing the effects of KXC in patients with RA were included in this study. Weighted mean differences (MDs) were calculated for net changes by employing Review Manager meta-analysis software. Nine RCTs were included in the systematic review with a total of 747 patients. The overall effects showed that KXC alone or combined with disease-modifying antirheumatic and drugs decreased tender joint counts (P=0.02, MD = −1.07, 95% CI: −1.95 to −0.18), shortened duration of morning stiffness (P<0.0001, MD = −9.01, 95% CI: −13.08 to −4.93), lowered erythrocyte sedimentation rate (P<0.00001, MD = −5.27, 95% CI: −6.78 to −3.77), and reduced C-reactive protein (P<0.0001, MD = −5.04, 95% CI: −7.28 to −2.80). The most common adverse events were gastrointestinal disturbances and abnormal liver function. These results suggest that KXC is likely to be a more effective and safe candidate for treating RA compared with conventional therapies.

scholarly journals Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047273
Author(s):  
Mei-Ying Kwan ◽  
Kit-Lun Yick ◽  
Joanne Yip ◽  
Chi-Yung Tse
Keyword(s):  
Systematic Review ◽  
Hallux Valgus ◽  
Outcome Measurement ◽  
Meta Analysis ◽  
Outcome Data ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
Systematic Analysis ◽  
Registration Number ◽  
Mean Differences

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

scholarly journals Comparison Between Cemented and Uncemented Hemiarthroplasty in Patients With Femoral Neck Fractures: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xiu Mei Tang ◽  
Duan Wang ◽  
Ying Liu ◽  
Jia Li Chen ◽  
Pei Fang Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Operative Duration ◽  
Operative Outcomes ◽  
Uncemented Hemiarthroplasty ◽  
Lower Pain ◽  
Pressure Injury ◽  
Hip Function ◽  
Mean Differences

Abstract BackgroundWe performed an updated systematic review and meta-analysis to compare the outcomes of CHA and UCHA in patients with FNFs.MethodsWe searched 6 English databases (Cochrane Library, ScienceDirect, PubMed, Embase, Medline, and Web of Science) and 4 Chinese databases (CNKI, VIP, Wang Fang, and Sino Med) in July 2020. The quality of each study was assessed according to the Cochrane handbook of systematic reviews. Data were pooled as risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). We used the random-effects model despite the heterogeneity among the studies. Data regarding baseline characteristics, hip function, complications both prosthetic-related and common, and operative outcomes are reported. ResultsA total of 24 RCTs based on 22 trials involving 3119 patients (CHA, 1575; UCHA, 1544) were included. Patients in CHA group show better hip function with HHS within 6 weeks (WMD=9.097, 95% CI, 3.034-15.161; P<0.003), 3 months (WMD=3.347, 95% CI, 1.478-5.216; P<0.001), 12 months (WMD=2.183, 95% CI, 0.161-4.205; P=0.034). The pooled results show that CHA had lower rates of refracture (RR=0.227, 95% CI, 0.135-0.381; P<0.0001), subsidence or loosening (RR=0.295, 95% CI, 0.112,0.778; P<0.014) and revision (RR=0.468, 95% CI, 0.279-0.786; P=0.004). Furthermore, CHA group tend to have lower pain(VAS score) (WMD=-0.568, 95% CI, -0.897 to -0.239; P=0.001), lower rate of pressure injury(RR=0.432, 95% CI, 0.221-0.846; P=0.014) and mortality at 1 year after surgery(RR=0.852, 95% CI, 0.727-0.998; P=0.047). UCHA showed a shorter operative duration(WMD=8.739, 95% CI, 6.354-11.124; P<0.0001).ConclusionsThis meta-analysis demonstrates that CHA has better hip function, lower rates of refracture, subsidence or loosening, revision, pressure ulcer, pain and one-year mortality than UCHA, while UCHA has shorter operative duration.

scholarly journals Reliability of Mouse Behavioural Tests of Anxiety: a Systematic Review and Meta-Analysis on the Effects of Anxiolytics.

2021 ◽  
Author(s):  
Marianna Rosso ◽  
Robin Wirz ◽  
Ariane Vera Loretan ◽  
Nicole Alessandra Sutter ◽  
Charlène Tatiana Pereira da Cunha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Control Treatment ◽  
Test Results ◽  
Animal Models Of Anxiety ◽  
Mean Differences ◽  
Behavioural Tests ◽  
Meta Analyses ◽  
Quality Checklist

