scholarly journals Effects ofVacciniumBerries on Serum Lipids: A Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Yitong Zhu ◽  
Ya Miao ◽  
Zheying Meng ◽  
Yuan Zhong
Keyword(s):  
Randomized Controlled Trials ◽  
Serum Lipids ◽  
Meta Analysis ◽  
The Other ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Insufficient Evidence ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Epidemiologic Evidence

The beneficial effects of anthocyanins consumption on cardiovascular risk are supported by mechanistic and epidemiologic evidence. In order to explore the effects ofVacciniumberries rich in anthocyanins on serum lipids, we conducted a meta-analysis of relevant randomized controlled trials (RCTs). Sixteen studies with 1109 subjects were included in this meta-analysis. Significant heterogeneity confirmed differential effects betweenVacciniumsubclasses. The whortleberry group is significantly superior to placebo in lipids improvement. Besides, bilberry groups show significant differences in reducing LDL-C and increasing HDL-C in comparison with other treatments. For many of the other subgroups and comparison arms, there was insufficient evidence to draw conclusions about efficacy.

scholarly journals Chinese Medicines as an Adjuvant Therapy for Unresectable Hepatocellular Carcinoma during Transarterial Chemoembolization: A Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-25 ◽  
Author(s):  
Fan Cheung ◽  
Xuanbin Wang ◽  
Ning Wang ◽  
Man-Fung Yuen ◽  
Tat-chi Ziea ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Chinese Medicines ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Long Term Follow Up

Objective. To conduct a comprehensive PRISMA-compliant systematic review and meta-analysis to evaluate the efficacy and safety of Chinese medicines (CMs) as an adjuvant therapy for unresectable HCC during transarterial chemoembolization (TACE).Methods. Main databases were searched up to October 2012 for randomized controlled trials (RCTs) evaluating the effects of CMs plus TACE on unresectable HCC compared with TACE alone. References of relevant reviews and eligible studies were also assessed. Risk ratios with 95% confidence intervals and mean difference were calculated. Heterogeneity and publication bias were examined.Results. Sixty-seven trials (N= 5,211) were included in the meta-analysis. Sensitivity analysis and random-effects model were performed for assessing significant heterogeneity. CMs plus TACE showed beneficial effects on tumor response, survival at 6, 12, 18, 24, and 36 months, quality of life, and TACE toxicity reduction compared with TACE alone.Conclusion. The results show that the use of CMs may increase the efficacy and reduce the toxicity of TACE in treating patients with unresectable HCC. These findings suggest that CMs could be considered as an adjuvant therapy for unresectable HCC patients during TACE. Larger-scale RCTs using standard methods and long-term follow-up are warranted to confirm these findings.

scholarly journals Efficacy and Safety of Adjunctive Aripiprazole, Metformin, and Paeoniae–Glycyrrhiza Decoction for Antipsychotic-Induced Hyperprolactinemia: A Network Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Ling Zhang ◽  
Han Qi ◽  
Yun-Yi Xie ◽  
Wei Zheng ◽  
Xiao-Hui Liu ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Adverse Drug Events ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Posterior Odds ◽  
Treatment Groups ◽  
Beneficial Effects ◽  
Randomized Controlled

Aripiprazole, metformin, and paeoniae–glycyrrhiza decoction (PGD) have been widely used as adjunctive treatments to reduce antipsychotic (AP)-induced hyperprolactinemia in patients with schizophrenia. However, the comparative efficacy and safety of these medications have not been previously studied. A network meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety between aripiprazole, metformin, and PGD as adjunctive medications in reducing AP-induced hyperprolactinemia in schizophrenia. Both international (PubMed, PsycINFO, EMBASE, and Cochrane Library databases) and Chinese (WanFang, Chinese Biomedical, and Chinese National Knowledge infrastructure) databases were searched from their inception until January 3, 2019. Data were analyzed using the Bayesian Markov Chain Monte Carlo simulations with the WinBUGS software. A total of 62 RCTs with 5,550 participants were included in the meta-analysis. Of the nine groups of treatments included, adjunctive aripiprazole (<5 mg/day) was associated with the most significant reduction in prolactin levels compared to placebo (posterior MD = −65.52, 95% CI = −104.91, −24.08) and the other eight treatment groups. Moreover, adjunctive PGD (>1:1) was associated with the lowest rate of all-cause discontinuation compared to placebo (posterior odds ratio = 0.45, 95% CI = 0.10, 3.13) and adjunctive aripiprazole (>10 mg/day) was associated with fewer total adverse drug events than placebo (posterior OR = 0.93, 95% CI = 0.65, 1.77) and other eight treatment groups. In addition, when risperidone, amisulpride, and olanzapine were the primary AP medications, adjunctive paeoniae/glycyrrhiza = 1:1, aripiprazole <5 mg/day, and aripiprazole >10 mg/day were the most effective treatments in reducing the prolactin levels, respectively. Adjunctive aripiprazole, metformin, and PGD showed beneficial effects in reducing AP-induced hyperprolactinemia in schizophrenia, with aripiprazole (<5 mg/day) being the most effective one.

