Insulin Glargine and Risk of Cancer: A Meta-Analysis

2012 ◽  
Vol 27 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Xinli Du ◽  
Rihua Zhang ◽  
Yi Xue ◽  
Dong Li ◽  
Jinmei Cai ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Long Term Effects ◽  
Open Label ◽  
Cancer Occurrence ◽  
Pubmed Database ◽  
Significant Difference ◽  
The Us ◽  
Risk Of Cancer

Aims Recently, more and more attention has been drawn on the long-term effects of insulin glargine. Here we strived to estimate the association of cancer occurrence with the use of insulin glargine. Methods We searched all the publications regarding the association between cancer occurrence and the use of insulin glargine using the US National Library of Medicine's PubMed database. Data were independently extracted and analyzed using random or fixed effects meta-analysis depending upon the degree of heterogeneity. Results Seven cohort studies were included in the meta-analysis. Cancer occurrence had no significant difference in glargine-treated patients compared to patients treated with other insulins (RR=0.86, 95% CI=0.69–1.07, p=0.17, Pheterogeneity <0.00001). In our subgroup analysis, glargine, compared to other insulins, did not increase the risk of breast cancer (RR=1.14, 95% CI=0.65–2.02, p=0.65, Pheterogeneity=0.002), prostate cancer (RR=1.00, 95% CI=0.79–1.26, p=0.99, Pheterogeneity=0.78), pancreatic cancer (RR=0.57, 95% CI=0.14–2.35, p=0.44, Pheterogeneity=0.0002) and gastrointestinal cancer (RR=0.80, heterogeneity 95% CI=0.62–1.02, p=0.07, Pheterogeneity=0.86). Conclusions This meta-analysis of open-label studies does not support an increased cancer risk in patients treated with insulin glargine. The result provides confidence for the development of insulin glargine, but needs confirmation by further clinical studies.

scholarly journals Nervous and Muscular Adverse Events after COVID-19 Vaccination: A Systematic Review and Meta-Analysis of Clinical Trials

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 939
Author(s):  
Jiaxin Chen ◽  
Yuangui Cai ◽  
Yicong Chen ◽  
Anthony P. Williams ◽  
Yifang Gao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Phase 1 ◽  
Cochrane Library ◽  
Categorical Variables ◽  
Control Group ◽  
Open Label

Background: Nervous and muscular adverse events (NMAEs) have garnered considerable attention after the vaccination against coronavirus disease (COVID-19). However, the incidences of NMAEs remain unclear. We aimed to calculate the pooled event rate of NMAEs after COVID-19 vaccination. Methods: A systematic review and meta-analysis of clinical trials on the incidences of NMAEs after COVID-19 vaccination was conducted. The PubMed, Medline, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched from inception to 2 June 2021. Two independent reviewers selected the study and extracted the data. Categorical variables were analyzed using Pearson’s chi-square test. The pooled odds ratio (OR) with the corresponding 95% confidence intervals (CIs) were estimated and generated with random or fixed effects models. The protocol of the present study was registered on PROSPERO (CRD42021240450). Results: In 15 phase 1/2 trials, NMAEs occurred in 29.2% vs. 21.6% (p < 0.001) vaccinated participants and controls. Headache and myalgia accounted for 98.2% and 97.7%, and their incidences were 16.4% vs. 13.9% (OR = 1.97, 95% CI = 1.28–3.06, p = 0.002) and 16.0% vs. 7.9% (OR = 3.31, 95% CI = 2.05–5.35, p < 0.001) in the vaccine and control groups, respectively. Headache and myalgia were more frequent in the newly licensed vaccines (OR = 1.97, 95% CI = 1.28–3.06, p = 0.02 and OR = 3.31, 95% CI = 2.05–5.35, p < 0.001) and younger adults (OR = 1.40, 95% CI = 1.12–1.75, p = 0.003 and OR = 1.54, 95% CI = 1.20–1.96, p < 0.001). In four open-label trials, the incidences of headache, myalgia, and unsolicited NMAEs were 38.7%, 27.4%, and 1.5%. Following vaccination in phase 3 trials, headache and myalgia were still common with a rate of 29.5% and 19.2%, although the unsolicited NMAEs with incidence rates of ≤ 0.7% were not different from the control group in each study. Conclusions: Following the vaccination, NMAEs are common of which headache and myalgia comprised a considerable measure, although life-threatening unsolicited events are rare. NMAEs should be continuously monitored during the ongoing global COVID-19 vaccination program.