Animal research on anxiety and anxiety disorders relies on valid animal models of anxiety. However, the validity of widely used rodent behavioural tests of anxiety has repeatedly been questioned, as they often fail to produce consistent results across independent replicate studies using different study populations or different anxiolytic compounds. In this study, we assessed the sensitivity of behavioural tests of anxiety in mice to detect anxiolytic effects of drugs prescribed to treat anxiety in humans. To this end, we conducted a pre-registered systematic review of studies reporting tests of anxiolytic compounds against a control treatment using common behavioural tests of anxiety in mice. PubMed and EMBASE were searched on August 21 st 2019 for studies published in English and 814 papers were identified for inclusion. Risk of bias was assessed based on Syrcle’s risk of bias tool and the Camarades study quality checklist on a randomly selected subsample of 180 papers. Meta-analyses on effect sizes of treatments using standardized mean differences (Hedges’ g) showed that only two of 17 test measures reliably detected effects of anxiolytic compounds other than diazepam. Further, we report considerable variation in both direction and size of effects of most anxiolytics on most outcome variables, indicating poor replicability of test results. This was corroborated by high heterogeneity in most test measures. Finally, we found an overall high risk of bias. Our findings indicate a general lack of sensitivity of common behavioural tests of anxiety in mice to anxiolytic compounds and cast serious doubt on both construct and predictive validity of most of those tests. The use of animals to model human conditions can be justified only if the expected results are informative, reproducible, and translatable. In view of scientifically valid and ethically responsible research, we call for a revision of behavioural tests of anxiety in mice and the development of more predictive tests .

scholarly journals Prevalence and incidence of dry eye in the USA: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e056203
Author(s):  
Paul McCann ◽  
Alison G Abraham ◽  
Darren G Gregory ◽  
Scott Hauswirth ◽  
Cristos Ifantides ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dry Eye ◽  
Meta Analysis ◽  
Visual Disturbance ◽  
Study Data ◽  
Risk Of Bias ◽  
Cross Sectional ◽  
Hand Search ◽  
Incidence Studies ◽  
The Usa

IntroductionDry eye is a multifactorial chronic condition characterised by tear film insufficiency and instability, and ocular symptoms including foreign body sensation, itching, irritation, soreness and visual disturbance. The prevalence and incidence of dry eye are major determinants of the magnitude of economic and societal costs of the disease. This protocol proposes a systematic review and meta-analysis of the prevalence and incidence of dry eye in the USA.Methods and analysisWorking with an information specialist, we will develop search strategies for Ovid Medline and Embase for population-based cross-sectional and cohort studies involving US-based populations that report the prevalence and/or incidence of dry eye. We will include studies involving persons of all ages from 1 January 2010 to the current date with no language restrictions. We will also hand-search references of included studies, dry eye epidemiology-related systematic reviews, clinical practice guidelines and literature provided by agencies and organisations. Two investigators will independently screen the titles and abstracts, and then full-text reports to determine eligibility. One investigator will extract study data and perform risk of bias assessments using tools designed specifically for prevalence and incidence studies. A second investigator will verify all extracted study data and risk of bias assessments. We will assess heterogeneity, qualitatively and quantitatively. When appropriate, we will meta-analyse prevalence and incidence estimates.Ethics and disseminationThis review does not require approval by an ethics committee because it will use published studies. We will publish our results in a peer-reviewed journal and present at relevant conferences.PROSPERO registration numberCRD42021256934.

scholarly journals Equivalence and switching between biosimilars and reference molecules in rheumatoid arthritis: protocol for two systematic reviews and meta-analyses

2020 ◽  
Author(s):  
Bruna de Oliveira Ascef ◽  
Matheus Oliveira Almeida ◽  
Ana Cristina de Medeiros Ribeiro ◽  
Danieli Castro Oliveira de Andrade ◽  
Haliton Alves de Oliveira Júnior ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Primary Outcome ◽  
Treatment Success ◽  
Health Assessment ◽  
Risk Of Bias ◽  
Biologic Drugs ◽  
Random Effects Models ◽  
The Impact

Abstract Background Biologic drugs such as adalimumab, etanercept, and infliximab represent major first-line and second-line treatments for rheumatoid arthritis (RA) patients. However, their high cost poses a massive burden on healthcare systems worldwide. The expiration of patents for these biologics has driven to the production of biosimilar drugs, which are potentially less costly and remarkably similar, albeit not identical to the reference molecules. These two systematic reviews aim to investigate the efficacy and safety profile of biosimilars compared to biologics (systematic review 1) and the impact of switching between biosimilar drugs and reference biologics on the management of RA patients (systematic review 2).Methods Electronic searches will be performed through MEDLINE (via Pubmed), EMBASE, LILACS, and CENTRAL (from inception to September 2020). Risk of bias assessments will be carried out with the Cochrane risk of bias tool, supplemented with specific domains from equivalence trials. Random-effects models will be fitted to obtain summary estimates using either relative risk or standardized mean difference as a metric. Between-trial heterogeneity will be tested and quantified with the Q-test and I2 metric, respectively, whereas assessment of small-study bias will be examined through contour-enhanced funnel plots and Egger and Harbord's tests. Meta-regression models will be fitted when appropriate. The primary outcome will be the rate of treatment success according to the American College of Rheumatology 20 (ACR20) and the co-primary outcome will be the Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index). Conclusions will be based on equivalence hypothesis testing using predefined margins of equivalence elicited from a group of experienced rheumatologists and prior studies. The overall certainty of evidence will be assessed based on the GRADE system.Discussion The two systematic reviews described here, to the best of our knowledge, are the first ones proposing a comprehensive, clinician-oriented approach to assess the equivalence and the impact of switching between biosimilars and biologics on the management of patients with RA. The results will elucidate the efficacy, safety, immunogenicity of biosimilars, and the clinical consequences of substituting biologics with biosimilars in the management of RA. Systematic Review Registration Protocol synopses were previously registered on PROSPERO (CRD42019137152 and CRD42019137155).