scholarly journals Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liping Gou ◽  
Zhenghao Wang ◽  
Ye Zhou ◽  
Xiaofeng Zheng
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Bladder Stones ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficiency of nephroscopy and cystoscopy in transurethral cystolithotripsy (TUCL) for bladder stones (BS). Methods The PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases were searched up to January 2021 for studies assessing the effect of different types of endoscopes among patients who underwent TUCL. The search strategy and study selection process were in accordance with the PRISMA statement. Results Five randomized controlled trials were included in the meta-analysis. The results showed no difference in stone-free rate (RR = 1.00, CI = 0.98–1.02, p = 1.00) between the two groups and nonsignificant heterogeneity (I2 = 0%, p = 1.00), and all patients were rendered stone free. Use of the nephroscope significantly shortened the operative time compared with the cystoscope group (RR= − 26.26, CI = − 35.84 to − 16.68, p < 0.00001), and there was significant heterogeneity (I2= 87%, p < 0.00001). There was no significant difference in mean urethral entries (RR = 0.66, CI = − 0.71 to − 2.04, p = 0.35), hospitalization (MD = 0.08, 95% CI = − 0.07 to 0.23, p = 0.31) or total complication rate (RR=1.37, 95% CI = 0.47–4.00, p = 0.56) between the two groups. Conclusions In conclusion, this systematic review demonstrates that both nephroscopy and cystoscopy have high stone clearance efficiency, low rates of complications and short hospitalizations. The mean urethral entries depend on the treatment method for large stone fragments. However, the use of nephroscopy can significantly reduce the operative time.

scholarly journals Efficacy of remdesivir versus placebo for the treatment of COVID-19: A protocol for systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Desye Gebrie ◽  
Desalegn Getnet ◽  
Tsegahun Manyazewal
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Antiviral Drug ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
List Type ◽  
Randomized Controlled

AbstractBackgroundIn spite of the global containment on prevention efforts, the spread of coronavirus disease 2019 (COVID-19) is continuing to rise, with 1.1 million confirmed cases and 60,124 deaths recorded worldwide since 04 April 2020. The outbreak has a significant threat to international health and economy. At present, there is no approved vaccine or treatment for the disease, while efforts are underway. Remdesivir, a nucleotide-analogue antiviral drug developed for Ebola, is determined to prevent and stop infections with COVID-19, while results are yet controversial. Here, we aim to conduct a systematic review and meta-analysis of randomized controlled trials to compare the effectiveness of remdesivir and placebo in patients with COVID-19.Method and analysisWe will search MEDLINE-PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and Google scholar databases without restriction in year of publication. We will include randomized controlled trials that assessed the effectiveness of remdesivir versus placebo for patients confirmed with COVID-19. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2015) guidelines for the design and reporting of the results. The primary endpoint will be time to clinical recovery. The secondary endpoints will be all cause mortality, discharged date, frequency of respiratory progression, and treatment-emergent adverse events. Two independent authors will perform study selection, data extraction, and methodology quality assessment. RevMan 5.3 software will be used for statistical analysis. Random/fixed effect model will be carried out to calculate mean differences for continuous outcomes and risk ratio for dichotomous outcomes between remdesivir and placebo.Ethics and disseminationThis study does not require ethical approval, because no participant’s data will be involved in this systematic review and meta-analysis. The findings of this study will be published in reputable and peer-reviewed journal.RegistrationThis review protocol is submitted in PROSPERO database for registration and we will include the registration number in the revised version of the manuscript.Strengths and limitations of this study➣This systematic review and meta-analysis will be derived from only randomized controlled trials which will increase the quality of evidences.➣This systematic review and meta-analysis will be derived from only randomized controlled trials which will reduce between study heterogeneity.➣Subgroup and sensitivity analysis will be carried out to identify possible reasons that may cause significant heterogeneity between studies.➣The use of Cochrane risk of bias tool to assess risk of bias for each included studies to extract and synthesize evidence based conclusions.➣One of the limitation of this study might be the restriction of trials published in English language.

