scholarly journals Efficacy of PD-1 or PD-L1 inhibitors and PD-L1 expression status in cancer: meta-analysis

BMJ ◽  
2018 ◽  
pp. k3529 ◽  
Author(s):  
Xian Shen ◽  
Bin Zhao
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Clinical Benefits ◽  
American Society ◽  
Randomised Controlled ◽  
Expression Status

Abstract Objective To evaluate the relative efficacy of programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors versus conventional drugs in patients with cancer that were PD-L1 positive and PD-L1 negative. Design Meta-analysis of randomised controlled trials. Data sources PubMed, Embase, Cochrane database, and conference abstracts presented at the American Society of Clinical Oncology and European Society of Medical Oncology up to March 2018. Review methods Studies of PD-1 or PD-L1 inhibitors (avelumab, atezolizumab, durvalumab, nivolumab, and pembrolizumab) that had available hazard ratios for death based on PD-L1 positivity or negativity were included. The threshold for PD-L1 positivity or negativity was that PD-L1 stained cell accounted for 1% of tumour cells, or tumour and immune cells, assayed by immunohistochemistry staining methods. Results 4174 patients with advanced or metastatic cancers from eight randomised controlled trials were included in this study. Compared with conventional agents, PD-1 or PD-L1 inhibitors were associated with significantly prolonged overall survival in both patients that were PD-L1 positive (n=2254, hazard ratio 0.66, 95% confidence interval 0.59 to 0.74) and PD-L1 negative (1920, 0.80, 0.71 to 0.90). However, the efficacies of PD-1 or PD-L1 blockade treatment in patients that were PD-L1 positive and PD-L1 negative were significantly different (P=0.02 for interaction). Additionally, in both patients that were PD-L1 positive and PD-L1 negative, the long term clinical benefits from PD-1 or PD-L1 blockade were observed consistently across interventional agent, cancer histotype, method of randomisation stratification, type of immunohistochemical scoring system, drug target, type of control group, and median follow-up time. Conclusions PD-1 or PD-L1 blockade therapy is a preferable treatment option over conventional therapy for both patients that are PD-L1 positive and PD-L1 negative. This finding suggests that PD-L1 expression status alone is insufficient in determining which patients should be offered PD-1 or PD-L1 blockade therapy.

scholarly journals Adverse events of exercise therapy in randomised controlled trials: a systematic review and meta-analysis

2019 ◽  
Vol 54 (18) ◽  
pp. 1073-1080 ◽  
Author(s):  
Andre Niemeijer ◽  
Hans Lund ◽  
Signe Nilssen Stafne ◽  
Thomas Ipsen ◽  
Cathrine Luhaäär Goldschmidt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Adverse Events ◽  
Exercise Therapy ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Randomised Controlled

ObjectiveTo evaluate the relative risk (RR) of serious and non-serious adverse events in patients treated with exercise therapy compared with those in a non-exercising control group.DesignSystematic review and meta-analysis.Data sourcesPrimary studies were identified based on The Cochrane Database of Systematic Reviews investigating the effect of exercise therapy.Eligibility criteriaAt least two of the authors independently evaluated all identified reviews and primary studies. Randomised controlled trials were included if they compared any exercise therapy intervention with a non-exercising control. Two authors independently extracted data. The RR of serious and non-serious adverse events was estimated separately.Results180 Cochrane reviews were included and from these, 773 primary studies were identified. Of these, 378 studies (n=38 368 participants) reported serious adverse events and 375 studies (n=38 517 participants) reported non-serious adverse events. We found no increase in risk of serious adverse events (RR=0.96 (95%CI 0.90 to 1.02, I2: 0.0%) due to exercise therapy. There was, however, an increase in non-serious adverse events (RR=1.19 (95%CI 1.09 to 1.30, I2: 0.0%). The number needed to treat for an additional harmful outcome for non-serious adverse events was 6 [95%CI 4 to 11).ConclusionParticipating in an exercise intervention increased the relative risk of non-serious adverse events, but not of serious adverse events. Exercise therapy may therefore be recommended as a relatively safe intervention.PROSPERO registration numberCRD42014014819.

