De impact van CYP2D6-polymorfisme op een behandeling met aripiprazol bij kinderen en jongeren: een systematische review

Genetic Variants ◽

Individual Variability ◽

Cytochrome P450 Enzyme ◽

Allelic Variants ◽

Cyp2d6 Polymorphism ◽

Systematische Review ◽

Impact of CYP2D6 polymorphism on children and adolescents treated with aripiprazole: a systematic review Psychotropic drugs show a significant individual variability in efficacy and adverse events. To explain these differences, there is a promising focus on studies which examine the genetic variants of the cytochrome P450 enzyme 2D6 (CYP2D6). The CYP2D6 gene has a large genetic variability with over 100 known allelic variants encoding this protein. These variants contain predictive value for the function of the CYP2D6 enzyme. Aripiprazole is metabolized by the CYP2D6 enzyme, thereby CYP2D6 allelic variants potentially affect the pharmacokinetics of the drug. This systematic literature review summarizes research on that potential influence of CYP2D6 polymorphism on the treatment outcomes of aripiprazole in minors, in terms of pharmacokinetic changes, efficacy and adverse events. Relevant articles were selected according to PRISMA guidelines (‘preferred reporting items for systematic reviews and meta-analyses’) using Embase and PubMed. After applying the inclusion and exclusion criteria, 10 relevant research articles were retained. The available research shows a possible link between genetic variants of the CYP2D6 enzyme on the one hand, and efficacy and adverse events such as hyperprolactinemia or weight gain on the other hand, in minors treated with aripiprazole. However, the number and quality of studies are low. Recommendations for future studies are made since this systematic review offers insight into the relevance of CYP2D6 genotyping in children and adolescents treated with aripiprazole.

Adverse Effects of Natural Products: A Brief Pre-Systematic Review

Current Nutraceuticals ◽

10.2174/2665978601999200702163914 ◽

2020 ◽

Vol 01 ◽

Author(s):

Carla Pires ◽

Ana Fernandes

Keyword(s):

Systematic Review ◽

Adverse Event ◽

Natural Products ◽

Adverse Events ◽

In Vitro Study ◽

Google Scholar ◽

Inclusion Criteria ◽

Exclusion Criteria ◽

Background: Natural products are commonly used for treating health problems. These products may be associated with adverse events, which are defined as "noxious and unintended response to a medicinal product" by the European Medicine Agency. Objectives: To identify studies describing at least one adverse event (or with potential to promote an adverse event) related to the use of natural products, as well as to describe the involved product(s) and adverse event(s). Methods: A pre-systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Keywords: "natural product(s)" and ["adverse drug reaction(s)" or "adverse effect(s)"]. Screened databases: PubMed, SciELO, DOAJ and Google Scholar. Inclusion criteria: papers describing at least one adverse event associated with the use of natural products and published between 2017 and 2019. Exclusion criteria: Repeated studies, reviews and papers written in other languages than English, Portuguese, French or Spanish. Results: 104 studies were identified (20 PubMed; 0 SciELO; 2 DOAJ; 82 Google Scholar), but only 10 were selected (4 PubMed and 6 Google Scholar): 1 in-vitro study; 2 non-clinical studies, 1 study reporting in-vitro and clinical data and 5 studies were cases reports. Globally, 997 reports of adverse drug reactions with natural products were identified, mainly non-severe cases. Conclusion: Since a limited number of studies was found, we conclude that adverse events due to natural products may be underreported, or natural products may have a good safety profile. This review contributes for assuring the safety of natural products consumers, by evaluating the knowledge/information on the potential adverse events and interactions of these products.

