Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials

Background Anxiety is commonly experienced during the delivery process and has shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to reduce the effects of anxiety in diverse populations, are low cost, are easily accessible, and have high acceptability. The aim of this review and meta-analysis was to assess the effectiveness of music interventions in reducing anxiety levels among women during labor. Methods Seven databases from inception to the end of December, 2018, without any language or time restriction including Embase, PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health, PsycINFO, Airiti Library, and PerioPath: Index to Taiwan Periodical Literature were searched using key terms related to pregnancy, anxiety, and music. Randomized controlled trials that assessed the effect of music during labor and measured anxiety levels as an outcome were included. Meta-analyses were conducted to assess anxiety reduction following a music intervention compared to that after placebo treatment. Results A total of 14 studies that investigated a total of 1,310 participants were included in this review. The meta-analyses indicated that those in the intervention group had a significant decrease in anxiety scores (standardized mean difference = −2.40, 95% confidence interval (CI) [−3.29 to −1.52], p < 0.001; I2 = 97.66%), heart rate (HR) (difference in means = −3.04 beats/min, 95% CI [−4.79 to −1.29] beats/min, p = 0.001; I2 = 0.00%), systolic blood pressure (SBP) (difference in means = −3.71 mmHg, 95% CI [−7.07 to −0.35] mmHg, p = 0.031; I2 = 58.47%), and diastolic blood pressure (DBP) (difference in means = −3.54 mmHg, 95% CI [−5.27 to −1.81] mmHg, p < 0.001; I2 = 0.00%) as compared to the women in the control group. Conclusions Music interventions may decrease anxiety scores and physiological indexes related to anxiety (HR, SBP, and DBP). Music interventions may be a good non-pharmacological approach for decreasing anxiety levels during labor.

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Almond Consumption and Risk Factors for Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Advances in Nutrition ◽

10.1093/advances/nmz043 ◽

2019 ◽

Vol 10 (6) ◽

pp. 1076-1088 ◽

Cited By ~ 11

Author(s):

Michelle A Lee-Bravatti ◽

Jifan Wang ◽

Esther E Avendano ◽

Ligaya King ◽

Elizabeth J Johnson ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Body Weight ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Meta Analyses

ABSTRACT Evidence suggests that eating nuts may reduce the risk of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating almond consumption and risk factors for CVD. MEDLINE, Cochrane Central, Commonwealth Agricultural Bureau, and previous systematic reviews were searched from 1990 through June 2017 for RCTs of ≥3 wk duration that evaluated almond compared with no almond consumption in adults who were either healthy or at risk for CVD. The most appropriate stratum was selected with an almond dose closer to 42.5 g, with a control most closely matched for macronutrient composition, energy intake, and similar intervention duration. The outcomes included risk factors for CVD. Random-effects model meta-analyses and subgroup meta-analyses were performed. Fifteen eligible trials analyzed a total of 534 subjects. Almond intervention significantly decreased total cholesterol (summary net change: −10.69 mg/dL; 95% CI: −16.75, −4.63 mg/dL), LDL cholesterol (summary net change: −5.83 mg/dL; 95% CI: −9.91, −1.75 mg/dL); body weight (summary net change: −1.39 kg; 95% CI: −2.49, −0.30 kg), HDL cholesterol (summary net change: −1.26 mg/dL; 95% CI: −2.47, −0.05 mg/dL), and apolipoprotein B (apoB) (summary net change: −6.67 mg/dL; 95% CI: −12.63, −0.72 mg/dL). Triglycerides, systolic blood pressure, apolipoprotein A1, high-sensitivity C-reactive protein, and lipoprotein (a) showed no difference between almond and control in the main and subgroup analyses. Fasting blood glucose, diastolic blood pressure, and body mass index significantly decreased with almond consumption of >42.5 g compared with ≤42.5 g. Almond consumption may reduce the risk of CVD by improving blood lipids and by decreasing body weight and apoB. Substantial heterogeneity in eligible studies regarding almond interventions and dosages precludes firmer conclusions.