scholarly journals Efficacy and safety of trimethoprim-sulfamethoxazole for the prevention of pneumocystis pneumonia in human immunodeficiency virus-negative immunodeficient patients: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248524
Author(s):  
Rui Li ◽  
Zhiyong Tang ◽  
Fu Liu ◽  
Ming Yang
Keyword(s):  
Human Immunodeficiency Virus ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Pneumocystis Pneumonia ◽  
Control Group ◽  
Drug Discontinuation ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Hiv Negative

Background Pneumocystis pneumonia (PCP) has a significant impact on the mortality of immunocompromised patients. It is not known whether the prophylactic application of trimethoprim-sulfamethoxazole (TMP-SMZ) can reduce the incidence of PCP and mortality in the human immunodeficiency virus (HIV)-negative immunodeficient population. The safety profile is also unknown. There have been few reports on this topic. The aim of this study was to systematically evaluate the efficacy and safety of the use of TMP-SMZ for the prevention of PCP in this population of patients from the perspective of evidence-based medicine. Methods A comprehensive search without restrictions on publication status or other parameters was conducted. Clinical randomized controlled trials (RCTs) or case-control trials (CCSs) of TMP-SMZ used for the prevention of PCP in HIV-negative immunocompromised populations were considered eligible. A meta-analysis was performed using the Mantel-Haenszel fixed-effects model or Mantel-Haenszel random-effects model, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and reported. Results Of the 2392 records identified, 19 studies (n = 4135 patients) were included. The efficacy analysis results indicated that the PCP incidence was lower in the TMP-SMZ group than in the control group (OR = 0.27, 95% CI (0.10, 0.77), p = 0.01); however, the rate of drug discontinuation was higher in the TMP-SMZ group than in the control group (OR = 14.31, 95% CI (4.78, 42.91), p<0.00001). In addition, there was no statistically significant difference in the rate of mortality between the two groups (OR = 0.54, 95% CI (0.21, 1.37), p = 0.19). The safety analysis results showed that the rate of adverse events (AEs) was higher in the TMP-SMZ group than in the control group (OR = 1.92, 95% CI (1.06, 3.47), p = 0.03). Conclusions TMP-SMZ has a better effect than other drugs or the placebo with regard to preventing PCP in HIV-negative immunocompromised individuals, but it may not necessarily reduce the rate of mortality, the rate of drug discontinuation or AEs. Due to the limitations of the research methodologies used, additional large-scale clinical trials and well-designed research studies are needed to identify more effective therapies for the prevention of PCP.

scholarly journals Effectiveness and safety of insulin glargine versus detemir analysis in patients with type 1 diabetes: systematic review and meta-analysis

2018 ◽  
Vol 9 (8) ◽  
pp. 241-254 ◽  
Author(s):  
Thales B. C. Silva ◽  
Paulo H. R. F. Almeida ◽  
Vania E. Araújo ◽  
Francisco de Assis Acurcio ◽  
Augusto A. Guerra Júnior ◽  
...  
Keyword(s):  
Systematic Review ◽  
Insulin Glargine ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Severe Hypoglycemia ◽  
Study Objective ◽  
Nocturnal Hypoglycemia ◽  
Significant Difference ◽  
Long Acting

