scholarly journals A systematic review and meta-analysis of the efficacy and safety of remdesivir in COVID-19 patients

2021 ◽  
Vol 4 (1) ◽  
pp. 298-303
Author(s):  
Sumanta Saha ◽  
Sujata Saha

Background: This systematic review compares the efficacy and safety of remdesivir between its recipient and non-recipient COVID-19 patients from the recently published randomized controlled trials (RCT).  Methods: For eligible trials comparing the above outcomes, a literature search took place in the PubMed database. The reviewed trials data were abstracted and critically appraised using the Cochrane tool. Then, a random-effect meta-analysis followed to compare the risk between the compared interventions in risk ratio (RR). By plying the I2 and Chi2 statistics, the heterogeneity estimation happened. A sensitivity analysis iterated the preliminary meta-analysis using a fixed-effect model. Results: Two eligible RCTs included in this review sourced data from about 833 COVID-19 patients from 115 hospitals in Asia, Europe, and the US. The risk of bias was primarily low. Random-effect meta-analysis suggested a clinical improvement (RR: 1.09; 95% CI: 1.02, 1.16; P=0.02; I2: 0%) and decrease in the risk of any serious side effects (RR: 0.64; 95% CI: 0.43, 0.94; P<0.001; I2: 0%) in the remdesivir treated COVID-19 patients. The rest of the outcomes did not vary between the juxtaposed interventions. Conclusion: Evidence-based on early RCTs suggest that remdesivir is a clinically useful and safe drug to treat COVID-19 patients.

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Liuting Zeng ◽  
Ganpeng Yu ◽  
Kailin Yang ◽  
Wensa Hao ◽  
Hua Chen

Aim. Probiotics are considered to be bone metabolism regulators, and their efficacy as an adjuvant treatment option for osteoporosis is still controversial. The purpose of this study is to compare the available data from randomized controlled trials (RCT) of probiotics in the treatment of osteoporosis and osteopenia. Methods. As of June 2021, databases such as Medline, Embase, Web of Science, and Central Cochrane Library have been used for English-language literature searches and CNKI and China Biomedical Database have been used for Chinese-language literature searches. RevMan 5.3 was used for bias risk assessment, heterogeneity detection, and meta-analysis. This research has been registered in PROSPERO (CRD42020085934). Results. This systematic review and meta-analysis included 10 RCTs involving 1156. Compared with the placebo, the absolute value of lumbar spine’s BMD was not statistically significant (WMD 0.04 (−0.00, 0.09), P = 0.07 , random effect model), while the percentage of lumbar spine’s BMD was higher (SMD 1.16 (0.21, 2.12), P = 0.02 , random effect model). Compared with the control group, the percentage of total hip’s BMD was not statistically significant (SMD 0.52 (−0.69, 1.73), P = 0.40 , random effect model). The safety analysis showed that, compared with control group, the adverse events in the experimental group were not statistically significant (RR 1.02 (0.92, 1.12), P = 0.70 , fixed effect model). Conclusion. Probiotics may be safety supplements to improve the lumbar spine’s BMD of patients with osteoporosis and osteopenia. More large-sample, random-controlled, high-quality RCTs are needed to further verify the effectiveness and safety of probiotics in intervening osteoporosis or osteopenia.


Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 127
Author(s):  
David Núñez-Fuentes ◽  
Esteban Obrero-Gaitán ◽  
Noelia Zagalaz-Anula ◽  
Alfonso Javier Ibáñez-Vera ◽  
Alexander Achalandabaso-Ochoa ◽  
...  

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Atlaw ◽  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Kenbon Seyoum ◽  
Damtew Solomon ◽  
...  

Abstract Background Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs. Conclusions The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.


2021 ◽  
pp. 10.1212/CPJ.0000000000001143
Author(s):  
Glenardi Glenardi ◽  
Tutwuri Handayani ◽  
Jimmy Barus ◽  
Ghea Mangkuliguna

ABSTRACTPurposeof Review: To investigate the efficacy and safety of CVT-301 for motor fluctuation in Parkinson’s disease (PD).Recent Findings:This study demonstrated that the CVT-301 group had a higher proportion of patients achieving an ON state than the placebo group (OR=2.68; 95% CI: 1.86-3.86; p<0.00001). Moreover, CVT-301 had also shown to improve motor function by UPDRS-III score (SMD=3.83; 95% CI: 2.44-5.23; p<0.00001) and promote an overall improvement of PD by PGIC self-rating (OR=2.95; 95% CI: 1.78-4.9; p<0.00001). The most common adverse events encountered were respiratory symptoms (OR=12.18; 95% CI: 5.01-29.62; p<0.00001) and nausea (OR=3.95; 95% CI: 1.01-15.41; p=0.05).Summary:CVT-301 had the potential to be an alternative or even a preferred treatment for motor fluctuation in PD patients.


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