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Effects of Angiotensin-Converting Enzyme Inhibitors on Arterial Stiffness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cardiovascular Therapeutics ◽

10.1155/2020/7056184 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Xiuli Li ◽

Peng Chang ◽

Qiongying Wang ◽

Hao Hu ◽

Feng Bai ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Randomized Controlled Trials ◽

Antihypertensive Drugs ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

High Quality ◽

Randomized Controlled ◽

And Control

To determine the effects of ACEIs on arterial stiffness, a meta-analysis of randomized controlled trials was conducted. Relevant articles that investigated the effects of ACEIs on arterial stiffness from PubMed, Embase, and the Cochrane library from inception to September 2018 were systematically retrieved. The investigated outcomes included brachial-ankle pulse wave velocity (ba-PWV) and carotid-femoral PWV (cf-PWV) by using weighted mean differences (WMDs) and 95% confidence intervals (CIs) with the random-effects model. A total of 17 RCTs including 1,458 individuals were included. The summary results indicated no significant differences between ACEIs and control for ba-PWV and cf-PWV. Also, no significant differences between ACEI and control for ba-PWV and cf-PWV were observed in hypertensive patients, while the therapeutic effects of ACEI versus placebo showed statistically significant difference. Moreover, subgroup analysis indicated that the levels of ba-PWV were significantly associated if the study was conducted in Western countries, mean age <60.0 years, percentage male ≥60.0%, compared with ARBs, baseline PWV <10.0, and high-quality study. Furthermore, the significant levels of cf-PWV in patients who received ACEIs were observed when percentage male was ≥60.0% and the studies were of high-quality. Finally, no significant differences were observed between ACEIs and other antihypertensive drugs regarding the changes of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The overall analysis suggested no significant differences between ACEIs and other antihypertensive drugs for ba-PWV and cf-PWV levels, whereas ACEIs versus placebo showed lower levels of ba-PWV and cf-PWV.

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Efficacy and safety of nebivolol in hypertensive patients: a meta-analysis of randomized controlled trials

Journal of International Medical Research ◽

10.1177/0300060520931625 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052093162

Author(s):

Jun-Ying Liu ◽

Li-Na Guo ◽

Wan-Zhong Peng ◽

Yang Jiang ◽

Ai-Li Wang ◽

...

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trials ◽

Second Generation ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Efficacy And Safety ◽

Hypertensive Patients ◽

Randomized Controlled ◽

Β Blockers

Purpose Our meta-analysis was undertaken to evaluate the efficacy and safety of nebivolol compared with other second-generation β blockers for hypertensive patients. Methods We searched PubMed, the Cochrane Library, EMBASE, and Clinical Trials.gov databases for randomized controlled trials (RCTs). The efficacy endpoints included systolic blood pressure (SBP), diastolic blood pressure (DBP), reduction of SBP and DBP, heart rate (HR), and adverse events (AEs). Findings Eight RCTs with 1514 patients met the inclusion criteria. HR was significantly lower in patients receiving other second-generation β blockers compared with patients receiving nebivolol. There was no difference the reduction of blood pressure (SBP and DBP) or the reduction of SBP or DBP between the groups. The incidence of AEs was lower in patients taking nebivolol compared with patients taking other second-generation β blockers. Conclusions No significant difference was demonstrated between nebivolol and other second-generation β blockers in the reduction of blood pressure, SBP, and DBP. The tolerability of nebivolol was significantly better compared with other second-generation β blockers, and nebivolol was also associated with a stable HR and a lower risk of AEs compared with other second-generation β blockers.