Effects of jump training on jumping performance of handball players: A systematic review with meta-analysis of randomised controlled trials

2020 ◽  
Vol 15 (4) ◽  
pp. 584-594 ◽  
Author(s):  
Rodrigo Ramirez-Campillo ◽  
Cristian Alvarez ◽  
Antonio Garcia-Hermoso ◽  
Justin WL Keogh ◽  
Felipe García-Pinillos ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Countermovement Jump ◽  
Jumping Performance ◽  
Jump Training ◽  
Jump Exercise ◽  
Randomised Controlled

This study aimed to assess the effects of jump training on the jumping performance of handball players compared with a control condition. The data sources utilised were PubMed, MEDLINE, Web of Science Core Collection and SCOPUS. Only peer-review randomised controlled trials were included. The inclusion criteria comprised: a jump training programme of at least 2 weeks; a control group; the assessment of the countermovement jump. The Physiotherapy Evidence Database scale was used to assess the risk of bias and methodological quality of eligible studies included in the meta-analysis. Risk of publication bias across studies was assessed using the extended Egger’s test. Cohen’s d effect sizes (ESs) were calculated from the countermovement jump and presented together with 95% confidence intervals (CIs). From 6108 records initially identified through database searching, 5 were eligible for meta-analysis. A significant improvement in countermovement jump height was observed, corresponding to 6.4 cm (95% CI = 4.9–7.9; Z = 8.4, p < 0.001), showing moderate heterogeneity ( I2 = 51.4%). The magnitude of the main effect was very large (ES = 2.2 (95% CI = 0.95–3.4), Z = 3.5, p < 0.001). Jump training is effective in increasing vertical jump performance in handball players. However, the insufficient number of studies conducted precluded analyses of moderator variables. In future, researchers are advised to conduct jump training studies of high methodological quality (e.g. randomised controlled trials) and assess different jump exercise prescriptions across handball players of different sexes, ages and competitive levels to analyse if exercise prescription and player characteristics may influence training responses.

Effects of different delivering matrices of β-glucan on lipids in mildly hypercholesterolaemic individuals: a meta-analysis of randomised controlled trials

2020 ◽  
pp. 1-14
Author(s):  
Dengfeng Xu ◽  
Hechun Liu ◽  
Chao Yang ◽  
Hui Xia ◽  
Da Pan ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Significant Difference ◽  
Liquid Products ◽  
Randomised Controlled

Abstract β-Glucan has been reported for its health benefits on blood lipids in hypercholesterolaemic individuals for years. However, people have paid little attention to the effects of β-glucan in populations with mild hypercholesterolaemia as well as the various delivering matrices. Our objective was to perform a meta-analysis to analyse the effects of β-glucan with different delivering matrices in mildly hypercholesterolaemic individuals. After conducting a comprehensive search in Web of Science, PubMed, Scopus and Cochrane Library, a total of twenty-one randomised controlled trials involving 1120 participants were identified to measure the pooled effect. The overall results indicated that consuming a dose of ≥3 g/d of β-glucan for at least 3 weeks could significantly reduce total cholesterol (TC) (−0·27 mmol/l, 95 % CI −0·33, −0·21, P < 0·001) and LDL-cholesterol (−0·26 mmol/l, 95% CI −0·32, −0·20, P < 0·001) compared with the control group in mildly hypercholesterolaemic individuals, while no significant difference was observed in TAG (−0·03 mmol/l, 95% CI −0·11, 0·06, P = 0·521) and HDL-cholesterol (0·01 mmol/l, 95% CI −0·03, 0·04, P = 0·777). There was evidence for modest unexplained heterogeneity in the meta-analysis. In conclusion, β-glucan can significantly reduce risk factors like TC and LDL-cholesterol for CVD in mildly hypercholesterolaemic individuals; furthermore, it appears that the effects of food matrices with both ‘solid products’ and ‘liquid products’ where β-glucan was incorporated into were ranked as the best way to exert its beneficial properties, while ‘liquid’ and ‘solid’ products were ranked as the second and third positions, respectively.

scholarly journals Efficacy and Adverse Effects of Atropine for Myopia Control in Children: A Meta-Analysis of Randomised Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
ChunWen Chen ◽  
JingYan Yao
Keyword(s):  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Rebound Effect ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
High Dose ◽  
Myopia Progression ◽  
Statistical Heterogeneity ◽  
Randomised Controlled

