scholarly journals Atazanavir / ritonavir versus Lopinavir / ritonavir-based combined antiretroviral therapy (cART) for HIV-1 infection: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
pp. 91-101 ◽  
Author(s):  
Bereket Molla Tigabu ◽  
Feleke Doyore Agide ◽  
Minoo Mohraz ◽  
Shekoufeh Nikfar
Keyword(s):  
Systematic Review ◽  
Viral Suppression ◽  
Adverse Drug Events ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Hiv 1 ◽  
Overall Risk

Background: This systematic review and meta-analysis was conducted to evaluate the safety and effectiveness of Atazanavir/ritonavir over lopinavir/ritonavir in human immunodeficiency virus-1 (HIV-1) infection. Methods: Clinical trials with a head-to-head comparison of atazanavir/ritonavir and lopinavir/ritonavir in HIV-1 were included. Electronic databases: PubMed/Medline CENTRAL, Embase, Scopus, and Web of Science were searched. Viral suppression below 50 copies/ml at the longest follow-up period was the primary outcome measure. Grade 2-4 treatment-related adverse drug events, lipid profile changes and grade 3-4 bilirubin elevations were used as secondary outcome measures. Results: A total of nine articles from seven trials with 1938 HIV-1 patients were included in the current study. Atazanavir/ritonavir has 13% lower overall risk of failure to suppress the virus level < 50 copies/ml than lopinavir/ritonavir in fixed effect model (pooled RR: 0.87; CI: 0.78, 0.96; P=0.006). The overall risk of hyperbilirubinemia is very high for atazanavir/ritonavir than lopinavir/ritonavir in the random effects model (pooled RR: 45.03; CI: 16.03, 126.47; P< 0.0001). Conclusion: Atazanavir/ritonavir has a better viral suppression at lower risk of lipid abnormality than lopinavir/ritonavir. The risk and development of hyperbilirubinemia from atazanavir-based regimens should be taken into consideration both at the time of pre- scribing and patient follow-up. Keywords: Atazanavir; Atazanavir/ritonavir; lopinavir/ritonavir; viral suppression.

A meta-analysis of taxanes in adjuvant chemotherapy (ACT) of early breast cancer (EBC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 545-545 ◽  
Author(s):  
A. K. Nowak ◽  
T. Ferguson ◽  
N. R. Wilcken ◽  
D. Ghersi
Keyword(s):  
Breast Cancer ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Quality Criteria ◽  
Fixed Effect Model ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Significant Heterogeneity

545 Background: Taxanes (docetaxel and paclitaxel) are highly active against breast cancer. Recent trials have examined taxanes as ACT for EBC. The objective of this meta-analysis is to compare taxane containing ACT regimens with ACT not containing a taxane in women with operable EBC. Methods: Eligible studies were properly randomized controlled trials in women with operable EBC receiving ACT (neoadjuvant CT was excluded) that compared taxane containing ACT regimens to ACT without a taxane. Studies were identified by a specifically designed search performed of the Cochrane Breast Cancer Group specialized register (to January 2007), Medline (to November 2006), and relevant conference proceedings (to November 2006). The primary outcome measure was overall survival (OS); secondary outcome measures included disease free survival (DFS) and toxicity. Two reviewers independently assessed eligibility, quality, and time-to-event (TTE) outcomes. Hazard ratios were derived for TTE outcomes where possible, and a fixed effect model was used for meta-analysis. Results: 20 studies were identified, 11 (4 abstracts; 7 full publications) with sufficient data published for inclusion (10 for OS, 11 for DFS). The average median follow-up was 54.6 months. All studies fulfilled quality criteria (allocation concealment, outcome measures, balance between arms, follow-up and intention to treat analysis) adequately or well. Amongst 17056 women with 2397 deaths, the HR for OS was 0.81, (95%CI=0.75–0.88, p<0.00001) favoring taxane-containing ACT. 19943 women were included in analysis of DFS with a HR=0.81 (95%CI=0.75- 0.86, p<0.00001) favoring taxane-containing ACT. There was no statistically significant heterogeneity for either OS or DFS. The effects were consistent in studies of node positive or node negative/positive patients, and with the same or longer duration of ACT in the taxane arm. Further analyses of taxane type (docetaxel or paclitaxel), sequential or concurrent taxane-anthracycline, and toxicity will be presented. Conclusions: This is the first meta-analysis quantifying the statistically significant OS and DFS benefit for the use of taxanes as ACT in operable EBC. Additional relevant studies remain unreported. Ongoing studies will define the optimal use of taxanes in EBC. No significant financial relationships to disclose.