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Colistin Nephrotoxicity: Meta-Analysis of Randomized Controlled Trials

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab026 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Khalid Eljaaly ◽

Monique R Bidell ◽

Ronak G Gandhi ◽

Samah Alshehri ◽

Mushira A Enani ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Random Effects Models ◽

Randomized Controlled ◽

Colistimethate Sodium ◽

Meta Analyses ◽

Risk Ratios ◽

Number Needed To Harm

Abstract Background Nephrotoxicity is a known adverse effect of polymyxin antibiotics, including colistin. Although previous meta-analyses have aimed to characterize colistin-associated nephrotoxicity risk relative to other antibiotics, included studies were observational in nature with high risk of confounding and heterogeneity. We conducted this systematic review and meta-analysis of exclusively randomized controlled trials (RCTs) to evaluate the incidence of nephrotoxicity associated with colistin versus minimally nephrotoxic antibiotics. Methods We searched PubMed, EMBASE, Cochrane Library, and 3 trial registries for RCTs comparing the nephrotoxicity of colistin to nonpolymyxin antibiotics. Randomized controlled trials that used aminoglycosides were excluded. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. The study outcome was the rate of nephrotoxicity. Results Five RCTs with a total of 377 patients were included. Most patients received colistin for pneumonia in the intensive care unit, and the comparators were β-lactam-based regimens. Colistimethate sodium was dosed at 9 million units/day (300 mg/day of colistin base activity), with administration of a loading dose in 4 studies. The nephrotoxicity incidence in patients who received colistin was 36.2% (95% CI, 23.3% to 51.3%). The nephrotoxicity rate was significantly higher in the colistin arm than comparators (RR, 2.40; 95% CI, 1.47 to 3.91; P ≤ .001; I2 = 0%), and the number needed to harm was 5. Findings persisted upon one-study-removed-analysis. Conclusions This meta-analysis of RCTs found a colistin-associated nephrotoxicity rate of 36.2% and an increase in this risk compared with β-lactam-based regimens by 140%. Colistin should be regarded as a last-line agent and safer alternatives should be considered when possible.

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Effects of Multivitamin and Multimineral Supplementation on Blood Pressure: A Meta-Analysis of 12 Randomized Controlled Trials

Nutrients ◽

10.3390/nu10081018 ◽

2018 ◽

Vol 10 (8) ◽

pp. 1018 ◽

Cited By ~ 3

Author(s):

Kelei Li ◽

Chunxiao Liu ◽

Xiaotong Kuang ◽

Qingxue Deng ◽

Feng Zhao ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Disease ◽

Systolic Blood Pressure ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled ◽

Lowering Effect ◽

Normotensive Subjects

Previous studies have not drawn a consistent conclusion about effect of multivitamin and multimineral supplementation (MVMS) on blood pressure. A comprehensive search of PubMed, Embase and Cochrane Library (up to May 2018) and references of relevant articles was undertaken. The present meta-analysis included 12 randomized controlled trials (RCTs), of which eight RCTs in 2011 subjects evaluated the effect of MVMS on blood pressure and four RCTs in 21,196 subjects evaluated the effect of MVMS on the risk of hypertension. MVMS had a lowering effect on systolic blood pressure (SBP) and diastolic blood pressure (DBP): the weighted mean difference (WMD) was −1.31 mmHg (95% CI, −2.48 to −0.14 mmHg) and −0.71 mmHg (95% CI, −1.43 to 0.00 mmHg), respectively. Subgroup analysis indicated that the lowering effect of MVMS on blood pressure was only significant in 134 subjects with chronic disease but not in 1580 healthy subjects, and the WMD for systolic blood pressure (SBP) and DBP in subjects with chronic disease was −6.29 mmHg (95% CI, −11.09 to −1.50 mmHg) and −2.32 mmHg (95% CI, −4.50 to −0.13 mmHg), respectively. The effect size of MVMS on SBP in 58 hypertensive subjects (WMD, −7.98 mmHg; 95% CI, −14.95 to −1.02 mmHg) was more than six times of that in 1656 normotensive subjects (WMD, −1.25 mmHg; 95% CI, −2.48 to −0.02 mmHg). However, no significant effect on DBP was observed in both hypertensive and normotensive subgroups. There was no significant effect of MVMS on risk of hypertension in 22,852 subjects with a normal blood pressure at baseline. In conclusion, although MVMS had a significant lowering effect on blood pressure in normotensive subjects, the lowering effect was too small to effectively prevent future hypertension. MVMS may be an effective method for blood pressure control in subjects with chronic disease including hypertension, but the sample size of subjects with hypertension or other chronic disease was too small, and more well-designed RCTs are needed to confirm this result.

