scholarly journals Inhibition of Androgen Signalling Improves the Outcomes of Therapies for Bladder Cancer: Results from a Systematic Review of Preclinical and Clinical Evidence and Meta-Analysis of Clinical Studies

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 351
Author(s):  
Massimiliano Creta ◽  
Giuseppe Celentano ◽  
Luigi Napolitano ◽  
Roberto La Rocca ◽  
Marco Capece ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Relative Risk ◽  
Clinical Studies ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Bladder Tumour ◽  
Signalling Pathways ◽  
Reductase Inhibitors ◽  
The Impact

Bladder cancer (BCa) is an endocrine-related tumour and the activation of androgen signalling pathways may promote bladder tumorigenesis. We summarized the available preclinical and clinical evidence on the implications of the manipulation of androgen signalling pathways on the outcomes of BCa therapies. A systematic review was performed in December 2020. We included papers that met the following criteria: original preclinical and clinical research; evaluating the impact of androgen signalling modulation on the outcomes of BCa therapies. Six preclinical and eight clinical studies were identified. The preclinical evidence demonstrates that the modulation of androgen receptor-related pathways has the potential to interfere with the activity of the Bacillus Calmette Guerin, doxorubicin, cisplatin, gemcitabine, and radiotherapy. The relative risk of BCa recurrence after transurethral resection of the bladder tumour (TURBT) is significantly lower in patients undergoing therapy with 5 alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT) (Relative risk: 0.50, 95% CI: 0.30–0.82; p = 0.006). Subgroup analysis in patients receiving 5-ARIs revealed a relative risk of BCa recurrence of 0.46 (95% CI: 0.22–0.95; p = 0.040). A significant negative association between the ratio of T1 BCa patients in treated/control groups and the relative risk of BCa recurrence was observed. Therapy with 5-ARIs may represent a potential strategy aimed at reducing BCa recurrence rate, mainly in patients with low stage disease. Further studies are needed to confirm these preliminary data.

scholarly journals Effect of anticoagulants and antiplatelet agents on the efficacy of intravesical BCG treatment of bladder cancer: A systematic review

2013 ◽  
Vol 7 (11-12) ◽  
pp. 740 ◽  
Author(s):  
Nader Fahmy ◽  
Alejandro Lazo-Langner ◽  
Alla E. Iansavichene ◽  
Stephen E. Pautler
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Bladder Tumour ◽  
Antiplatelet Agents ◽  
Protective Role ◽  
Protective Effects ◽  
Increased Risk ◽  
Intravesical Bcg ◽  
The Impact ◽  
Group 1

We performed a systematic review of publications describing a correlation between oral anticoagulant medications and intravesical BCG outcome. We collected information on the impact of such medications on tumour recurrence and progression and we excluded papers not reporting outcome correlations. Patients were divided into group 1 and 2 based on whether they were taking or not taking any anticoagulant medications. A total of 7 manuscripts published between 1990 and 2009 were included in this study. Data heterogeneity precluded meta-analysis. In studies combining all anticoagulant medications, 3 out of 5 (60%) publications did not identify any difference in outcome, while 2 (40%) documented significantly more recurrences in group 1 patients. In studies performing multivariate analysis and only examining the intake of 1 medication, warfarin alone seemed to be associated with increased risk of bladder tumour recurrences and progression following intravesical BCG treatment, while ASA alone seemed to be associated with more protective effects. There is no strong evidence to support the allegations of a protective role of ASA and a deleterious role for warfarin. Further, well-designed experimental and clinical studies are needed to clarify the mechanism of action of intravesical BCG along with possible drug interactions. 

scholarly journals Association between Perioperative Blood Transfusions and Clinical Outcomes in Patients Undergoing Bladder Cancer Surgery: A Systematic Review and Meta-Analysis Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Juan P. Cata ◽  
Javier Lasala ◽  
Greg Pratt ◽  
Lei Feng ◽  
Jay B. Shah
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Study ◽  
Blood Transfusions ◽  
Cancer Specific Survival ◽  
Packed Red Blood Cells ◽  
The Impact

Background. Perioperative blood transfusions are associated with poor survival in patients with solid tumors including bladder cancer. Objective. To investigate the impact of perioperative blood transfusions on oncological outcomes after radical cystectomy. Design. Systematic review and meta-analysis. Setting and Participants. Adult patients who underwent radical cystectomy for bladder cancer. Intervention. Packed red blood cells transfusion during or after radical cystectomy for bladder cancer. Outcome Measurements and Statistical Analysis. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). We calculated the pooled hazard ratio (HR) estimates and 95% confidence intervals by random and fixed effects models. Results and Limitation. Eight, seven, and five studies were included in the OS, CSS, and RFS analysis, respectively. Blood transfusions were associated with 27%, 29%, and 12% reduction in OS, CSS, and RFS, respectively. A sensitivity analysis supported the association. This study has several limitations; however the main problem is that it included only retrospective studies. Conclusions. Perioperative BT may be associated with reduced RFS, CSS, and OS in patients undergoing RC for BC. A randomized controlled study is needed to determine the causality between the administration of blood transfusions and bladder cancer recurrence.

