Faculty Opinions recommendation of Outcomes of older patients with follicular lymphoma using individual data from 5922 patients in 18 randomized controlled trials.

2021 ◽  
Author(s):  
Pierre Feugier ◽  
Charline Moulin
Keyword(s):  
Follicular Lymphoma ◽  
Randomized Controlled Trials ◽  
Older Patients ◽  
Controlled Trials ◽  
Individual Data ◽  
Randomized Controlled

scholarly journals Outcomes of older patients with follicular lymphoma using individual data from 5922 patients in 18 randomized controlled trials

2021 ◽  
Vol 5 (6) ◽  
pp. 1737-1745
Author(s):  
Carla Casulo ◽  
Jesse G. Dixon ◽  
Fang-Shu Ou ◽  
Eva Hoster ◽  
Bruce A. Peterson ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Follicular Lymphoma ◽  
Randomized Controlled Trials ◽  
Age Groups ◽  
Progression Free Survival ◽  
Controlled Trials ◽  
Early Disease ◽  
End Points ◽  
Randomized Controlled ◽  
Disease Outcomes

Abstract Limited data exist to describe the clinical features and outcomes for elderly patients with follicular lymphoma (FL). The Follicular Lymphoma Analysis of Surrogacy Hypothesis (FLASH) group performed a prospectively planned pooled analysis of individual patient data from first-line randomized controlled trials (RCTs) and examined associations between age (≤70 vs >70 years), clinical characteristics, and FL outcomes. We identified 18 multicenter clinical RCTs in the FLASH database that enrolled elderly patients (>70 years). Primary end points were early disease outcomes, CR24 and CR30, and progression-free survival (PFS) at 24 months (PFS24). Secondary end points were PFS and overall survival (OS). We identified 5922 previously untreated FL patients from 18 RCTs. Patients age >70 years (vs ≤70 years) more commonly had elevated lactate dehydrogenase, hemoglobin <12 g/dL, ECOG PS ≥2, and elevated β2-microglobulin. Median follow-up was 5.6 years. Patients >70 years did not differ from patients ≤70 years in rates of CR24, CR30, or PFS24. With a median OS of 14.6 years for all patients, median OS was 7.4 and 15.7 years for patients >70 and ≤70 years of age, respectively (hazard ratio = 2.35; 95% confidence interval = 2.03-2.73; P < .001). Age >70 years was a significant predictor of OS and PFS due to higher rates of death without progression, but not PFS24, CR24, or CR30. FL patients >70 years treated on trials have similar early disease outcomes to younger patients. There is no disease-specific outcome difference between age groups. Age alone should not disqualify patients from standard treatments or RCTs.

scholarly journals Efficacy of front-line immunochemotherapy for follicular lymphoma: a network meta-analysis of randomized controlled trials

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Yucai Wang ◽  
Shouhao Zhou ◽  
Xinyue Qi ◽  
Fang Yang ◽  
Matthew J. Maurer ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Follicular Lymphoma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Similar Efficacy ◽  
Controlled Trials ◽  
Front Line ◽  
Free Survival ◽  
Randomized Controlled

Abstract Front-line treatment for follicular lymphoma has evolved with the introduction of maintenance therapy, bendamustine (Benda), obinutuzumab (G), and lenalidomide (Len). We conducted a random-effects Bayesian network meta-analysis (NMA) of phase 3 randomized controlled trials (RCTs) to identify the regimens with superior efficacy. Progression-free survival (PFS) was compared between 11 modern regimens with different immunochemotherapy and maintenance strategies. G-Benda-G resulted in with the best PFS, with an HR of 0.41 compared to R-Benda, a surface under the cumulative ranking curve (SUCRA) of 0.97, a probability of being the best treatment (PbBT) of 72%, and a posterior ranking distribution (PoRa) of 1 (95% BCI 1–3). This was followed by R-Benda-R4 (HR = 0.49, PbBT = 25%, PoRa = 2) and R-Benda-R (HR = 0.60, PbBT = 3%, PoRa = 3). R-CHOP-R (HR = 0.96) and R-Len-R (HR = 0.97) had similar efficacy to R-Benda. Bendamustine was a better chemotherapy backbone than CHOP either with maintenance (R-Benda-R vs R-CHOP-R, HR = 0.62; G-Benda-G vs G-CHOP-G, HR = 0.55) or without maintenance therapy (R-Benda vs R-CHOP, HR = 0.68). Rituximab maintenance improved PFS following R-CHOP (R-CHOP-R vs R-CHOP, HR = 0.65) or R-Benda (R-Benda-R vs R-Benda, HR = 0.60; R-Benda-R4 vs R-Benda, HR = 0.49). In the absence of multi-arm RCTs that include all common regimens, this NMA provides an important and useful guide to inform treatment decisions.