scholarly journals Efficacy of Probiotics in Rheumatoid Arthritis and Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 354
Author(s):  
Pauline Sanchez ◽  
Jean-Guillaume Letarouilly ◽  
Yann Nguyen ◽  
Johanna Sigaux ◽  
Thomas Barnetche ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Dietary Intervention ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Probiotic Supplementation ◽  
Randomized Controlled ◽  
Probiotic Strains

Background: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of probiotics supplementation on symptoms and disease activity in patients with chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondylarthritis (SpA), or psoriatic arthritis). Methods: A systematic literature review and meta-analysis from RA and SpA randomized controlled trials were conducted searching for articles in MEDLINE/PubMed and abstracts from recent international rheumatology meetings. The control group was a placebo or another dietary intervention. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration tool and the Jadad scale. Results: The initial search yielded 173 articles. Of these, 13 studies were included in the qualitative synthesis, 8 concerning a total of 344 RA patients and 2 concerning a total of 197 SpA patients. Three meta-analyses were also analyzed. Probiotic strains and quantities used were different among trials (5 studies using Lactobacillus sp., 1 trial Bacillus coagulans and the others a mix of different probiotic strains). Time to assess response ranged from 8 weeks to one year. Two studies associated probiotic supplementation with a dietary intervention. Meta-analysis showed a statistically significant decrease of C-reactive protein (CRP) concentration (mean difference (MD)) −3.04 (95% CI −4.47, −1.62) mg/L, p < 0.001; I2 = 20%, n patients = 209) with probiotics in RA. However, after excluding high-risk-of-bias trials of meta-analysis, there was no difference between probiotics and placebo on DAS28 (standard MD −0.54; 95% CI −1.94 to 0.85, p = 0.45, I2 93%, n patients = 143). The two studies on SpA patients showed no efficacy of probiotics. Conclusions: Probiotic supplementation might decrease RA activity with a moderate decrease effect on CRP, but lack of evidence and studies’ heterogeneity do not allow us to propose them to patients with inflammatory arthritis to control their disease. Further RCTs are required in the future to determinate the efficacy of probiotics and the optimal administration design.

scholarly journals Equivalence and switching between biosimilars and reference molecules in rheumatoid arthritis: protocol for a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Bruna O. Ascef ◽  
Matheus O. Almeida ◽  
Ana Cristina de Medeiros Ribeiro ◽  
Danieli C. O. Andrade ◽  
Haliton A. de Oliveira Júnior ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Treatment Success ◽  
Health Assessment ◽  
Efficacy And Safety ◽  
Biologic Drugs ◽  
Link Type ◽  
The Impact

Abstract Background Biologic drugs such as adalimumab, etanercept, and infliximab represent major first-line and second-line treatments for rheumatoid arthritis (RA) patients. However, their high cost poses a massive burden on healthcare systems worldwide. The expiration of patents for these biologics has driven the production of biosimilar drugs, which are potentially less costly and remarkably similar, albeit not identical to the reference molecules. This paper aims to outline the protocol of a systematic review that will investigate the efficacy and safety profile of biosimilars compared to biologics (objective 1) and the impact of switching between biosimilar drugs and reference biologics on the management of RA patients (objective 2). Methods We will investigate the effects of any biosimilars of adalimumab, etanercept, and infliximab on RA patients. We will include randomized controlled trials (RCTs) or quasi-RCTs to assess efficacy and safety outcomes and RCTs with two- or multiple-part designs to evaluate the consequences of switching from reference biologics to biosimilar drugs (and vice-versa). Electronic searches will be performed through MEDLINE (via PubMed), EMBASE, LILACS, and CENTRAL (from inception to April 2021). Two independent reviewers will screen studies, extract data, and evaluate the risk of bias. The latter will be carried out considering specific domains from equivalence trials and switching studies. Random-effects models will be fitted to obtain summary estimates using either relative risk or standardized mean difference as a metric. The primary outcome will be the rate of treatment success according to the American College of Rheumatology 20 (ACR20), and the co-primary outcome will be the Health Assessment Questionnaire—Disability Index (HAQ-DI). Conclusions will be based on equivalence hypothesis testing using predefined margins of equivalence elicited from a group of experienced rheumatologists and prior studies. The overall certainty of the evidence will be assessed based on the GRADE system. Discussion The present investigation proposes a comprehensive, clinician-oriented approach to assess the equivalence and the impact of switching between biosimilars and biologics on the management of patients with RA. Our results will elucidate the efficacy, safety, immunogenicity of biosimilars, and the clinical consequences of substituting biologics with biosimilars in the management of RA. Systematic review registration PROSPERO CRD42019137152 and CRD42019137155

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