scholarly journals Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaoqin Xiong ◽  
Ting Yu ◽  
Tiantian Xu ◽  
Xinhong Wang ◽  
Wenguang Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Large Scale ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Healthcare Research ◽  
Oral Lichen

Abstract Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Six electronic databases including Medline, Web of Science, etc. were searched. Included studies are observational human studies written in English. Population of interest were those with/without OLP who received dental implant treatment. Follow-up time after implantation is from one month to 20 years. The quality of the included literature regarding risk of bias and methodology was assessed with Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² tests. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of 139 literatures, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM; 17.0% (19/112) vs. 10.9% (12/110) for PI. Meta-analysis found no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available literature regarding the effects of OLP on PIDs remains very limited. Existing evidence seems not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to test the findings. Keywords : dental implants; peri-implant diseases; oral lichen planus; systematic review; meta-analysis.

scholarly journals DOP43 The risk of extra-intestinal cancer in inflammatory bowel disease (IBD): A systematic review and meta-analysis of population-based cohort studies

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S080-S081
Author(s):  
B Z S Lo ◽  
M Zhao ◽  
I Vind ◽  
J Burisch
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Population Based ◽  
Site Specific ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Stratified Analysis ◽  
Year 2000 ◽  
Overall Risk

Abstract Background Patients with Crohn’s disease (CD) and ulcerative colitis (UC) are at increased risk of developing intestinal cancer compared with the background population. However, less is known about the risk of extra-intestinal cancers (EICs). A previous meta-analysis did not find an increased overall risk of EICs but was limited by the scarcity of available studies and the short length of follow-up in those cohorts. The aim of this study was to conduct a systematic review and meta-analysis of population-based cohorts assessing the risk of EICs in inflammatory bowel disease (IBD) patients. Methods A systematic literature search was carried out. Only population-based studies reporting on the prevalence or incidence of EICs were included. All studies were screened (603), and included studies were quality assessed by two investigators (BL, MZ). Studies eligible for meta-analysis were pooled for events, expected events or events in a control-population, and the length of follow-up in patient-years. A meta-analysis of the overall and site-specific risk of EICs and a stratified analysis of the cohorts (according to whether there were most patients followed before or after the year 2000) were conducted. Results In total, 36 studies were included in the systematic review and 14 studies were included in the meta-analysis. The majority of the studies reporting on the overall risk of EICs in their respective cohort were inconclusive due to lack of power. In the meta-analysis, the overall risk of EICs was found to be increased in both CD (IRR: 1.45 [1.26, 1.67]) and UC (IRR: 1.15 [1.02, 1.31]) patients (Figures 1 and 2). The stratified analysis showed a significant increased risk of EICs among CD patients both before (IRR: 1.58 [1.09, 2.28]) and after (IRR: 1.47 [1.28, 1.69]) the year 2000, while no increased risk was found among UC patients. Assessing site-specific EICs, both CD and UC patients demonstrated an increased risk of skin and hepatobiliary malignancies. Furthermore, CD demonstrated an increased risk of haematological and lung malignancies (Figures 3 and 4). Conclusion In conclusion, this systematic review and meta-analysis demonstrated that IBD patients, both CD and UC patients, are at an increased risk of developing EICs; both overall and at specific sites. The transition of the millennium did not increase the risk of EICs in CD or UC patients. However, more studies with longer follow-up are needed to assess the true risk of EICs posed by IBD.

