scholarly journals Trichloroacetic Acid Peeling for Treating Photoaging: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Irma Bernadette S. Sitohang ◽  
Lili Legiawati ◽  
Lis Surachmiati Suseno ◽  
Fadhila Dea Safira
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Combination Therapy ◽  
Adverse Events ◽  
Trichloroacetic Acid ◽  
Prospective Trial ◽  
Treatment Result ◽  
Secondary Outcome ◽  
Skin Rejuvenation ◽  
Skin Preparation

Photoaging can significantly contribute to lower quality of life. Medium-deep peeling using trichloroacetic acid allows controlled keratocoagulation through the dermis and into the dermal papillary layer that is effective for skin rejuvenation. The purpose of this article is to give updates regarding the efficacy, possible adverse events, and patient satisfaction of trichloroacetic acid (TCA) peeling for skin rejuvenation by assessing various photoaging parameters. A systematic review of prospective trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane, and Scopus databases was conducted on November 2, 2020. Treatment efficacy was assessed based on the photoaging parameters used by each study. Adverse events and patient satisfaction as the secondary outcome were assessed based on patients-perceived improvements. Five studies included three randomized comparison studies and two prospective cohort studies. These studies show that TCA peeling significantly improve the cosmesis of photoaged facial skin. Low concentration is effective for superficial sun damage. Medium-depth peels using a higher concentration of TCA or as combination therapy are effective as skin resurfacing agents to reduce wrinkles. Some adverse effects may occur but usually resolve within weeks. Overall patients were satisfied with the treatment result. An equivalent basic skin preparation such as topical retinoic acid skin priming prior to intervention is necessary for more objective comparison. Further research studies with a larger sample size and longer follow-up period are required. This evidence suggests that TCA peeling is effective in photoaging treatment, either as monotherapy or as combination therapy with other modalities.

scholarly journals Combination Therapy for Neuropathic Pain. A Systematic Review

2021 ◽  
Author(s):  
Ancor Serrano Afonso ◽  
Thiago Carnaval ◽  
Sebastiá Videla Cés
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Complete Analysis ◽  
Secondary Outcome ◽  
Double Blind ◽  
Adult Participants ◽  
Drop Outs ◽  
Quality Evidence

Pharmacological treatment is poorly effective for neuropathic pain (NP). A progressive decrease in the estimated effect of NP drugs has been reported, giving rise to an increase in multimodal analgesic approach. We performed a systematic review to assess whether there is more and better-quality evidence available since the last review. We evaluated the efficacy, tolerability and safety of double-blind randomized controlled trials involving only adult participants comparing combination therapy (CT: ≥ 2 drugs) to placebo and/or at least one other comparator with NP indication. The primary outcome was the proportion of participants reporting ≥ 50% pain reduction from baseline. Secondary outcome was the proportion of drop-outs due to treatment-emergent-adverse-events. After removing duplicates, 2323 citations were screened. 164 articles were assessed for eligibility, from which 16 were included for qualitative analysis. From the latter, only 5 lasted for at least 12 weeks and only 6 complied with required data for complete analysis, but not for meta-analysis. CT has been adopted for years without robust evidence. Efforts to achieve better quality evidence have not improved over the years. In this regard, guidelines for NP should attempt to make recommendations on CT research, prioritizing which combinations to analyze.

scholarly journals Association of Survival and Immune-Related Adverse Events With Anti-PD-1/PD-L1 and Anti-CTLA-4 Inhibitors, Alone or Their Combination for the Treatment of Cancer: A Systematic Review and Meta-Analysis of 13 Clinical Trials

2021 ◽  
Vol 11 ◽  
Author(s):  
Leyin Zhang ◽  
Leitao Sun ◽  
Yiwen Zhou ◽  
Jieru Yu ◽  
Yingying Lin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Adverse Events ◽  
Survival Benefit ◽  
Data Extraction ◽  
Meta Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
High Grade ◽  
Bias Analysis