Background: Diabetes mellitus type 1 (DM1) is an autoimmune disease characterized by metabolic destruction of pancreatic cells responsible for insulin production, with treatment based on replacing insulin. Long-acting insulin analogs are indicated for patients with DM1 who exhibit important oscillations of their daily glycemia, despite its higher cost. Our study objective was to evaluate the effectiveness and safety of two long-acting insulins, insulin glargine and detemir, in treating patients with DM1. Methods: We undertook a systematic review with meta-analysis of observational studies (cohort and registry) available in the databases and the gray literature, and a complementary search in the Diabetes Care journal. Outcomes assessed were: glycated hemoglobin concentration; fasting plasma or capillary glucose; occurrence of episodes of severe hypoglycemia and occurrence of nocturnal hypoglycemia. The assessment of methodological quality was performed using the Newcastle score. The meta-analyses were performed on software Review Manager® 5.2. Results: Out of 705 publications, 8 cohort studies were included. The quality of these studies was classified as high. In the meta-analysis, results regarding episodes of severe hypoglycemia ( p = 0.02) and fasting glucose ( p = 0.01) were in favor of detemir. The glycated hemoglobin ( p = 0.49; I2 = 89) showed high heterogeneity and no statistically significant difference between the two. The meta-analysis of total insulin dose favored glargine ( p = 0.006; I2 = 75). The rates of nocturnal hypoglycemia (NH) were evaluated only for one study and showed a significant reduction of NH after therapy with detemir, ( p < 0.0001). Conclusion: Although some outcomes were favorable to detemir insulin analog, it has not been possible to identify important differences of effectiveness and safety between the two analogs. These results can help in the current debate on the inclusion of long-acting analogs on the list of reimbursed medicines in Brazil, especially with the recent introduction of an insulin glargine biosimilar at a considerably lower price.

Effectiveness and Safety Studies of Omalizumab in Children and Adolescents With Moderate-To-Severe Asthma

2021 ◽  
pp. 089719002110382
Author(s):  
Lu Cheng ◽  
Tianrui Yang ◽  
Xiang Ma ◽  
Yuling Han ◽  
Yongtai Wang
Keyword(s):  
Children And Adolescents ◽  
Allergic Asthma ◽  
Severe Asthma ◽  
Fixed Effects ◽  
Vital Capacity ◽  
Immunoglobulin E ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Significant Difference ◽  
Severe Allergic Asthma

Background Omalizumab is currently approved for the treatment of moderate-to-severe allergic asthma in patients 6 years and older. Objective To assess the effectiveness and safety of subcutaneous omalizumab as an add-on therapy option for moderate–severe allergic asthma in patients aged 6—20 years old. Methods The studies published from July, 1970 to May, 2021 were searched from the electronic databases which followed keywords: (“anti-IgE” OR “anti-immunoglobulin E” OR “anti-IgE antibody” OR “omalizumab” OR “rhuMAb-E25” OR “Xolair”) AND “asthma” AND (“child” OR “children” OR “adolescents” OR “youth” OR “teenager” OR “kids” OR “pediatric”). Thirteen studies were pooled to determine the effectiveness and safety of omalizumab. Efficacy endpoints were evaluated using a fixed-effects model or a random-effects model depending on heterogeneity. Safety endpoints were evaluated by odds ratio. Results Thirteen studies were included. In this meta-analysis, our results showed that fractional exhaled nitric oxide and asthma control test scores were significantly improved with omalizumab treatment. Serum immunoglobulin E was also decreased in children with moderate-to-severe asthma after treatment with omalizumab. The analysis found that there was no significant difference between pre-and post-treatment in forced expiratory volume in one second/ forced vital capacity ratio, forced expiratory flow between 25 and 75% of vital capacity, or FEV1. Overall, more adverse events occurred with omalizumab compared to placebo. However, the degree was mild to moderate. Conclusion This meta-analysis indicates that omalizumab is safe and effective to treat children and adolescents with moderate-to-severe asthma.

Vitamin B12 and Folate as Risk Factors for Retinal Vein Occlusion: A Meta-Analysis

2021 ◽  
Author(s):  
Dimitrios Kazantzis ◽  
Panagiotis Theodossiadis ◽  
Christos Kroupis ◽  
George Theodossiadis ◽  
Irini Chatziralli
Keyword(s):  
Vitamin B12 ◽  
Retinal Vein Occlusion ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Mean Difference ◽  
Serum Folate ◽  
Case Control Studies ◽  
Vein Occlusion ◽  
Pubmed Database ◽  
Significant Difference