Adverse events associated with abacavir use in HIV-infected children and adolescents: a systematic review and meta-analysis

The Lancet HIV ◽

10.1016/s2352-3018(15)00225-8 ◽

2016 ◽

Vol 3 (2) ◽

pp. e64-e75 ◽

Cited By ~ 9

Author(s):

Julie Jesson ◽

Désiré L Dahourou ◽

Françoise Renaud ◽

Martina Penazzato ◽

Valériane Leroy

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis

Multicomponent Lifestyle Interventions for Treating Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analyses

Journal of Obesity ◽

10.1155/2017/5021902 ◽

2017 ◽

Vol 2017 ◽

pp. 1-14 ◽

Cited By ~ 13

Author(s):

I. K. Ø. Elvsaas ◽

L. Giske ◽

B. Fure ◽

L. K. Juvet

Keyword(s):

Systematic Review ◽

Group Treatment ◽

Overweight And Obesity ◽

Lifestyle Interventions ◽

Significant Difference ◽

Subgroup Analyses ◽

Specialist Health Care ◽

Moderate Effect ◽

Background. Treatment of childhood obesity is important in preventing development of obesity-related diseases later in life. This systematic review evaluates the effect of multicomponent lifestyle interventions for children and adolescents from 2 to 18 years.Methods and Results. We performed systematic searches in nine databases. Thirty-nine studies met the criteria for meta-analyses. We found a significant difference in body mass index (BMI) after 6 months (MD −0.99 (95% CI −1.36 to −0.61)), 12 months (MD −0.67 (95% CI −1.01 to −0.32)), and 24 months (MD −0.96 (95% CI −1.63 to −0.29)) in favour of multicomponent lifestyle interventions compared to standard, minimal, and no treatment. We also found a significant difference in BMIZscores after 6 months (MD −0.12 (95% CI −0.17 to −0.06)), 12 months (MD −0.16 (95% CI −0.21 to −0.11)), and 24 months (MD −0.16 (95% CI −0.21 to −0.10)) in favour of multicomponent lifestyle interventions. Subgroup analyses suggested an increased effect in specialist health care with a group treatment component included in the intervention.Conclusion. Multicomponent lifestyle interventions have a moderate effect on change in BMI and BMIZscore after 6, 12, and 24 months compared with standard, minimal, and no treatment.

Efficacy and harms of remdesivir for the treatment of COVID-19: a systematic review and meta-analysis

10.1101/2020.05.26.20109595 ◽

2020 ◽

Cited By ~ 1

Author(s):

Alejandro Piscoya ◽

Luis Fernando Ng-Sueng ◽

Angela Parra del Riego ◽

Renato Cerna-Viacava ◽

Vinay Pasupuleti ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Clinical Improvement ◽

Meta Analysis ◽

Case Series ◽

Length Of Hospital Stay ◽

Invasive Ventilation ◽

Serious Adverse Events ◽

All Cause Mortality ◽

AbstractBackgroundWe evaluated the efficacy and safety of remdesivir for the treatment of COVID-19.MethodsSystematic review in five engines, pre-print webpages and RCT registries until May 22, 2020 for randomized controlled trials (RCTs) and observational studies evaluating remdesivir on confirmed, COVID-19 adults with pneumonia and/or respiratory insufficiency. Primary outcomes were all-cause mortality, clinical improvement or recovery, need for invasive ventilation, and serious adverse events (SAE). Secondary outcomes included length of hospital stay, progression of pneumonia, and adverse events (AE). Inverse variance random effects meta-analyses were performed.ResultsTwo placebo-controlled RCTs (n=1300) and two case series (n=88) were included. All studies used remdesivir 200mg IV the first day and 100mg IV for 9 more days, and followed up until 28 days. Wang et al. RCT was stopped early due to AEs; ACTT-1 was preliminary reported at 15-day follow up. Time to clinical improvement was not decreased in Wang et al. RCT, but median time to recovery was decreased by 4 days in ACTT-1. Remdesivir did not decrease all-cause mortality (RR 0.71, 95%CI 0.39 to 1.28) and need for invasive ventilation at 14 days (RR 0.57, 95%CI 0.23 to 1.42), but had fewer SAEs (RR 0.77, 95%CI 0.63 to 0.94). AEs were similar between remdesivir and placebo arms. Risk of bias ranged from some concerns to high risk in RCTs.InterpretationThere is paucity of adequately powered and fully reported RCTs evaluating effects of remdesivir in adult, hospitalized COVID-19 patients. Remdesivir should not be recommended for the treatment of severe COVID-19.