scholarly journals RADT-17. RADIOTHERAPY IN THE MANAGEMENT OF OPTIC NERVE SHEATH MENINGIOMAS: AN INTERNATIONAL SYSTEMATIC REVIEW AND META-ANALYSIS OF EIGHTEEN STUDIES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii185-ii185
Author(s):  
Yash J Vaishnav ◽  
Raj Singh ◽  
Prabhanjan Didwania ◽  
Eric J Lehrer ◽  
Tatiana Bakaeva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Optic Nerve ◽  
Meta Analysis ◽  
Optic Nerve Sheath ◽  
Secondary Outcome ◽  
Chronic Radiation ◽  
Nerve Sheath ◽  
Radiation Induced ◽  
Meta Analyses

Abstract INTRODUCTION Optic nerve sheath meningiomas (ONSMs) are often managed with radiotherapy (RT) with the goal of achieving radiographic local control (LC) to prevent further decline in visual acuity (VA); however, reports on outcomes are limited to small retrospective series. Thus, we aimed to perform a systematic review and meta-analysis of outcomes for patients with ONSM treated with RT. METHODS A PICOS/PRISMA/MOOSE selection criteria was utilized to identify studies for inclusion. Primary outcomes were stable or improved VA and radiographic LC at last follow-up. The secondary outcome was incidence of radiation-induced retinopathy. Weighted random effects meta-analyses using the DerSimonian and Laird methods were conducted to characterize effect sizes. Mixed effects regression models were used to examine potential correlations between gross tumor volume (GTV) and outcomes. RESULTS In total, 381 patients with ONSM across 18 published studies were included. Of these, 332 and 386 treated ONSMs had information on VA or LC, respectively. Median age was 46.75 (range: 9-87), median/mean GTV was 2.905cc (range: 0.28-26.3), and median follow-up was 51.15 months (range: 1-248.4 months). The estimated LC rate at last follow-up was 100% (95% CI: 98-100%), and the estimated proportion of patients with stable or improved VA at last follow-up was 89% (95% CI: 84-93%). The rate of chronic radiation retinopathy was estimated to be 7% (95% CI: 5-11%). GTV was significantly associated with VA (p=0.014) with estimated VA rates of 96.4%, 91.4%, and 80.5% for GTVs of 2.0, 3.0, and 4.0ccs, respectively. CONCLUSIONS RT was well-tolerated in the treatment of ONSM with excellent LC achieved. Nearly 90% of patients noted either stability or improvement in VA. Larger ONSMs were found to be associated with poorer VA. Incidences of radiation-induced retinopathy were limited and estimated to be less than 10%.

scholarly journals The Effectiveness of Interpersonal Psychotherapy Versus Cognitive Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Qihang Xie ◽  
Pengcheng Yi ◽  
Xinyang Hu ◽  
Jianxiang Lei ◽  
Jiacheng Kong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Interpersonal Psychotherapy ◽  
Cognitive Behavioral ◽  
Secondary Outcome ◽  
Future Research

Abstract Purpose: Interpersonal psychotherapy (IPT) has been proposed as a treatment strategy for eating disorders (EDs). However, cognitive behavioral therapy (CBT) is the treatment more effectively and widely used than IPT. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness of IPT versus CBT on EDs. Methods: We systematically searched PubMed, Embase, Medline, Cochrane, Web of Science, and the Clinical Trials Database for RCTs that compared IPT and CBT.Results: Of 468 studies initially identified, 10 were suitable for incorporation into our meta-analysis (N = 833 participants). In those studies, IPT and CBT had comparable effects in terms of primary outcome (i.e., ED score) (SMD = 0.08), while IPT had a better effect in terms of secondary outcome (i.e., Inventory of Interpersonal Problems) (SMD = 0.32) than CBT. Compared with CBT, IPT had a better treatment effect for ED populations with lower Body Mass Index (SMD = 0.27) and age (SMD = 0.43). IPT and CBT both had follow-up effects of pre-test and follow-up comparison after fewer than 6 months (SMD = 1.61, 1.83), 6–12 months (SMD =1.48, 1.65), and more than 12 months (SMD = 1.29, 1.33). At the same time, only CBT showed a dose-response relationship trend (β = 0.017, p = 0.067). Conclusion: The meta-analysis provided clear evidence that IPT is an effective treatment measure for patients with EDs. This review also suggested that future research is needed to determine the effects of IPT in the treatment of EDs.Level of evidence Level I, systematic review and meta-analysis.