BackgroundCancer, with sustained high mortality, is a worldwide threat to public health. Despite the survival benefit over conventional therapies shown in immune checkpoint inhibitor (ICI), only a minority of patients benefit from single ICI. But combination therapy holds the promise of achieving better efficacy over monotherapy. We performed a systematic review and meta-analysis to assess the efficacy and safety of ICI-based combination therapy for cancer.MethodsA search was conducted to retrieve relevant studies in electronic databases and major conferences. Two investigators independently performed data extraction, making a systematic data extraction, assembly, analysis and interpretation to compare the overall survival (OS), progression-free survival (PFS), overall response rate (ORR), all and high grade immune related adverse events (IRAEs) between combination therapy and monotherapy. Therefore, only the studies satisfying the criteria were included. Finally, we performed subgroup, sensitivity, and publication bias analysis to examine the heterogeneity and bias of resources.ResultsA total of 2,532 patients from thirteen studies were enrolled. Compared to ICI alone, combination therapy, with a high risk and high grade IRAEs for the majority of all, offers a better survival benefit (OS: HR: 0.86, 95% CI: 0.76 to 0.98; PFS: HR: 0.79, 95% CI: 0.69 to 0.90) and objective response (ORR: RR: 1.91, 95% CI: 1.40 to 2.60).ConclusionsICI-based combination therapy was confirmed as the optimum treatment for cancer, especially when using specific dosage and regimen to treat certain tumor types with no absolute demand for the detection of PD-L1 expression. Meanwhile, attention should also be paid on potential toxicity, especially the IRAEs.

Is there a role for modified probiotics as beneficial microbes: a systematic review of the literature

2017 ◽  
Vol 8 (5) ◽  
pp. 739-754 ◽  
Author(s):  
L. Zorzela ◽  
S.K. Ardestani ◽  
L.V. McFarland ◽  
S. Vohra
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Safety Data ◽  
Probiotic Strain ◽  
Incidence Rates ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Treatment Trials ◽  
Probiotic Strains

Our objective was to conduct a systematic review and meta-analysis for the use of modified (heat-killed or sonicated) probiotics for the efficacy and safety to prevent and treat various diseases. Recent clinical research has focused on living strains of probiotics, but use in high-risk patients and potential adverse reactions including bacteremia has focused interest on alternatives to the use of live probiotics. We searched MEDLINE/PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, Alt Health Watch, Web of Science, Scopus, PubMed, from inception to February 14, 2017 for randomised controlled trials involving modified probiotic strains. The primary outcome was efficacy to prevent or treat disease and the secondary outcome was incidence of adverse events. A total of 40 trials were included (n=3,913): 14 trials (15 arms with modified probiotics and 20 control arms) for the prevention of diseases and 26 trials (29 arms with modified probiotics and 32 control arms) for treatment of various diseases. Modified microbes were compared to either placebo (44%), or the same living probiotic strain (39%) or to only standard therapies (17%). Modified microbes were not significantly more or less effective than the living probiotic in 86% of the preventive trials and 69% of the treatment trials. Modified probiotic strains were significantly more effective in 15% of the treatment trials. Incidence rates of adverse events were similar for modified and living probiotics and other control groups, but many trials did not collect adequate safety data. Although several types of modified probiotics showed significant efficacy over living strains of probiotics, firm conclusions could not be reached due to the limited number of trials using the same type of modified microbe (strain, daily dose and duration) for a specific disease indication. Further research may illuminate other strains of modified probiotics that may have potential as clinical biotherapeutics.