The Assessment of Functional Movement in Children and Adolescents: A Systematic Review and Meta-Analysis

Sports Medicine ◽

10.1007/s40279-021-01529-3 ◽

2021 ◽

Author(s):

Wesley O’Brien ◽

Zeinab Khodaverdi ◽

Lisa Bolger ◽

Giampiero Tarantino ◽

Conor Philpott ◽

...

Keyword(s):

Systematic Review ◽

Secondary School ◽

Meta Analysis ◽

Developmental Trajectory ◽

School Level ◽

Functional Movement ◽

School Aged Children ◽

Small Effect Size ◽

Abstract Background The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents. Objective We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI). Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio. Results A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r = − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents. Conclusion This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among ‘at risk’ groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores.

Efficacy and Safety of Adrenergic Alpha-1 Receptor Antagonists in Older Adults: A Systematic Review and Meta-analysis for the Development of Recommendations to Reduce Potentially Inappropriate Prescribing

10.21203/rs.3.rs-1132435/v1 ◽

2022 ◽

Author(s):

Felix Mansbart ◽

Gerda Kienberger ◽

Andreas Sönnichsen ◽

Eva Mann

Keyword(s):

Systematic Review ◽

Older Adults ◽

Adverse Events ◽

Arterial Hypertension ◽

Urinary Symptoms ◽

Cochrane Library ◽

Quality Appraisal ◽

Receptor Antagonists ◽

Abstract BackgroundAdrenergic alpha-1 receptor antagonists (alpha-1 antagonists) are frequently used medications in the management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and in the management of therapy-resistant arterial hypertension, two conditions frequently found in older adults. This systematic review aims at presenting a complete overview of evidence over the benefits and risks of alpha-1 antagonist treatment in people ≥ 65 years, and at deriving recommendations for a safe application of alpha-1 antagonists in older adults from the evidence found.MethodsA comprehensive literature search was performed including multiple databases (Medline/Pubmed, Embase, the Cochrane Library) and using the PICOS framework to define search terms. The selection of the studies was done by two independent reviewers in a two-step approach, followed by a systematic data extraction. Quality appraisal was performed for each study included using standardised appraisal tools. The studies retrieved and additional literature were used for the development of recommendations, which were rated for strength and quality according to the GRADE methodology. ResultsFourteen studies were included: 3 meta-analyses, 6 randomised controlled trials and 5 observational trials. Doxazosin in the management of arterial hypertension was associated with a higher risk of cardiovascular disease, particularly heart failure, than chlorthalidone. Regarding treatment of LUTS suggestive of BPH, alpha-1 antagonists appeared to be effective in the relief of urinary symptoms and improvement of quality of life. They seemed to be less effective in preventing disease progression. Analyses of the risk profile indicated an increase in vasodilation related adverse events and sexual adverse events for some agents. One large observational study points at an increased risk of falls and fractures. The effects of long-term treatment remained unclear. All meta-analyses and 5 out of 6 interventional studies were downgraded in the quality appraisal. 4 out of 5 observational studies were of good quality.ConclusionsIt cannot be recommended to use doxazosin as first-line antihypertensive agent neither in older adults nor in younger patients. In the management of BPH alpha-1 antagonists promise to effectively relieve urinary symptoms with uncertainty regarding their efficacy in preventing long-term progression events.

Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review

BMC Psychiatry ◽

10.1186/s12888-020-02956-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Gian Loreto D’Alò ◽

◽

Franco De Crescenzo ◽

Laura Amato ◽

Fabio Cruciani ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Grey Literature ◽

Indirect Evidence ◽

Autism Spectrum ◽

National Guidelines ◽

Adolescents With Autism ◽

Adolescents With Asd

Abstract Background It is unclear whether the administration of antipsychotics to children and adolescents with autism spectrum disorders (ASD) is acceptable, equitable, and feasible. Methods We performed a systematic review to support a multidisciplinary panel in formulating a recommendation on antipsychotics, for the development of the Italian national guidelines for the management of ASD. A comprehensive search strategy was performed to find data related to intervention acceptability, health equity, and implementation feasibility. We used quantitative data from randomized controlled trials to perform a meta-analysis assessing the acceptability and tolerability of antipsychotics, and we estimated the certainty of the effect according to the GRADE approach. We extracted data from systematic reviews, primary studies, and grey literature, and we assessed the risk of bias and methodological quality of the published studies. Results Antipsychotics were acceptable (dropouts due to any cause: RR 0.61, 95% CI 0.48–0.78, moderate certainty of evidence) and well tolerated (dropouts due to adverse events: RR 0.99, 95% CI 0.55–1.79, low certainty of evidence) by children and adolescents with ASD. Parents and clinicians did not raise significant issues concerning acceptability. We did not find studies reporting evidence of reduced equity for antipsychotics in disadvantaged subgroups of children and adolescents with ASD. Workloads, cost barriers, and inadequate monitoring of metabolic adverse events were indirect evidence of concerns for feasibility. Conclusion Antipsychotics in children and adolescents with ASD were likely acceptable and possibly feasible. We did not find evidence of concern for equity.

Genetic variants of the human host influencing the coronavirus-associated phenotypes (SARS, MERS and COVID-19): rapid systematic review and field synopsis

Human Genomics ◽

10.1186/s40246-020-00280-6 ◽

2020 ◽

Vol 14 (1) ◽

Cited By ~ 5

Author(s):

Emilio Di Maria ◽

Andrea Latini ◽

Paola Borgiani ◽

Giuseppe Novelli

Keyword(s):

Systematic Review ◽

Genetic Variants ◽

Ad Hoc ◽

Current Knowledge ◽

Rapid Review ◽

Variable Response ◽

Systemic Complications ◽

Human Host ◽

Hla Haplotypes ◽

Abstract The COVID-19 pandemic has strengthened the interest in the biological mechanisms underlying the complex interplay between infectious agents and the human host. The spectrum of phenotypes associated with the SARS-CoV-2 infection, ranging from the absence of symptoms to severe systemic complications, raised the question as to what extent the variable response to coronaviruses (CoVs) is influenced by the variability of the hosts’ genetic background. To explore the current knowledge about this question, we designed a systematic review encompassing the scientific literature published from Jan. 2003 to June 2020, to include studies on the contemporary outbreaks caused by SARS-CoV-1, MERS-CoV and SARS-CoV-2 (namely SARS, MERS and COVID-19 diseases). Studies were eligible if human genetic variants were tested as predictors of clinical phenotypes. An ad hoc protocol for the rapid review process was designed according to the PRISMA paradigm and registered at the PROSPERO database (ID: CRD42020180860). The systematic workflow provided 32 articles eligible for data abstraction (28 on SARS, 1 on MERS, 3 on COVID-19) reporting data on 26 discovery cohorts. Most studies considered the definite clinical diagnosis as the primary outcome, variably coupled with other outcomes (severity was the most frequently analysed). Ten studies analysed HLA haplotypes (1 in patients with COVID-19) and did not provide consistent signals of association with disease-associated phenotypes. Out of 22 eligible articles that investigated candidate genes (2 as associated with COVID-19), the top-ranked genes in the number of studies were ACE2, CLEC4M (L-SIGN), MBL, MxA (n = 3), ACE, CD209, FCER2, OAS-1, TLR4, TNF-α (n = 2). Only variants in MBL and MxA were found as possibly implicated in CoV-associated phenotypes in at least two studies. The number of studies for each predictor was insufficient to conduct meta-analyses. Studies collecting large cohorts from different ancestries are needed to further elucidate the role of host genetic variants in determining the response to CoVs infection. Rigorous design and robust statistical methods are warranted.