Abstract Purpose To evaluate the association between serum vitamin B12/folate and retinal vein occlusion (RVO). Methods A comprehensive search of the PubMed database was performed, which identified 271 abstracts to be screened. Ten studies met our inclusion criteria and a meta-analysis of these comparative case-control studies was performed on the mean ± standard deviation serum vitamin B12 and folate levels, without language restrictions. Nine studies with 720 patients with RVO and 613 controls were included in the meta-analysis for vitamin B12, and 10 studies with 784 patients with RVO and 677 controls in the meta-analysis for folate. Results There was no statistically significant difference between patients with RVO and controls in serum vitamin B12 levels (mean difference: − 40.25 pg/mL, p = 0.28), either central RVO (mean difference: − 18.24 pg/mL, p = 0.71) or branch RVO (mean difference: − 23.56 pg/mL, p = 0.48). On the contrary, the plasma folate level was significantly lower in RVO patients than in controls (mean difference: − 1.34 ng/mL, p = 0.001), as well as in patients with CRVO compared to controls (mean difference: − 1.48 ng/mL, p = 0.006), but not in BRVO patients (mean difference: − 0.72 ng/mL, p = 0.11). Conclusions RVO is associated with low serum folate levels, but not with serum vitamin B12 levels.

Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000 to 2015: a multilevel analysis

2019 ◽  
Author(s):  
NÁDIA CRISTINA PINHEIRO RODRIGUES ◽  
Gisele O’Dwyer ◽  
Mônica Kramer de Noronha Andrade ◽  
Denise Leite Maia Monteiro ◽  
Inês Reis Nascimento Reis ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cancer Mortality ◽  
Fixed Effects ◽  
Mortality Rates ◽  
Lung Cancers ◽  
Esophageal Cancers ◽  
Risk Of Death ◽  
Colon Cancers ◽  
Significant Difference ◽  
Risk Of Cancer

Abstract Background. In Brazil, cancer is the second most common cause of death, and the most incident types of cancer are prostate, breast, lung, colon and rectum. This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals from 2000 to 2015. Methods. Data from 2005-2015 cancer mortality and resident population were collected from Information Technology Department of the Brazilian Unified Health System (DATASUS), the Brazilian Institute of Geography and Statistics (IBGE) and the Brazilian Mortality Information (SIM). State capitals were the study’s analytic units. A multilevel Poisson model was used to estimate the adjusted risk of cancer mortality (prostate, breast, cervix, colon, lung and esophageal cancers). The adjusted models included the following variables as fixed effects: age, Gross Domestic Product, region, year squared and year of death. Results. A statistically significant difference was found between mortality rates by gender for colon, lung and esophageal cancers. The highest mortality rates were observed in the older age group, especially for prostate and lung cancers, which values were higher than 100 deaths per 100,000. Comparing with those aged 40-59 years, men older than 59 years showed 47 times higher mortality risk for prostate cancer, 8-9 times higher for lung or colon cancers and four times higher for esophageal cancer. Compared with those aged 40-59 years, women older than 59 years old showed 5-7 times higher mortality risk for esophageal, lung or colon cancers and 2-3 times higher for breast or cervix cancers. Conclusions. Colon cancer mortality rate increased from 2000 to 2015 for both genders, while breast and lung cancers mortality increased over the period only for women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Northern capitals had a lower risk of death by prostate and breast cancer and a higher risk of death by cervix cancer.

A meta-analysis of biologic therapies on risk of new or recurrent cancer in patients with rheumatoid arthritis and a prior malignancy

Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 930-939 ◽  
Author(s):  
Wenhui Xie ◽  
Shiyu Xiao ◽  
Yanrong Huang ◽  
Xiaoying Sun ◽  
Dai Gao ◽  
...  
Keyword(s):  
Relative Risk ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Optimal Time ◽  
Biologic Therapies ◽  
Recurrent Cancer ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
Prior Malignancy