Efficacy of frontline treatment regimens in follicular lymphoma: A network meta-analysis of phase III randomized controlled trials.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 7556-7556
Author(s):  
Yucai Wang ◽  
Shouhao Zhou ◽  
Fang Yang ◽  
Grzegorz S. Nowakowski ◽  
Thomas Matthew Habermann ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Pairwise Comparison ◽  
Progression Free Survival ◽  
Phase Iii ◽  
Controlled Trials ◽  
Treatment Regimens ◽  
Randomized Controlled ◽  
Frontline Treatment

7556 Background: The frontline treatment for advanced follicular lymphoma has evolved with the introduction of maintenance therapy, bendamustine (Benda), obinutuzumab (G), and lenalidomide (Len). We conducted a network meta-analysis of phase 3 randomized controlled trials (RCTs) to identify the regimens with superior efficacy. Methods: Data were extracted from 7 RCTs (FOLL05, StiL NHL1, BRIGHT, PRIMA, GALLIUM, StiL NHL7, and RELEVANCE). Progression-free survival (PFS) was compared between 11 regimens with different immunochemotherapy and maintenance strategies. To incorporate direct and indirect comparisons, random-effects Bayesian network meta-analyses were conducted after adjusting for study-wise variation. The posterior inference was derived based on Markov chain Monte Carlo methods and implemented using JAGS v4.3.0. Pairwise comparison of hazard ratios (HRs) and 95% credible intervals (CIs) were calculated. Results: PFS HRs of other regimens compared to the reference regimen are summarized in the Table. Compared to Rituximab(R)-Benda, R-CHOP had inferior PFS, R-CHOP-R, G-CHOP-G, and R-Len-R had similar PFS, while R-Benda-R, R-Benda-R4 and G-Benda-G had better PFS. Compared to R-CHOP-R, G-CHOP-G and R-Len-R had similar PFS, while R-Benda-R, R-Benda-R4 and G-Benda-G had better PFS. In addition, the PFS for G-Benda-G was similar to R-Benda-R4 (HR 0.94, 95% CI 0.78-1.09) but better than R-Benda-R (HR 0.82, 95% CI 0.75-0.97). Conclusions: Compared with the commonly used R-Benda and R-CHOP-R regimens, G-CHOP-G, R-Benda-R and R-Benda-R4 had better PFS, while the chemotherapy-free regimen R-Len-R had similar PFS. [Table: see text]

Drug-Eluting Versus Bare-Metal Stents in Older Patients: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 20 (9) ◽  
pp. 744-751 ◽  
Author(s):  
Babikir Kheiri ◽  
Mohammed Osman ◽  
Ahmed Abdalla ◽  
Tarek Haykal ◽  
Adam Chahine ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Older Patients ◽  
Meta Analysis ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Controlled Trials ◽  
Bare Metal ◽  
Randomized Controlled ◽  
Drug Eluting

scholarly journals Efficacy of Repetitive Transcranial Magnetic Stimulation in Fibromyalgia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (20) ◽  
pp. 4669
Author(s):  
Yu-Chi Su ◽  
Yao-Hong Guo ◽  
Pei-Chun Hsieh ◽  
Yu-Ching Lin
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Older Patients ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

This article aimed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in fibromyalgia. The PubMed, Medline, Cochrane Library, and Web of Science databases were searched for articles published through 14 August 2021. We enrolled only randomized controlled trials. The Cochrane Collaboration risk of bias tool was used for quality assessment. Outcomes were analyzed as standardized mean differences (SMDs) with 95% CIs. The beta coefficient and p value were adopted for meta-regression. We included 18 studies comprising 643 participants. A significant reduction in disease influence, as measured by the Fibromyalgia Impact Questionnaire, was observed (SMD, −0.700, 95% CI, −1.173 to −0.228), and the reduction was larger in older patients (β = −0.1327, p = 0.008). The effect persisted at least two weeks after the final treatment session (SMD, −0.784, 95% CI, −1.136 to −0.432). Reductions in pain, depression, and anxiety were discovered, which persisted for at least two weeks after the last intervention. The effects on pain and depression remained significant up to one and a half months after the final session. No serious adverse events were reported by the included articles. In conclusion, our systematic review and meta-analysis revealed that rTMS is safe and effective for managing multiple domains of fibromyalgia-related symptoms and older patients may have a stronger treatment effect. Larger randomized controlled trials with sufficient male populations are warranted to confirm our findings, detect rare adverse events, and determine the optimal stimulation parameters.

Management of atrial fibrillation in older patients: A network meta-analysis of randomized controlled trials

2018 ◽  
Vol 41 (10) ◽  
pp. 1385-1387
Author(s):  
Babikir Kheiri ◽  
Mohammed Osman ◽  
Ahmed Abdalla ◽  
Tarek Haykal ◽  
Mahmoud Barbarawi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Randomized Controlled Trials ◽  
Older Patients ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled
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