Poly adenosine diphosphate ribose polymerase inhibitors maintenance in patients with ovarian cancer: A systematic review and meta-analysis of randomized controlled trials.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17081-e17081
Author(s):  
Thura WIN Htut ◽  
Aung Tun ◽  
Anita Sultan ◽  
Sriman Swarup ◽  
Myo Zaw ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Adenosine Diphosphate ◽  
Parp Inhibitors ◽  
The Other ◽  
Phase Iii ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Platinum Based Chemotherapy

e17081 Background: Ovarian cancer is the deadliest of gynecologic cancers and many recur despite achieving a clinical response to initial platinum-based chemotherapy. The use of poly adenosine diphosphate ribose polymerase (PARP) inhibitors maintenance has shown to improve survival in ovarian cancer. Methods: MEDLINE, EMBASE databases and meeting abstracts from inception through January 2019 were queried. Phase 3 randomized controlled trials (RCT) which employed PARP inhibitors maintenance in ovarian cancer were incorporated in the analysis. A generic inverse variance method was used to calculate the estimated pooled hazard ratio (HR) for progression-free survival (PFS) with 95% confidence interval (CI). Heterogeneity was assessed with Cochrane Q -statistic. Random effects were used due to some heterogeneity among studies. Results: Four phase III RCTs with a total of 1792 patients were eligible. The study arm used olaparib or niraparib or rucaparib while the control arm utilized placebo. The randomization ratio was 2:1 in all studies. Participants were sensitive to platinum-based chemotherapy, as newly diagnosed in SOLO-1 trial and had been previously on two such regimens in the other trials, with an objective response. Almost all patients in the SOLO-2 and SOLO-1 trials had a gBRCA mutation, while there were patients with and without the said mutation in the other two studies. The pooled HR for PFS was statistically significant at 0.32 (95% CI: 0.27-0.38; P < 0.0001), including gBRCA cohort (HR, 0.28; 95% CI: 0.24-0.33; P < 0.0001) and non-gBRCA cohort (HR, 0.39; 95% CI: 0.32-0.48; P < 0.0001). Conclusions: Our meta-analysis demonstrated that the use of maintenance therapy with PARP inhibitors significantly improved PFS compared to placebo, regardless of the presence or absence of gBRCA mutation.

P653PCSK-9 inhibitors and acute coronary syndrome in hyperlipidemic patients: a systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A A Asbeutah ◽  
A M Asbeutah ◽  
M A Abu-Assi ◽  
F K Welty
Keyword(s):  
Acute Coronary Syndrome ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Inhibitor Therapy ◽  
Controlled Trials ◽  
Number Needed To Treat ◽  
Significant Heterogeneity ◽  
Coronary Syndrome ◽  
Randomized Controlled ◽  
Coronary Events

Abstract Introduction Hyperlipidemia has been associated with several adverse cardiac and cerebrovascular events. Treatment with statins has proven to reduce the risk of cardiovascular events, however not all patients could reach adequate low-density lipoprotein targets or tolerate statin therapy. This has led to a recent increase in the use of PCSK-9 inhibitors for management of uncontrolled hyperlipidemia. Purpose Effect of PCSK-9 inhibitors on the reduction of acute coronary events in patients with hyperlipidemia. Methods A systematic search of electronic databases for published phase 2 or 3 randomized controlled trials involving hyperlipidemic adults on PCSK-9 inhibitors was conducted. Trials involving evolocumab or alirocumab were included in the analysis. The end points of myocardial infarction and unstable angina were computed together as the composite outcome of acute coronary events. Meta-analysis using a random effects model, with dichotomous outcomes expressed as odds ratios (OR) with 95% confidence intervals (CI), was performed. Results Thirty randomized controlled trials comprising 62,961 patients were included in the meta-analysis, including the recently published ODYSSEY OUTCOMES trial with 18,942 patients. Analysis was stratified according to PCSK-9 inhibitor, either evolocumab or alirocumab. In the stratified analysis, evolocumab was associated with a significantly lower rate of acute coronary events with an OR: 0.79 (95% CI, 0.72–0.87; P<0.001). In contrast, alirocumab was not associated with a significantly lower rate of acute coronary events with an OR: 0.71 (95% CI, 0.47–1.10; P=0.12). For the combined group, compared with no PCSK-9 inhibitor therapy, PCSK9 inhibitor therapy was associated with a significantly lower rate of acute coronary events (4.3% versus 5.8%; OR: 0.81 (95% CI, 0.75–0.87; P<0.001). The modest reduction of risk of acute coronary events of 1.5% translates into a number needed to treat of 67. Neither publication bias, nor significant heterogeneity was observed in the analysis. Acute coronary events Conclusions PCSK-9 inhibitor therapy significantly reduces the risk of acute coronary syndrome when compared to the usual standard of care in adults with uncontrolled hyperlipidemia.

scholarly journals The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 118 ◽  
Author(s):  
Yanjie Zhang ◽  
Paul D. Loprinzi ◽  
Lin Yang ◽  
Jing Liu ◽  
Shijie Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Vas Scores

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status.

