scholarly journals Long-Acting Injectable Antipsychotics: A Systematic Review of Their Non-Systemic Adverse Effect Profile

2021 ◽  
Vol Volume 17 ◽  
pp. 1917-1926
Author(s):  
Monica Zolezzi ◽  
Rawan Abouelhassan ◽  
Yassin Eltorki ◽  
Peter M Haddad ◽  
Mahtab Noorizadeh
Keyword(s):  
Systematic Review ◽  
Adverse Effect ◽  
Adverse Effect Profile ◽  
Systemic Adverse Effect ◽  
Long Acting

scholarly journals Carfilzomib Based Regimens for Treatment of Newly Diagnosed Multiple Myeloma: A Systematic Review

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5588-5588
Author(s):  
Maimoona Khan ◽  
Asma Waheed ◽  
Rida Ul Jannat ◽  
Arafat Ali Ali Farooqui ◽  
Muhammad Saad Farooqi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Effect ◽  
Multiple Myeloma ◽  
Clinical Trials ◽  
Induction Therapy ◽  
Drug Combination ◽  
Alkylating Agents ◽  
Adverse Effect Profile ◽  
Newly Diagnosed ◽  
Grade 3

Background: Carfilzomib (Car), a second-generation proteasome inhibitor (PI), has been approved by the US Food and Drug Administration (FDA) as therapy for relapsed and /or refractory multiple myeloma (RRMM), either as a single agent or in combination with other agents. It has proven to be superior in many ways compared to the the first generation PI, bortezomib, both in terms of superior efficacy and neuropathy related adverse effect profile. Carfilzomib has lower rate of peripheral neuropathy. In this review, we gathered data from trials which studied Carfilzomib for newly diagnosed MM (NDMM). Carfilzomib based two and three drug combination as induction regimens for the management of NDMM is an emerging approach. Through this systematic review, we explore efficacy, adverse effect profile of Car based regimens for NDMM. Methods: Per PRISMA guidelines, a thorough database search was conducted on 06/24/2019 using the following search engines; PubMed, EMBASE, Cochrane library, Scopus, Web of Science, CINAHL, and Clinicaltrials.gov. We included all published trials that used carfilzomib as an induction agent in NDMM patients and had at least response rates after induction. Results: The total number of articles identified with initial search were 1131, out of which 19 articles met our selection / eligibility criteria (n=2286). The overall response rates (ORR) after induction therapy with carfilzomib based regimens was very impressive (range: 84.3% - 100%). Two drug combination using carfilzomib and dexamethasone (n=72) had an ORR of 90% and a greater than very good partial response rate (>VGPR) of 84%. Three drug combinations used for induction therapy included carfilzomib/dexamethasone with immunomodulators (n=391) and alkylating agents (n=308). The combination of carfilzomib/dexamethasone with lenalidomide (n=189, ORR: 97% - 98%, >VGPR: 69% - 98%) and thalidomide (n=202, ORR: 90% - 94%, >VGPR: 66% - 68%) showed the best response. Alkylating agents used in combination with carfilzomib were melphalan (n=98, ORR: 90% - 93%, >VGPR: 58% - 70%), cyclophosphamide (n=192, ORR: 87% - 95%, >VGPR: 39% - 71%) and bendamustine (n=18, ORR; 100%, >VGPR: 89%). Four drug combinations with carfilzomib used were daratumumab/lenalidomide/dexamethasone (n=22, ORR: 100%, >VGPR: 90%, 12m PFS: 95%) and cyclophosphamide / thalidomide / dexamethasone (n=64, ORR; 91%, >VGPR: 69%, 24m PFS: 76%). One trial directly compared carfilzomib/melphalan/dexamethasone (n=478, ORR: 84%, >VGPR: 61%, PFS: 22.3m) with bortezomib/melphalan/dexamethasone (n=477, ORR: 79%, >VGPR: 49%, PFS: 22.1m). Another trial compared the combination of carfilzomib / dexamethasone with lenalidomide (n=315) or cyclophosphamide (n=159) that showed similar ORR (97% vs 91%) though >VGPR rate was better with lenalidomide (75% vs 60%). Efficacy data including progression free survival (PFS) for carfilzomib based regimens is reported in table 1. Most common >grade 3 hematological adverse effects reported were anemia (2% - 35%), lymphopenia (5% - 76%), thrombocytopenia (4% - 28%) and neutropenia (1% - 38%). Most Common >grade 3 non-hematological adverse events included cardiac events (5% - 10%), respiratory disorders (8% - 16%), infections (2% - 9%), hypertension (6% - 17%), renal events (9% - 10%) and hyperglycemia (6% - 23%). (Table 1) Conclusion: The overall efficacy and favorable adverse effect profile of Carfilzomib-based induction regimens seem very promising for the treatment of NDMM. Car is now approved for weekly dosing which is convenient. Due to cardiovascular toxicity seen in upto 10% cases, Car should be used very judiciously in patients with cardiovascular risk factors and heart failure. Several ongoing phase 3 clinical trials are studying Carfilzomib in various combinations will help to establish foundation for future standard therapy as well as next phase of drug development through clinical trials. Disclosures Anwer: In-Cyte: Speakers Bureau; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.

scholarly journals Safety and adverse effect profile of colchicine in renal impairment: a systematic review of randomised trials