scholarly journals Risk of Secondary Malignancies in Patients with prostate cancer: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Keyvan Heydari ◽  
Sahar Rismantab ◽  
Amir Shamshirian ◽  
Pouya Houshmand ◽  
Parisa Lotfi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
General Population ◽  
Meta Analysis ◽  
Secondary Malignancy ◽  
Secondary Malignancies ◽  
Number Of Patients ◽  
Risk Of Cancer ◽  
Overall Risk

AbstractIMPORTANCEProstate cancer (PC) is the second most common cancer among males globally, however, the survival rate is favorable in most patients. In a small number of patients, who suffer from advanced or invasive cancer, various side effects such as secondary malignancies or treatment-related secondary malignancies (SMs) may be seen.OBJECTIVETo systematically asses the risk of secondary malignancies in patients with prostate cancer.DATA SOURCESWe have searched for longitudinal studies through databases of Web of Science, Scopus and PubMed for all available data up to September 2019.STUDY SELECTIONStudies with longitudinal design on prostate cancer patients that declared the results in SIR or those that the SIR could be calculated were eligible.DATA EXTRACTION AND SYNTHESISThe heterogeneity was evaluated using the I2 test. According to the results and in case of I2 ≥ 50%, the random effect model was used to combine the results. To identify the cause of heterogeneity in the studies, the analysis of sub-groups was performed based on the site of secondary malignancy, the treatment procedure, and duration of follow-up. Data were analyzed using STATA version 11.MAIN OUTCOMES AND MEASURESOverall SIR and based on treatment of prostate cancer and duration of follow-up.RESULTSTwenty-six studies involving more than 2223,704 patients with PC and more than 86034 cases of SMs were entered into this study. The meta-analysis showed that the risk of cancer after PC was 1.03 (95% CI 0.90 - 1.15) and the SIRs of some cancers such as the bladder 1.52 (1.06 - 1.99) and melanoma 1.32 (0.78 - 1.87) were higher than expected. While, malignancies such as rectum 0.92 (0.85 - 1.00), lung 0.85 (0.74 - 0.96) and liver 0.76 (0.54 - 0.98) showed lower incidence in compare to general population.CONCLUSIONS AND RELEVANCEThe overall risk of SMs in patients with prostate cancer is not significantly different from general population, and even in patients undergoing prostatectomy or brachytherapy, the risk is lower. But the incidence of some cancers such as melanoma, bladder, and urinary tract appears to be higher than the public in all types of treatment approaches.Key PointsQuestioIs the risk of secondary malignancy in patients with prostate cancer higher than the general population?FindingsThis systematic review and meta-analysis of 26 unique trials including 2223,704 patients, showed that the SIRs of some cancers such as the bladder and melanoma were higher than expected.MeaningThese findings suggest that the overall risk of some cancer such as bladder and melanoma in patients with prostate cancer were higher than the general population.

scholarly journals Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (10) ◽  
pp. 2016
Author(s):  
Mariachiara Ippolito ◽  
Barbara Simone ◽  
Carlotta Filisina ◽  
Francesca Romana Catalanotto ◽  
Giulia Catalisano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Outcome ◽  
Web Of Science ◽  
Meta Analysis ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Secondary Outcome ◽  
Inclusion Criteria ◽  
Clinical Consequences

Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality of this patient population. Methods: A systematic search was performed on PubMed, EMBASE, and Web of Science from inception to 19 April 2021. The primary outcome was the occurrence of BSIs among hospitalized patients with COVID-19. The secondary outcome was mortality at the longest available follow-up. Results: Forty-six studies met the inclusion criteria, with a total of 42,694 patients evaluated. The estimated occurrence of BSIs was 7.3% (95% CI 4.7–1.1%) among hospitalized patients with COVID-19, with a mortality rate of 41% (95% CI 30%–52.8%). The subgroup analysis conducted on patients admitted to ICU provided an estimated occurrence of 29.6% (95% CI 21.7%–38.8%). A higher occurrence of BSI was observed in patients with COVID-19, in comparison with patients without COVID-19 (OR 2.77; 95% CI 1.53–5.02; p < 0.001). Conclusions: Our analysis estimated the occurrence of BSIs among hospitalized patients with COVID-19 at around 7%. A four-times higher occurrence was estimated among patients admitted to ICU.