Objectives. To explore the rebound effects and safety of atropine on accommodation amplitude in slowing myopia progression. Methods. We conducted a meta-analysis to testify proper dosage of atropine in children with myopia. We searched in PubMed, EMBASE, Ovid, and the Cochrane Library up to March 30, 2021. We selected randomised controlled trials (RCTs) that evaluated the efficacy of atropine for controlling myopia progression in children. We performed the inverse variance random-effects model to pool the data using mean difference (MD) for continuous variables. Statistical heterogeneity was assessed using the I2 test. Additionally, we conducted subgroup analyses and sensitivity analyses. Results. Seventeen RCTs involving 2955 participants were included. Myopia progression was significantly less in the atropine group than that of the control group, with MD = 0.38 D per year (95% confidence interval, 0.20 to 0.56). Less axial elongation was shown with MD = −0.19 mm per year (95% CI, −0.25 to −0.12). There was a statistically difference among various doses ( p = 0.00001 ). In addition, 1.0% atropine showed the rebound effect with MD = −0.54 D per year (95% CI, −0.81 to −0.26) and was more effective in the latter six months than in the former one. Less accommodation amplitude was shown in 0.01% atropine. Conclusion. The efficacy of atropine is dose dependent, and 0.01% atropine may be the optimal dose in slowing myopia progression in children with no accommodation dysfunction. A rebound effect is more prominent in high-dose atropine in the former cessation after discontinuation.

Safety and effect of sildenafil on treating paediatric pulmonary arterial hypertension: a meta-analysis on the randomised controlled trials

2020 ◽  
Vol 30 (12) ◽  
pp. 1882-1889
Author(s):  
Qingyou Zhang ◽  
Bowen Xu ◽  
Jichen Lv ◽  
Zhijian Wang ◽  
Junbao Du
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Hypertensive Crisis ◽  
Control Group ◽  
Controlled Trials ◽  
Pulmonary Arterial ◽  
Randomised Controlled

AbstractBackground:Efficacy of sildenafil in treating paediatric pulmonary arterial hypertension is controversial. This systematic review aimed to explore the safety and effect of sildenafil on treating paediatric pulmonary arterial hypertension (PAH) through meta-analysis.Methods and results:In this study, the electronic databases, including the Cochran Library database, EMBASE, and MEDLINE were systemically retrieved to identify the related randomised controlled trials (RCTs). Two reviewers had independently completed study selection, data collection, and assessment of the bias risk. Amongst 938 articles researched according to our retrieval strategy, 15 papers that involved 673 cases had been screened. Relative to control group, the sildenafil group had markedly reduced mortality (RR = 0.25, 95% CI: 0.12–0.51; p < 0.0001), but difference within the mortality was not statistically significant between high- and low-dose sildenafil groups (p = 0.152). Nonetheless, difference of the mean pulmonary arterial pressure between sildenafil as well as control group was of no statistical significance. Differences in the length of hospital stay and the incidences of pulmonary hypertensive crisis between children with PAH and controls were of no statistical significance. However, the summary estimate favoured that sildenafil reduced the duration of mechanical ventilation time, as well as the length of ICU stay and inotropic support.Conclusions:Sildenafil therapy reduces the mortality of PAH patients, but its effects on the haemodynamic outcomes and other clinical outcomes are still unclear.

scholarly journals Adjunctive Peony-Glycyrrhiza decoction for antipsychotic-induced hyperprolactinaemia: a meta-analysis of randomised controlled trials

2018 ◽  
Vol 31 (1) ◽  
pp. e100003 ◽  
Author(s):  
Wei Zheng ◽  
Dong-Bin Cai ◽  
Hai-Yan Li ◽  
Yu-Jie Wu ◽  
Chee H Ng ◽  
...  
Keyword(s):  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Adult Patients ◽  
Current Evidence ◽  
Cochrane Library ◽  
Serum Prolactin ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomised Controlled