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Effects of Melatonin Supplementation On Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hormone and Metabolic Research ◽

10.1055/a-0841-6638 ◽

2019 ◽

Vol 51 (03) ◽

pp. 157-164 ◽

Cited By ~ 5

Author(s):

Amir Hadi ◽

Ehsan Ghaedi ◽

Sajjad Moradi ◽

Makan Pourmasoumi ◽

Abed Ghavami ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Sensitivity Analysis ◽

Randomized Controlled Trials ◽

Publication Bias ◽

Meta Analysis ◽

Favorable Effect ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled

AbstractMelatonin is a physiological indoleamine secreted from the pineal gland into the bloodstream. This hormone has antioxidant effects in cardiovascular disease, but the evidence regarding its effects on blood pressure (BP) has not been conclusive. Therefore, we assessed the impact of melatonin supplementation on systolic BP (SBP) and diastolic BP (DBP) through a systematic review and meta—analysis of available randomized controlled trials (RCTs). Medline, Scopus, Web of Science, Cochrane library, and Google scholar (until May 2018) were searched to identify potential RCTs with information on melatonin supplementation and BP. Mean Differences (MD) were pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias. Pooling 5 RCTs (6 treatment arms) together identified significant reduction for SBP (MD: −3.43 mmHg, 95% confidence interval (CI): −5.76 to −1.09, p=0.004) and DBP (MD: −3.33 mmHg, 95% CI: −4.57 to −2.08, p<0.001) after supplementation with melatonin compared with control treatment. The sensitivity analysis indicated that the results were robust. We did not observe any evidence regarding publication bias. The findings of this meta-analysis support the overall favorable effect of melatonin supplementation on BP regulation.

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Effects of LCZ696 (Sacubitril/Valsartan) on Blood Pressure in Patients with Hypertension: A Meta-Analysis of Randomized Controlled Trials

Cardiology ◽

10.1159/000507327 ◽

2020 ◽

Vol 145 (9) ◽

pp. 589-598 ◽

Cited By ~ 1

Author(s):

Qiang Geng ◽

Rongqiang Yan ◽

Zhengzhong Wang ◽

Fangjie Hou

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trials ◽

Angiotensin Receptor Blockers ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Angiotensin Receptor ◽

Blood Pressure Lowering Effect ◽

Randomized Controlled ◽

Neprilysin Inhibitor

Background: LCZ696 (sacubitril/valsartan), a ﬁrst-in-class angiotensin receptor-neprilysin inhibitor, can significantly reduce blood pressure in patients with heart failure. We performed this meta-analysis to determine the antihypertensive effect of LCZ696 in patients with hypertension. Methods: Randomized controlled trials were searched in MEDLINE, the Cochrane Library, and Clinicaltrials.gov. Twelve studies with a total of 6,064 participants were included. Results: Compared with angiotensin receptor blockers (ARBs), LCZ696 100 mg caused a significant reduction in systolic blood pressure (SBP) (mean difference [MD] –1.58 mm Hg, 95% confidence interval [CI] –2.09 to –1.07, p < 0.05) and diastolic blood pressure (DBP) (MD –0.66 mm Hg, 95% CI –0.98 to –0.33, p < 0.05). LCZ696 200 mg caused a significant reduction in SBP (MD –4.94 mm Hg, 95% CI –6.54 to –3.35, p < 0.05), DBP (MD –2.24 mm Hg, 95% CI –2.74 to –1.75, p < 0.05), 24-h ambulatory SBP (24 h ASBP; MD –3.69 mm Hg, 95% CI –4.80 to –2.58, p < 0.05), and 24-h ADBP (MD –1.71 mm Hg, 95% CI –2.13 to –1.28, p < 0.05). LCZ696 400 mg caused a significant reduction in SBP (MD –6.25 mm Hg, 95% CI –7.90 to –4.61, p < 0.05), DBP (MD -2.30 mm Hg, 95% CI –2.80 to –1.80, p < 0.05), 24-h ASBP (MD –4.31 mm Hg, 95% CI –6.56 to –2.07, p < 0.05), and 24 h ADBP (MD –1.69 mm Hg, 95% CI –2.59 to –0.79, p < 0.05). Compared with LCZ696 200 mg, LCZ696 400 mg caused a significant reduction in SBP (MD 1.71 mm Hg, 95% CI 1.15 to 2.27, p < 0.05), DBP (MD 0.90 mm Hg, 95% CI 0.65 to 1.16, p < 0.05), 24-h ASBP (MD 1.50 mm Hg, 95% CI 0.84 to 2.17, p < 0.05), and 24-h ADBP (MD 0.76 mm Hg, 95% CI 0.47 to 1.06, p < 0.05). Conclusions: The blood pressure-lowering effect of LCZ696 is dose-related. This meta-analysis confirms the antihypertensive effects of LCZ696.