2020 ◽  
Vol 9 (4) ◽  
pp. e28-e28
Author(s):  
Julian Yaxley ◽  
William Yaxley ◽  
Tahira Scott
Keyword(s):  
Systematic Review ◽  
Adverse Effect ◽  
Side Effects ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Randomised Trial ◽  
Gastrointestinal Symptoms ◽  
Adverse Effect Profile ◽  
Randomised Trials ◽  
Increased Risk

Introduction: Colchicine is an anti-inflammatory drug prescribed for numerous medical conditions. Side effects are frequently encountered, particularly gastrointestinal symptoms. Caution and dose reduction are advised in patients with renal impairment because of a presumed increased risk of side effects. This systematic review intends to summarise the available literature to define the adverse effect profile of colchicine used in patients with kidney disease. Methods: We conducted a systematic review of randomised clinical trials seeking to evaluate the association between renal impairment and colchicine toxicity. We limited our search to randomised studies in humans in the English language. We allowed colchicine prescribed for any duration, dose or indication. Results: Our literature search identified a total of 7707 records. Only a single randomised trial was ultimately identified as meeting the inclusion criteria and addressing our research question. In patients with renal impairment, colchicine was not associated with an increased risk of dialysis, time until dialysis, or the incidence of liver function test derangement. We found no data for adverse events such as leukopenia, thrombocytopenia or diarrhoea in the kidney disease subgroup. Data was sparse and of poor quality. Conclusion: It is widely recommended that colchicine dose be reduced in patients with renal impairment due to an increased risk of drug accumulation and side effects. In our study, we failed to identify any robust clinical research substantiating this association. This is the first systematic review of randomised trials to investigate this link. Further research is required before the safety and tolerability of colchicine in renal disease can be confirmed.

Su1658 A SYSTEMATIC REVIEW AND META-ANALYSIS ASSESSING ADVERSE EFFECT PROFILE OF OBETICHOLIC ACID

2020 ◽  
Vol 158 (6) ◽  
pp. S-1377
Author(s):  
Mohammad Alomari ◽  
Laith Al momani ◽  
Bara El Kurdi ◽  
Muhammad Talal Sarmini ◽  
George Khoudari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Effect ◽  
Meta Analysis ◽  
Adverse Effect Profile ◽  
Obeticholic Acid

scholarly journals Triple versus LAMA/LABA combination therapy for patients with COPD: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Koarai ◽  
Mitsuhiro Yamada ◽  
Tomohiro Ichikawa ◽  
Naoya Fujino ◽  
Tomotaka Kawayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Combination Therapy ◽  
Triple Therapy ◽  
Odds Ratio ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Beta Agonist ◽  
History Of ◽  
Dyspnea Score ◽  
Long Acting

Abstract Background Recently, the addition of inhaled corticosteroid (ICS) to long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination therapy has been recommended for patients with COPD who have severe symptoms and a history of exacerbations because it reduces the exacerbations. In addition, a reducing effect on mortality has been shown by this treatment. However, the evidence is mainly based on one large randomized controlled trial IMPACT study, and it remains unclear whether the ICS add-on treatment is beneficial or not. Recently, a large new ETHOS trial has been performed to clarify the ICS add-on effects. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety including ETHOS trial. Methods We searched relevant randomized control trials (RCTs) and analyzed the exacerbations, quality of life (QOL), dyspnea symptom, lung function and adverse events including pneumonia and mortality, as the outcomes of interest. Results We identified a total of 6 RCTs in ICS add-on protocol (N = 13,579). ICS/LAMA/LABA treatment (triple therapy) significantly decreased the incidence of exacerbations (rate ratio 0.73, 95% CI 0.64–0.83) and improved the QOL score and trough FEV1 compared to LAMA/LABA. In addition, triple therapy significantly improved the dyspnea score (mean difference 0.33, 95% CI 0.18–0.48) and mortality (odds ratio 0.66, 95% CI 0.50–0.87). However, triple therapy showed a significantly higher incidence of pneumonia (odds ratio 1.52, 95% CI 1.16–2.00). In the ICS-withdrawal protocol including 2 RCTs, triple therapy also showed a significantly better QOL score and higher trough FEV1 than LAMA/LABA. Concerning the trough FEV1, QOL score and dyspnea score in both protocols, the differences were less than the minimal clinically important difference. Conclusion Triple therapy causes a higher incidence of pneumonia but is a more preferable treatment than LAMA/LABA due to the lower incidence of exacerbations, higher trough FEV1 and better QOL score. In addition, triple therapy is also superior to LABA/LAMA due to the lower mortality and better dyspnea score. However, these results should be only applied to patients with symptomatic moderate to severe COPD and a history of exacerbations. Clinical Trial Registration: PROSPERO; CRD42020191978.

scholarly journals Efficiency of The use of Long-Acting Reversible Contraception: A Systematic Review of the Literature

2018 ◽  
Vol 21 ◽  
pp. S164
Author(s):  
F Gomez de la Rosa ◽  
J Alvis Zakzuk ◽  
N Alvis Guzman ◽  
DJ Moreno ◽  
M Rincon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Review Of The Literature ◽  
Long Acting

scholarly journals Reporting and understanding the safety and adverse effect profile of mobile apps for psychosocial interventions: An update

2016 ◽  
Vol 6 (2) ◽  
pp. 187 ◽  
Author(s):  
Farooq Naeem ◽  
Nadeem Gire ◽  
Shuo Xiang ◽  
Megan Yang ◽  
Yumeen Syed ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Mobile Apps ◽  
Psychosocial Interventions ◽  
Adverse Effect Profile
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