Facial Soft Tissue Augmentation With Bellafill: A Review of 4 Years of Clinical Experience in 212 Patients

2020 ◽  
pp. 229255032093367
Author(s):  
Philip Solomon ◽  
Chew Lip Ng ◽  
Jaimie Kerzner ◽  
Richard Rival
Keyword(s):  
Patient Satisfaction ◽  
Soft Tissue ◽  
Adverse Events ◽  
Clinical Experience ◽  
Soft Tissue Augmentation ◽  
Secondary Outcome ◽  
Lower Lip ◽  
Tear Trough ◽  
Acne Scars ◽  
Soft Tissue Filler

Introduction: Bellafill (Suneva Medical Inc) is a semipermanent injectable soft tissue filler composed of smooth and uniform polymethylmetacrylate (PMMA) microspheres suspended in a bovine collagen gel. It is a third generation PMMA filler, with more uniform shapes and sizes of the PMMA microspheres, which has been purported to decrease the incidence of granuloma formation. Methods: We performed a retrospective review of our clinical experience from 2014 to 2017 with Bellafill as a soft tissue injectable filler in the following clinical scenarios: deep nasolabial folds, depressed facial acne scars, malar volume loss, temporal wasting, tear trough deformity, chin augmentation, angle of jaw augmentation, and lip augmentation. The primary outcome is the rate of adverse events, and the secondary outcome is subjective patient satisfaction. Results: From 2014 to 2017, 842 syringes of Bellafill were administered to 212 patients, for a total of 417 procedures. Of the 417 procedures, 96 (23.0%) were for acne scars, 82 (19.7%) malar volume restorations, 65 (15.6%) nasolabial fold augmentations, 45 (10.8%) chin augmentations, 42 (10.1%) tear trough volume restorations, 28 (6.7%) temple volume restorations, 25 (6.0%) rhinoplasty touch-ups for small areas of nasal depression, 22 (5.3%) lip augmentations, and 12 (2.9%) jaw angle augmentations were performed. A range of 1 to 12 syringes were injected into each patient, over 1 to 3 sessions; 6 cases of adverse events occurred (1.4%). There were 4 cases of solitary nodules in the injection site, 1 case of lower eyelid oedema which persisted for 3 months and 1 case of lower lip oedema which resolved within hours. Patient satisfaction rates ranged from 83.3% for angle of jaw augmentation to 99.0% for improvement of acne scars. Conclusion: Bellafill is a safe and effective option for a semipermanent soft tissue filler, with high patient satisfaction and a good safety profile.

scholarly journals Exploring failure of antimicrobial prophylaxis and pre-emptive therapy for transplant recipients: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034940
Author(s):  
Anne-Grete Märtson ◽  
Martijn Bakker ◽  
Hans Blokzijl ◽  
Erik A M Verschuuren ◽  
Stefan P Berger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Outcome Measures ◽  
Opportunistic Infections ◽  
Antimicrobial Prophylaxis ◽  
Acquired Resistance ◽  
Secondary Outcome ◽  
Solid Organ ◽  
Cell Transplant ◽  
Transplant Recipients

ObjectivesInfections remain a threat for solid organ and stem cell transplant recipients. Antimicrobial prophylaxis and pre-emptive therapy have improved survival of these patients; however, the failure rates of prophylaxis are not negligible. The aim of this systematic review is to explore the reasons behind failure of antimicrobial prophylaxis and pre-emptive therapy.SettingThis systematic review included prospective randomised controlled trials and prospective single-arm studies.ParticipantsThe studies included were on prophylaxis and pre-emptive therapy of opportunistic infections in transplant recipients. Studies were included from databases MEDLINE, CENTRAL and Embase published until October first 2018.Primary and secondary outcome measuresPrimary outcome measures were breakthrough infections, adverse events leading to stopping of treatment, switching medication or dose reduction. Secondary outcome measures were acquired resistance to antimicrobials, antifungals or antivirals and death.ResultsFrom 3317 identified records, 30 records from 24 studies with 2851 patients were included in the systematic review. Seventeen focused on prophylactic and pre-emptive treatment of cytomegalovirus and seven studies on invasive fungal infection. The main reasons for failure of prophylaxis and pre-emptive therapy were adverse events and breakthrough infections, which were described in 54% (13 studies) and 38% (9 studies) of the included studies, respectively. In 25%, six of the studies, a detailed description of patients who experienced failure of prophylaxis or pre-emptive therapy was unclear or lacking.ConclusionsOur results show that although failure is reported in the studies, the level of detail prohibits a detailed analysis of failure of prophylaxis and pre-emptive therapy. Clearly reporting on patients with a negative outcome should be improved. We have provided guidance on how to detect failure early in a clinical setting in accordance to the results from this systematic review.PROSPERO registration numberCRD42017077606.