scholarly journals Sarcopenia as a predictor of all-cause mortality among older nursing home residents: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e021252 ◽  
Author(s):  
Xiaoming Zhang ◽  
Conghua Wang ◽  
Qingli Dou ◽  
Wenwu Zhang ◽  
Yunzhi Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Muscle Mass ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Nursing Home Residents ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
All Cause Mortality

ObjectivesThis study aims to review the evidence of sarcopenia as a predictor of all-cause mortality among nursing home residents.DesignSystematic review and meta-analysis of observational cohort studies.Data sourcesPubMed, EMBASE and the Cochrane Library databases were searched for relevant articles.ParticipantsNursing home residents.Primary and secondary outcome measuresAll-cause mortality.Data analysisSummary-adjusted HRs or risk ratios (RRs) were calculated by fixed-effects model. The risk of bias was assessed by Newcastle-Ottawa Scale.ResultsOf 2292 studies identified through the systematic review, six studies (1494 participants) were included in the meta-analysis. Sarcopenia was significantly associated with a higher risk for all-cause mortality among nursing home residents (pooled HR 1.86, 95% CI 1.42 to 2.45, p<0.001, I2=0). In addition, the subgroup analysis demonstrated that sarcopenia was associated with all-cause mortality (pooled HR 1.87,95% CI 1.38 to 2.52, p<0.001) when studies with a follow-up period of 1 year or more were analysed; however, this was not found for studies with the follow-up period less than 1 year. Furthermore, sarcopenia was significantly associated with the risk of mortality among older nursing home residents when using bioelectrical impedance analysis to diagnosis muscle mass (pooled HR 1.88, 95% CI 1.39 to 2.53, p<0.001); whereas, it was not found when anthropometric measures were used to diagnosis muscle mass.ConclusionSarcopenia is a significant predictor of all-cause mortality among older nursing home residents. Therefore, it is important to diagnose and treat sarcopenia to reduce mortality rates among nursing home residents.PROSPERO registration numberCRD42018081668

scholarly journals The efficacy of combined Albendazole and Praziquantel therapy versus Albendazole monotherapy in treatment of parenchymal neurocysticercosis: A systematic review

2021 ◽  
Vol 10 (2) ◽  
pp. 90-96
Author(s):  
Gaurav Nepal ◽  
Jessica Holly Rehrig ◽  
Rajan Sharma Kandel ◽  
Shaik Tanveer Ahamad ◽  
Bipin Kandel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Meta Analysis ◽  
Dual Therapy ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Radiographic Evaluation ◽  
Treatment Groups ◽  
Significant Difference ◽  
Parasitic Effect

Preliminary studies suggest combined albendazole and praziquantel (ABZ+PZQ) therapy has superior anti-parasitic effect compared to albendazole (ABZ) or praziquantel (PZQ) monotherapy, due to potential pharmacokinetic synergism. We thus present an evidence-based review evaluating the risks and benefits associated with combination ABZ+PZQ therapy compared to standard ABZ monotherapy in the treatment of viable parenchymal Neurocysticercosis (NCC). Our systematic review is based on PRISMA (Preferred Reporting Items for Systematic review and Meta- Analysis) statement. Our primary outcome measure was to compare the efficacy of ABZ+PZQ with ABZ alone for treatment of NCC. Efficacy was determined based on clinical and radiographic evaluation. The secondary outcome measured the incidence of adverse effects in each treatment group. Literature search yielded a total of 120 articles. After excluding duplicates and those not meeting inclusion criteria, five papers were reviewed for data collection. Medication regimens, number of cyst, patient age, and location varied amongst included papers. The combination therapy resulted in significant symptom and cyst resolution in patients with more than two viable parenchymal cysts as compared to monotherapy. The two treatment arms were comparable in treating NCC with low cyst burden. There was no significant difference in the adverse effects between two treatment groups. In individuals with multi-cystic NCC, the patients who received dual therapy had better outcomes than those who received ABZ monotherapy as evidenced by radiographic improvement and reduced seizure episodes. The adverse effect profile in patients receiving dual therapy was similar and comparable to those with monotherapy.

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