Injectable Ketorolac and Corticosteroid Use in Athletes: A Systematic Review

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120946008 ◽

2020 ◽

Vol 12 (6) ◽

pp. 521-527

Author(s):

Timothy R. Jelsema ◽

Anthony C. Tam ◽

James L. Moeller

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Corticosteroid Injection ◽

Data Extraction ◽

Return To Sport ◽

Level Of Evidence ◽

Football Game ◽

Early Return ◽

Meta Analyses ◽

Intramuscular Ketorolac

Context: The use of injectable medications to help athletes quickly return to the field of play after injury is common. Understanding the effects and risks of these medications will help providers make informed decisions regarding their use in this patient population. Objective: To evaluate the utilization, efficacy, and adverse effects of injectable ketorolac and corticosteroids in athletes. Data Sources: This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov). Secondary references were appraised for relevant articles. No randomized controlled trials or other prospective studies were identified. Articles included retrospective database reviews and physician survey studies. Study Selection: A total of 6 studies met the inclusion and exclusion criteria and were reviewed by 2 independent reviewers with a third consulted in the case of disagreement, which was not needed. Study Design: Systematic review. Level of Evidence: Level 5. Data Extraction: Two reviewers recorded rate of use, effectiveness of treatment, and reported side effect data. Results: Most studies centered around the football athlete, either professional or collegiate. Professional football game day use of intramuscular ketorolac declined from 93.3% (28/30) in 2002 to 48% in 2016. Collegiate football game day use of intramuscular ketorolac declined from 62% in 2008 to 26% in 2016. Game day corticosteroid injection was far lower than ketorolac usage. Both medications were reported to be effective with few adverse events. Conclusion: Use of injectable ketorolac is common but declining in professional and college football. Pain control efficacy is good, and risk of adverse events is low. The incidence of injectable corticosteroid use in athletes is unknown. Use of injectable corticosteroids in athletes allows for early return to sport activities with no reported complications.

The Prevalence of Allergic Rhinitis among Iranian Children: A Systematic Review and Meta-Analysis

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190515100735 ◽

2020 ◽

Vol 20 (2) ◽

pp. 189-197

Author(s):

Rasoul N. Kalmarzi ◽

Pedram Ataee ◽

Asadollah Fathollahpour ◽

Masoud Behzadifar ◽

Maryam Moradi ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Publication Bias ◽

Meta Analysis ◽

Scientific Information ◽

Educational Strategies ◽

Common Chronic Disease ◽

Iranian Children ◽

Background: The prevalence of allergic rhinitis in the world is 10-15%, and it is currently the most common chronic disease among children. There is no comprehensive statistics about the prevalence of allergic rhinitis among Iranian children, therefore, this systematic review and metaanalysis was conducted to evaluate the prevalence of allergic rhinitis among the Iranian children. Methods: The present study was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The data was collected using key words including allergic rhinitis, prevalence, epidemiology, child OR children, pediatrics and Iran, in international databases including PubMed, Scopus, Web of Science, Cochrane, Embase, and three national databases including Magiran, Iran Medex, and Scientific Information Databank (SID) till December 2018. The STROBE checklist was used for quality assessment. The data were analyzed using STATA software version 12.1. Results: The prevalence of allergic rhinitis in children and adolescents were 18% (99.7% CI: 10-28% with publication bias of 0.174) and 25% (99.8% CI: 17-33 with publication bias of 0.617) respectively. The prevalence of allergic rhinitis in males was estimated to be 27% (99.4% CI: 17-36) with publication bias of 0.538 and in females was 23% (99.4% CI: 14-31) with publication bias of 0.926. Conclusion: The prevalence of allergic rhinitis is approximately high among Iranian children and adolescents; thus, educational strategies should be considered to decrease the prevalence of this disease in Iran.