scholarly journals Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022202 ◽  
Author(s):  
Martin Müller ◽  
Jonas Jürgens ◽  
Marcus Redaèlli ◽  
Karsten Klingberg ◽  
Wolf E Hautz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Adverse Events ◽  
Patient Outcomes ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Communication Tool ◽  
Clinical Routine ◽  
Wide Range ◽  
The Impact

ObjectivesCommunication breakdown is one of the main causes of adverse events in clinical routine, particularly in handover situations. The communication tool SBAR (situation, background, assessment and recommendation) was developed to increase handover quality and is widely assumed to increase patient safety. The objective of this review is to summarise the impact of the implementation of SBAR on patient safety.DesignA systematic review of articles published on SBAR was performed in PUBMED, EMBASE, CINAHL, Cochrane Library and PsycINFO in January 2017. All original research articles on SBAR fulfilling the following eligibility criteria were included: (1) SBAR was implemented into clinical routine, (2) the investigation of SBAR was the primary objective and (3) at least one patient outcome was reported.SettingA wide range of settings within primary and secondary care and nursing homes.ParticipantsA variety of heath professionals including nurses and physicians.Primary and secondary outcome measuresAspects of patient safety (patient outcomes) defined as the occurrence or incidence of adverse events.ResultsEight studies with a before–after design and three controlled clinical trials performed in different clinical settings met the inclusion criteria. The objectives of the studies were to improve team communication, patient hand-offs and communication in telephone calls from nurses to physicians. The studies were heterogeneous with regard to study characteristics, especially patient outcomes. In total, 26 different patient outcomes were measured, of which eight were reported to be significantly improved. Eleven were described as improved but no further statistical tests were reported, and six outcomes did not change significantly. Only one study reported a descriptive reduction in patient outcomes.ConclusionsThis review found moderate evidence for improved patient safety through SBAR implementation, especially when used to structure communication over the phone. However, there is a lack of high-quality research on this widely used communication tool.Trial registrationnone

Impact of a scribe program on patient throughput, physician productivity, and patient satisfaction in a community-based emergency department

2017 ◽  
Vol 25 (1) ◽  
pp. 216-224 ◽  
Author(s):  
Waqas Shuaib ◽  
John Hilmi ◽  
Joshua Caballero ◽  
Ijaz Rashid ◽  
Hashim Stanazai ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Prospective Trial ◽  
Secondary Outcome ◽  
Patient Throughput ◽  
Time Motion ◽  
Physician Productivity ◽  
Relative Value ◽  
Quasi Experimental ◽  
The Impact

Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods. Patient throughput metrics were (1) door-to-room time, (2) room-to-doc time, (3) door-to-doc time, (4) doc-to-disposition time, and (5) length of stay for discharged/admitted patients. Our secondary outcome was physician productivity, which was calculated by measuring total patients seen per hour and work relative value units per hour. Additionally, we calculated the time-motion analysis in minutes to measure the emergency department physician’s efficiency by recording the following: (1) chart preparation, (2) chart review, (3) doctor–patient interaction, (4) physical examination, and (5) post-visit documentation. Finally, we measured patient satisfaction as provided by Press Ganey surveys. Data analysis was conducted in 12,721 patient encounters in the pre-scribe cohort, and 13,598 patient encounters in the post-scribe cohort. All the patient throughput metrics were statistically significant (p < 0.0001). The patients per hour increased from 2.3 ± 0.3 pre-scribe to 3.2 ± 0.6 post-scribe cohorts (p < 0.001). Total work relative value units per hour increased from 241(3.1 ± 1.5 per hour) pre-scribe cohort to 336 (5.2 ± 1.4 per hour) post-scribe cohort (p < 0.001). The pre-scribe patient satisfaction was high and remained high in the post-scribe cohort. There was a significant increase in the clinician providing satisfactory feedback from the pre-scribe (3.9 ± 0.3) to the post-scribe (4.7 ± 0.1) cohorts (p < 0.01). We describe a prospective trial of medical scribe use in the emergency department setting to improve patient throughput, physician productivity, and patient satisfaction. We illustrate that scribe use in community emergency department is feasible and results in improvement in all three metrics

scholarly journals Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis

2019 ◽  
Vol 35 (9) ◽  
pp. 1609-1618 ◽  
Author(s):  
Chien-Wei Huang ◽  
Min-Jing Lee ◽  
Liang-Jen Wang ◽  
Po-Tsang Lee ◽  
Yu-Kang Tu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Combination Therapy ◽  
Adverse Events ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Meta Analysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background Restless legs syndrome (RLS) is common in end-stage renal disease (ESRD) patients and impairs health and quality of life significantly. However, the optimal treatment of RLS in ESRD patients is uncertain and less studied compared with idiopathic RLS patients. Methods We conducted a systematic review and network meta-analysis to compare the efficacy and acceptability of treatments for RLS in ESRD patients. Randomized controlled trials (RCTs) by February 2019 in the PubMed, Cochrane Library, Embase and ClinicalTrials.gov were reviewed. RLS severity reduction was treated as treatment efficacy, and adverse events were treated as acceptable. Both outcomes were appraised using a random effects model expressed as standardized mean differences and odds ratios with 95% confidence intervals (CIs), respectively, and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to obtain a hierarchy of interventions. Results A total of 12 RCTs were included, comprising 9 interventions and 498 participants. All the interventions significantly improved RLS severity without critical side effects compared with placebo. Gabapentin achieved the greatest decrease of RLS severity [standardized mean difference (SMD) = 1.95, 95% CI 0.81–3.09 (SUCRA: 79.3%)], despite its frequent adverse events [SMD = 0.18, 95% CI 0.02–1.50 (19.9%)]. The combination therapy of exercise plus dopamine agonist had better efficacy [SMD = 1.60, 95% CI 0.08–3.12 (59.8%)] and acceptability [SMD = 1.41, 95% CI 0.01–142.53 (63.9%)] compared with that of vitamin C plus vitamin E [SMD = 1.50, 95% CI 0.47–2.54 (56.6%); SMD = 0.32, 95% CI 0.04–2.86 (32.5%)]. Conclusions This network meta-analysis supports that gabapentin is the most effective treatment for RLS in ESRD patients. Exercise plus dopamine agonist is a favorable combination therapy concerning side effects. Future large RCTs with long-term treatment outcomes are necessary.

scholarly journals Triple Combination Therapy With PD-1/PD-L1, BRAF, and MEK Inhibitor for Stage III–IV Melanoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ye Liu ◽  
Xilan Zhang ◽  
Guoying Wang ◽  
Xinchang Cui
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Combination Therapy ◽  
Adverse Events ◽  
Meta Analysis ◽  
Stage Iii ◽  
Controlled Trials ◽  
Triple Combination ◽  
Triple Combination Therapy ◽  
Randomized Controlled