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Effect of Foot Reflexology Intervention on Depression, Anxiety, and Sleep Quality in Adults: A Meta-Analysis and Metaregression of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/2654353 ◽

2020 ◽

Vol 2020 ◽

pp. 1-21

Author(s):

Wei-Li Wang ◽

Hao-Yuan Hung ◽

Ying-Ren Chen ◽

Kuang-Huei Chen ◽

Szu-Nian Yang ◽

...

Keyword(s):

Sleep Quality ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled ◽

Adult Depression ◽

Long Term Follow Up ◽

Improve Sleep Quality ◽

Meta Analyses

Objectives. The aim of this study was to conduct a systematic review, meta-analysis, and metaregression to determine the current best available evidence of the efficacy and safety of foot reflexology for adult depression, anxiety, and sleep quality. Methods. Electronic databases (PubMed, ClinicalKey, ScienceDirect, EMBASE, PsycINFO, and the Cochrane Library) were searched till August, 10, 2020, and the validity of the eligible studies was critically appraised. Randomized controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety, and sleep quality were included. Twenty-six eligible studies were included to assess the effect of foot reflexology intervention on the reducing symptoms of depression and anxiety and improving quality of sleep, respectively, as the primary outcome. Results. Twenty-six randomized controlled trials involving 2,366 participants met the inclusion criteria. The meta-analyses showed that foot reflexology intervention significantly improved adult depression (Hedges’ g = −0.921; 95% CI: −1.246 to −0.595; P < 0.001), anxiety (Hedges’ g = −1.237; 95% CI −1.682 to −0.791; P < 0.001), and sleep quality (Hedges’ g = −1.665; 95% CI −2.361 to −0.970; P < 0.001). Metaregression reveals that an increase in total foot reflexology time (P = 0.002) and duration (P = 0.01) can significantly improve sleep quality. Conclusions. Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, high quality and rigorous design RCTs in specific population, along with an increase in participants, and a long-term follow-up are recommended in the future.

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Dose-dependent effect of nuts on blood pressure: a systematic review and meta-analysis of randomized controlled trials

10.1101/2021.05.21.21257564 ◽

2021 ◽

Author(s):

Ahmad Jayedi ◽

Tauseef Ahmad Khan ◽

Amin Mirrafiei ◽

Bahareh Jabbarzadeh ◽

Yasaman Hosseini ◽

...

Keyword(s):

Blood Pressure ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Dependent Effect ◽