BackgroundHyperprolactinaemia is a common adverse effect of antipsychotics (APs). The results of Peony-Glycyrrhiza decoction (PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent.AimThis meta-analysis of randomised controlled trials (RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia.MethodsEnglish (PubMed, Embase, Cochrane Library, PsycINFO) and Chinese (Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PICOS—Participants: adult patients with schizophrenia; Intervention: PGD plus APs; Comparison: APs plus placebo or AP monotherapy; Outcomes: efficacy and safety; Study design: RCTs. The weighted mean difference (WMD) and risk ratio (RR) along with their 95% CIs were calculated using Review Manager (RevMan) V.5.3 software.ResultsFive RCTs (n=450) were included and analysed. Two RCTs (n=140) were double-blind and four RCTs (n=409) reported ‘random’ assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group (n=380, WMD: −32.69  ng/mL (95%  CI −41.66 to 23.72), p<0.00001, I2=97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale (n=403, WMD: −0.62 (95% CI −2.38 to 1.15), p=0.49, I2=0%). There were similar rates of all-cause discontinuation (n=330, RR 0.93 (95% CI 0.63 to 1.37), p=0.71, I2=0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from ‘very low’ (14.3%), ‘low’ (42.8%), ‘moderate’ (14.3%), to ‘high’ (28.6%).ConclusionsCurrent evidence supports the adjunctive use of PGD to suppress elevated prolactin and improve prolactin-induced symptoms without significant adverse events in adult patients with AP-induced hyperprolactinaemia. High-quality RCTs with longer duration are needed to confirm these findings.Trial registration number42016037017.

scholarly journals A Systematic Review and Meta-Analysis ofGinkgo bilobain Neuropsychiatric Disorders: From Ancient Tradition to Modern-Day Medicine

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Natascia Brondino ◽  
Annalisa De Silvestri ◽  
Simona Re ◽  
Niccolò Lanati ◽  
Pia Thiemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Peripheral Nerve Damage ◽  
Clinical Benefits ◽  
Schizophrenic Patients ◽  
Randomised Controlled ◽  
Neuropsychiatric Conditions

Ginkgo biloba(Gb) has demonstrated antioxidant and vasoactive properties as well as clinical benefits in several conditions such as ischemia, epilepsy, and peripheral nerve damage. Additionally, Gb is supposed to act as potential cognitive enhancer in dementia. So far, several trials have been conducted to investigate the potential effectiveness of Gb in neuropsychiatric conditions. However, the results of these studies remain controversial. We conducted a systematic review and a meta-analysis of three randomised controlled trials in patients with schizophrenia and eight randomised controlled trials in patients with dementia. Gb treatment reduced positive symptoms in patients with schizophrenia and improved cognitive function and activities of daily living in patients with dementia. No effect of Gb on negative symptoms in schizophrenic patients was found. The general lack of evidence prevents drawing conclusions regarding Gb effectiveness in other neuropsychiatric conditions (i.e., autism, depression, anxiety, attention-deficit hyperactivity disorder, and addiction). Our data support the use of Gb in patients with dementia and as an adjunctive therapy in schizophrenic patients.

scholarly journals Do exercise-based prevention programmes reduce non-contact musculoskeletal injuries in football (soccer)? A systematic review and meta-analysis with 13 355 athletes and more than 1 million exposure hours

2021 ◽  
pp. bjsports-2020-103683
Author(s):  
Italo Ribeiro Lemes ◽  
Rafael Zambelli Pinto ◽  
Vitor N Lage ◽  
Bárbara A B Roch ◽  
Evert Verhagen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Musculoskeletal Injuries ◽  
Physical Contact ◽  
Control Group ◽  
Football Players ◽  
Controlled Trials ◽  
Prevention Programmes ◽  
Randomised Controlled

ObjectiveThe aim of this systematic review was to investigate the effect of exercise-based programmes in the prevention of non-contact musculoskeletal injuries among football players in comparison to a control group.DesignSystematic review and meta-analysis of randomised controlled trials.Data sourcesMEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SPORTDiscus databases were searched from the earliest record to January 2021.Eligibility criteriaStudies were eligible if they (1) included football players aged 13 years or older, (2) used exercise-based programmes as intervention, (3) presented the number of non-contact musculoskeletal injuries (ie, defined as any acute sudden onset musculoskeletal injury that occurred without physical contact) and exposure hours for each group, and (4) had a control group (eg, usual training, minimal intervention, education). All types of exercise-based prevention programmes were eligible for inclusion. Risk of bias for each included study and overall quality of evidence for the meta-analysis were assessed.ResultsTen original randomised controlled trials with 13 355 football players and 1 062 711 hours of exposure were selected. Pooled injury risk ratio showed very low-quality evidence that exercise-based prevention programmes reduced the risk of non-contact musculoskeletal injuries by 23% (0.77 (95% CI 0.61 to 0.97)) compared with a control group.ConclusionExercise-based prevention programmes may reduce the risk of non-contact musculoskeletal injuries by 23% among football players. Future high-quality trials are still needed to clarify the role of exercise-based programmes in preventing non-contact musculoskeletal injuries among football players.PROSPERO registration numberCRD42020173017.

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