Effect of Pycnogenol on Blood Pressure: Findings From a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Studies

Angiology ◽  
2019 ◽  
Vol 71 (3) ◽  
pp. 217-225 ◽  
Author(s):  
Federica Fogacci ◽  
Giuliano Tocci ◽  
Amirhossein Sahebkar ◽  
Vivianne Presta ◽  
Maciej Banach ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Clinical Studies ◽  
Randomized Clinical Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Double Blind ◽  
Double Blind Placebo ◽  
The Impact

Results of previous clinical trials evaluating the effect of pycnogenol supplementation on blood pressure (BP) are controversial. Therefore, we aimed to assess the impact of pycnogenol on BP through a systematic review of literature and meta-analysis of available randomized, double-blind, placebo-controlled clinical studies (randomized clinical trials [RCTs]). Literature search included SCOPUS, PubMed-Medline, ISI Web of Science, and Google Scholar databases up to January 10, 2019 to identify RCTs investigating the impact of pycnogenol on BP. Two investigators independently extracted data on study characteristics, methods, and outcomes. This systematic review and meta-analysis is registered in International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42018112172. Overall, the impact of pycnogenol on BP was reported in 7 trials involving 626 participants. Meta-analysis did not suggest any significant improvement in systolic BP (weighted mean difference [WMD]: −0.028 mm Hg; 95% confidence interval [CI]: −0.182 to 0.127; P = .726; I2 = 46%), diastolic BP (WMD: −0.144 mm Hg; 95% CI: −0.299 to 0.010; P = .067; I2 = 0%), mean arterial pressure (WMD: −0.091 mm Hg; 95% CI: −0.246 to 0.063; P = .246; I2 = 0%), and pulse pressure (WMD: −0.003 mm Hg; 95% CI: −0.151 to 0.158; P = .966; I2 = 0%) following pycnogenol treatment. Results persisted in the leave-one-out sensitivity analysis. Therefore, the present meta-analysis does not suggest any significant effect of pycnogenol on BP.

scholarly journals A systematic review and meta-analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens

2018 ◽  
Vol 123 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Andrea Mari ◽  
Shoji Kimura ◽  
Beat Foerster ◽  
Mohammad Abufaraj ◽  
David D'Andrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Meta Analysis ◽  
The Impact

scholarly journals The impact of thrombosis and bleeding among patients with Myeloproliferative Neoplasm: Systematic Review and Meta Analysis.

2020 ◽  
Author(s):  
Tsegahun Worku Brhanie
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Early Detection ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Myeloproliferative Neoplasm ◽  
Risk Difference ◽  
Keywords Thrombosis ◽  
The Impact

Background: Thrombosis and bleeding are the most common complications which contribute to significant morbidity and mortality of myeloproliferative patients. This study aimed to find out the incidence of thrombotic and bleeding events during diagnosis and follow up among patients with myeloproliferative neoplasm. This might help in the early detection of thrombosis and bleeding and prevention of such complications for MPN patients. Methods: A systematic review and meta-analysis was conducted to assess the incidence of thrombosis and bleeding. Data extracted from the literatures in Google scholars, Mendeley, PubMed, and EMBASE databases. Studies that had thrombosis and/or bleeding reports with any types of myeloproliferative neoplasm were included in this study. We used random effect model to estimate the odd ratio, relative risk and risk difference with 95%CI of each studies and the pooled results based on Cochrane methods of Revman. A funnel plot and I2 test checked to see the publication bias and heterogeneity respectively. Results: Nineteen studies with 14706 participants that had fitted the inclusion criteria were included in the overall thrombosis study. Five studies (n=931) included for incidence thrombosis at diagnosis and follow up. The pooled overall frequency thrombosis was 18.6%. The pooled incidence of thrombosis at diagnosis was 26.5% and odds ratio (OR= 3.17,95%CI 0.96 to10.43); relative risk (RR= 2.07,95%CI 0.98 to 4.34); risk difference (RD=21%, 95%CI -0.05 to 0.48, high certainty). Thrombosis had significant differences during diagnosis and follow up. A history of thrombosis, age >60years, and smoking were some of the risk factors for thrombosis. Conclusions: Based on the findings, thrombosis and bleeding are the highest complications occurred among myeloproliferative neoplasm patients. This problem is also common both during diagnosis and follow up of MPN patients. Early detection and follow up is needed to prevent MPN complications. Keywords: Thrombosis, bleeding, MPN, diagnosis, follow up.

scholarly journals The Therapeutic Potential of Carnosine/Anserine Supplementation against Cognitive Decline: A Systematic Review with Meta-Analysis

Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 253 ◽  
Author(s):  
Giuseppe Caruso ◽  
Justyna Godos ◽  
Sabrina Castellano ◽  
Agnieszka Micek ◽  
Paolo Murabito ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Clinical Studies ◽  
Therapeutic Potential ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Elderly Subjects ◽  
Neuroprotective Effects ◽  
The Impact

Carnosine is a natural occurring endogenous dipeptide that was proposed as an anti-aging agent more than 20 years ago. Carnosine can be found at low millimolar concentrations at brain level and different preclinical studies have demonstrated its antioxidant, anti-inflammatory, and anti-aggregation activity with neuroprotective effects in animal models of Alzheimer’s disease (AD). A selective deficit of carnosine has also been linked to cognitive decline in AD. Different clinical studies have been conducted to evaluate the impact of carnosine supplementation against cognitive decline in elderly and AD subjects. We conducted a systematic review with meta-analysis, in accordance with the PRISMA guidelines coupled to the PICOS approach, to investigate the therapeutic potential of carnosine against cognitive decline and depressive symptoms in elderly subjects. We found five studies matching the selection criteria. Carnosine/anserine was administered for 12 weeks at a dose of 1 g/day and improved global cognitive function, whereas no effects were detected on depressive symptoms. These data suggest a preliminary evidence of clinical efficacy of carnosine against cognitive decline both in elderly subjects and mild cognitive impairment (MCI) patients, although larger and long-term clinical studies are needed in MCI patients (with or without depression) to confirm the therapeutic potential of carnosine.

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