Randomized Controlled ◽

Long Term Follow Up ◽

Meta Analyses ◽

Dose Dependent ◽

Dose Dependent Effect

Objective: Traditional pairwise meta-analyses indicated that nuts consumption can improve blood pressure. We iamed to determine the dose-dependent effect of nuts on systolic (SBP) and diastolic blood pressure (DBP) in adults. Methods: A systematic search was undertaken in PubMed, Scopus, and ISI Web of Science till March 2021. Randomized controlled trials (RCT) evaluating the effects of nuts on SBP and DBP in adults were included. We estimated change in blood pressure for each 20 g/d increment in nut consumption in each trial and then, calculated mean difference (MD) and 95%CI using a random-effects model. We estimated dose-dependent effect using a dose-response meta-analysis of differences in means. The certainty of evidence was rated using the GRADE instrument, with the minimal clinically important difference being considered 2 mmHg. Results: A total of 31 RCTs with 2784 participants were included. Each 20 g/d increase in nut consumption reduced SBP (MD: -0.50 mmHg, 95%CI: -0.79, -0.21; I2 = 12%, n = 31; GRADE = moderate certainty) and DBP (MD: -0.23 mmHg, 95%CI: -0.38, -0.08; I2 = 0%, n = 31; GRADE = moderate certainty). The effect of nuts on SBP was more evident in patients with type 2 diabetes (MD: -1.31, 95%CI: -2.55, -0.05; I2 = 31%, n = 6). The results were robust in the subgroup of trials with low risk of bias. Levels of SBP decreased proportionally with the increase in nuts consumption up to 40 g/d (MD40g/d: -1.60, 95%CI: -2.63, -0.58), and then appeared to plateau with a slight upward curve. A linear dose-dependent reduction was seen for DBP, with the greatest reduction at 80 g/d (MD80g/d: -0.80, 95%CI: -1.55, -0.04). Conclusions: The available evidence provides a good indication that nut consumption can result in a small improvement in blood pressure in adults. Well-designed trials are needed to confirm the findings in long term follow-up.

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Do Docosahexaenoic and Eicosapentaenoic Acids Have Similar Effects on Inflammation Markers? Pairwise and Network Meta-Analyses of Randomized Controlled Trials

Current Developments in Nutrition ◽

10.1093/cdn/nzaa045_118 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 485-485

Author(s):

Cécile Vors ◽

Janie Allaire ◽

Sonia Blanco Mejia ◽

Tauseef Khan ◽

John Sievenpiper ◽

...

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Outcome Data ◽

Cochrane Library ◽

Controlled Trials ◽

Eligibility Criteria ◽

Randomized Controlled ◽

Tnf Α ◽

Mean Differences ◽

Meta Analyses

Abstract Objectives The aim of this study was to compare the effect of DHA and EPA on several markers of systemic inflammation by pairwise and network meta-analyses of randomized controlled trials (RCTs). Methods MEDLINE, EMBASE and The Cochrane Library were searched through September 2019. We included RCTs of ≥ 7 days that directly compared the effects of DHA with EPA and RCTs of indirect comparisons, in which the effects of DHA or EPA were assessed individually compared with a control fatty acid. Differences in circulating concentrations of CRP, IL-6, TNF-α and adiponectin were the primary outcome. Data were pooled by pairwise and network meta-analysis and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic) in the pairwise meta-analysis. Inconsistency and transitivity were evaluated in the network meta-analysis. The certainty of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Results Eligibility criteria were met by 5 RCTs (N = 411) for the pairwise meta-analysis and 20 RCTs (N = 1231) for the network meta-analysis. In the pairwise meta-analysis, DHA and EPA had similar effects on plasma CRP (MDDHA vs. EPA = 0.14 mg/L [95% CI −0.57, 0.85]; I2 = 61%), IL-6 (MDDHA vs. EPA = 0.10 pg/mL [−0.15, 0.34]; I2 = 40%) and TNF-α (MDDHA vs. EPA = −0.10 pg/mL [−0.37, 0.18]; I2 = 40%). The effects of DHA and EPA on plasma CRP (MDDHA vs. EPA = −0.33 mg/L [−0.75, 0.10]), IL-6 (MDDHA vs. EPA = 0.09 pg/mL [−0.12, 0.30]) and TNF-α (MDDHA vs. EPA = −0.02 pg/mL [−0.25, 0.20]) were also similar according to the network meta-analysis. DHA and EPA had similar effects on plasma adiponectin in the network meta-analysis. Conclusions The present pairwise and network meta-analyses comparing EPA to DHA suggest that DHA and EPA do not differentially modify systemic markers of subclinical inflammation. Funding Sources The authors have no funding to report.

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