A Meta-analysis of Outcomes After Routine Aspiration of the Gallbladder During Cholecystectomy

2011 ◽  
Vol 96 (1) ◽  
pp. 21-27 ◽  
Author(s):  
M. R. S. Siddiqui ◽  
M. S. Sajid ◽  
A. Nisar ◽  
H. Ali ◽  
A. Zaborszky ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Random Effects ◽  
Meta Analysis ◽  
Gallbladder Perforation ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Random Effects Model ◽  
Infection Rates ◽  
Randomized Controlled ◽  
Significant Difference

Abstract We conducted a meta-analysis of published literature comparing outcomes after aspirating (ASP) the gallbladder versus nonaspiration (NASP). Electronic databases were searched from January 1985 to November 2009. A meta-analysis was performed to obtain a summative outcome. Two randomized, controlled trials involving 360 patients were analyzed. A total of 180 patients were in the ASP group, and 180 were in the NASP group. There was no significant increase in operative time in the ASP group compared with the NASP group [random-effects model: standardized mean difference, −0.72; 95% confidence interval (CI), −2.16, 0.71; z  =  0.99; df  =  1; P  =  0.32], but there was significant heterogeneity among trials (Q  =  42.4; P &lt; 0.001; I2  =  98%). Patients undergoing ASP were less likely to have a gallbladder perforation [random-effects model: risk ratio (RR), 0.42; 95% CI, 0.19, 0.96; z  =  2.05; df  =  1; P &lt; 0.05], but no difference was found regarding the loss of gallstones (random-effects model: RR, 1.33; 95% CI, 0.30, 5.85; z  =  0.38; df  =  1; P  =  0.70). No difference was seen for liver bed bleeding (P  =  0.43) or overall 30-day infection rates (P  =  0.66). After aspiration, gallbladder perforation rates may be lower. This does not appear to translate into decreased loss of gallstones or infection rates. There was no significant difference between techniques in blood loss from the liver bed. Further randomized, controlled trials and follow-up studies are required to confirm these results and to establish long-term sequelae.

scholarly journals Is metoclopramide beneficial for the post-pyloric placement of nasoenteric tubes? A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xin Ouyang ◽  
Rong Qu ◽  
Bei Hu ◽  
Yifan Wang ◽  
Fen Yao ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Success Rate ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Beneficial Effects ◽  
Randomized Controlled

Abstract BackgroundMetoclopramide is frequently prescribed as an adjuvant for the post-pyloric placement of nasoenteric tubes (NETs). However, the efficacy and safety of metoclopramide remain controversial. The latest meta-analysis showed that metoclopramide was not beneficial in adults. Thus, this study aimed to reevaluate the effect of metoclopramide on the post-pyloric placement of NETs.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data was conducted up to August 2020 for randomized controlled trials (RCTs) comparing metoclopramide with placebo or no intervention. The effect sizes of eligible studies were pooled using the relative risk (RR) and 95% confidence interval (CI) in a random-effects model. Trial sequential analysis (TSA) was used for the primary outcomes (the success rate of the post-pyloric placement of NETs).ResultsSeven eligible RCTs that included 520 participants were identified. The results of the pooled effect sizes showed that metoclopramide significantly facilitated the post-pyloric placement of NETs (RR, 1.48; 95% CI, 1.11–1.97; P = 0.007; I2 = 37%). However, the risk of bias assessment and the TSA results indicated that the qualities of the RCTs and the sample sizes were insufficient to confirm the efficacy of metoclopramide. Further subgroup analysis revealed that successful post-pyloric placement was more pronounced in studies in which spiral NETs were employed (RR, 1.85; 95% CI, 1.41–2.43; P < 0.001; I2 = 0%). Additionally, a significant increase in the success rate was also observed for post-D1 (reaching the second portion of the duodenum or beyond), post-D2 (reaching the third portion of the duodenum or beyond), and post-D3 (reaching the fourth portion of the duodenum or beyond) placement of spiral NETs. Overall adverse events were minimal.ConclusionsThe evidence accumulated so far was not strong enough to demonstrate metoclopramide’s beneficial effects on the post-pyloric placement of NETs; however, it might be effective for spiral NETs. Further high-quality, large-sample RCTs are required to elucidate the effects of metoclopramide.Trial registrationPROSPERO CRD42019123424 (10 July 2019)

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