Triple combination of anti-PD-1/PD-L1 immunotherapy and anti-BRAF plus anti-MEK targeted therapy is a promising antitumor strategy and is increasingly being used in clinical trials. To evaluate the safety and efficacy of triple combination of PD-1/PD-L1, BRAF, and MEK inhibition in patients diagnosed with stage III-IV melanoma, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs). The PubMed, EMBASE, and Cochrane Library were searched for all studies published from inception to January 2021. The progression free survival (PFS), overall survival (OS), overall response rate (ORR), and risk of adverse events (AEs) were extracted by two independent investigators and pooled hazard ratio (HR) or risk ratio (RR) with 95% CI were determined using the random-effects model for data synthesis. Overall, five randomized controlled trials encompassing 1,266 patients with stage III-IV melanoma were selected. Triple combination therapy significantly improved PFS (HR = 0.71; 95% CI = 0.59 to 0.86; P = 0.0005) and 2-year OS (RR = 1.12; 95% CI = 1.03 to 1.23; P = 0.01), but had no impact on ORR (RR = 1.09; 95% CI = 0.91 to 1.30; P = 0.37) when compared with controlled treatment group. In addition, triple combination therapy was associated with increased risks of hypothyroidism, arthralgia, myalgia, ALT increased, AST increased, asthenia, and pyrexia compared with control group. Triple combination therapy of PD-1/PD-L1, BRAF, and MEK inhibition achieved better survival benefits but had higher incidence of some adverse events over two-drug combination or monotherapy. Further randomized controlled clinical trials are needed to verify our results.Systematic Review RegistrationPROSPERO 2021 CRD42021235845 Available from https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021235845.

scholarly journals Risk of ophthalmic adverse events in patients treated with immune checkpoint inhibitor regimens: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Yan-li Hou ◽  
Di-ya Wang ◽  
Ru-yue Tian ◽  
Jie-xuan Hu ◽  
Wei Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Randomized Controlled ◽  
Comprehensive Search ◽  
Ophthalmic Treatment

Abstract Background We performed a systematic review and meta-analysis to evaluate the risks of ophthalmic adverse events (AEs) associated with immune checkpoint inhibitors (ICIs) in patients with solid tumors.Methods Eligible studies were selected after a comprehensive search of multiple databases including phase II/III randomized controlled trials (RCTs) investigating ICIs in patients with the solid tumor. The data was analyzed by R software.Results After exclusion of ineligible studies, 21 RCTs met our strict inclusion criteria for the meta-analysis, included 11930 patients. Compared with chemotherapy, the odds ratio of all-grade ophthalmic treatment-related adverse events (trAEs) were significantly lower for PD-L1 inhibitors (OR: 0.18; 95% CI: 0.08-0.39; p<0.0001) and PD-1 inhibitors (OR 0.44, 95% CI: 0.23-0.83, p<0.050). The combination therapy of PD-1 plus CTLA-4 inhibitors significantly increased the risks of all-grade ophthalmic trAEs (OR 5.29, 95% CI: 1.59-17.57, p<0.05) and all-grade ophthalmic immune-related AEs (irAEs) ( OR: 3.67; 95%CI: 1.08-12.50; p<0.05) compared with PD-1 or CTLA-4 inhibitors monotherapy. The combination therapy of ICIs plus chemotherapy also significantly increased the risks of all-grade ophthalmic trAEs (OR, 3.44; 95%CI, 1.72-6.88; p<0.001) and all-grade ophthalmic irAEs ( OR: 3.69; 95%CI: 1.32-10.32; p<0.05) compared with chemotherapy. The risks of high-grade ophthalmic AEs had no difference in any subgroup compared with control.Conclusions Our meta-analysis demonstrated that compared with chemotherapy, PD-L1/PD-1 inhibitors had lower risks of all-grade ophthalmic trAEs and non-specific ophthalmic trAEs (NS-trAEs) but had the same risk of ophthalmic irAEs. Combination therapy of ICIs plus chemotherapy had higher risks of all-grade ophthalmic trAEs and irAEs. Compared with PD-1 or CTLA-4 inhibitors monotherapy, PD-1 plus CTLA-4 inhibitors combination therapy had significantly higher risks of all-grade ophthalmic trAEs and irAEs.

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