Abstract Objectives To explore the risk of new and recurrent cancer in adult RA patients with prior malignancy and subsequently exposed to biologic therapies. Methods Separate searches were performed of PubMed, EMBASE and Cochrane Library and conference proceedings for observational studies reporting cancer incidence or recurrence in patients with RA and prior malignancy treated with biologics and conventional synthetic DMARDs (csDMARDs). Mantel-Haenszel fixed-effects method was conducted to calculate relative risk and 95% CI. Results A total of 12 studies involving 13 598 patients and 32 473 patient-years of follow-up were included (10, 3 and 1 studies for TNF inhibitors [TNFi], rituximab and anakinra, respectively). The crude incidence of new and recurrent cancer per 1000 patient-years were 34.4 for TNFi, 32.3 for rituximab, 32.3 for anakinra and 31.8 for csDMARDs. In the quantitative meta-analysis, biologics were not associated with an increased risk of new or recurrent cancer compared with csDMARDs in patients with RA and prior cancer (TNFi: relative risk = 0.95, 95% CI = 0.83, 1.09; rituximab: relative risk = 0.89, 95% CI = 0.52, 1.53). Secondary analyses of stratification of cancer types, the interval between initiation of TNFi and prior cancer diagnosis, and duration of TNFi exposure, found similar results. Conclusion Compared with csDMARDs, there is no increased risk of developing cancer overall or some specific subtypes in RA patients with a prior cancer receiving biologics. More investigations are warranted to explore the risk of cancer development in individual cancer as well as to determine optimal time to initiate biologic therapy after the diagnosis of cancer or completion of cancer treatment.

scholarly journals Radiofrequency ablation versus hepatic resection for recurrent hepatocellular carcinoma: an updated meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daopeng Yang ◽  
Bowen Zhuang ◽  
Yan Wang ◽  
Xiaoyan Xie ◽  
Xiaohua Xie
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Hepatic Resection ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Recurrent Hepatocellular Carcinoma ◽  
Major Complications ◽  
Alternative Treatment Option ◽  
Significant Difference

Abstract Background The clinical benefits of treatment with radiofrequency ablation (RFA) and repeat hepatic resection (RHR) for recurrent hepatocellular carcinoma (RHCC) remain controversial. This meta-analysis aims to evaluate the outcomes and major complications of RFA versus RHR in patients with early-stage RHCC. Methods PubMed, Embase, Web of Science and the Cochrane Library were systematically searched for comparative studies on the evaluation of RHR versus RFA for RHCC. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS) and major complications. Meta-analysis was performed using a random-effects model or fixed-effects model, and heterogeneity was tested by the Cochran Q statistic. Results Ten studies with 1612 patients (RHR = 654, RFA = 958) were included in the meta-analysis. The meta-analysis showed that RHR had superior OS (HR 0.77, 95% CI =0.65–0.92, P = 0.004) and PFS (HR 0.81, 95% CI =0.67–0.98, P = 0.027) compared to RFA, whereas major complications may be less frequent in the RFA group (OR 0.15, 95% CI = 0.06–0.39, P < 0.001). In the subgroup analysis of patients with single RHCC ≤3 cm, OS (HR 1.03, 95% CI =0.69–1.52, P = 0.897) and PFS (HR 0.99, 95% CI = 0.71–1.37, P = 0.929) showed no significant differences in the comparison of RHR and RFA. In single RHCC> 3 cm and ≤ 5 cm, RFA showed an increased mortality in terms of OS (HR 0.57, 95% CI = 0.37–0.89, P = 0.014). Conclusion RHR offers a longer OS and PFS than RFA for patients with RHCC, but no statistically significant difference was observed for single RHCC ≤3 cm. The advantages of fewer major complications may render RFA an alternative treatment option for selected patients.

scholarly journals The Protective Effect of Dietary Phytosterols on Cancer Risk: A Systematic Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Lu Jiang ◽  
Xin Zhao ◽  
Jun Xu ◽  
Chujun Li ◽  
Yue Yu ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Case Control ◽  
Systematic Evaluation ◽  
Response Analysis ◽  
Relative Risks ◽  
Anticancer Effects ◽  
Summary Relative Risk ◽  
Risk Of Cancer

Backgrounds/Aims. Many studies have explored the association between dietary phytosterols and cancer risk, but the results have been inconsistent. We aimed to provide a synopsis of the current understanding of phytosterol intake for cancer risk through a systematic evaluation of the results from previous studies. Methods. We performed a literature search of PUBMED, EMBASE, CNKI, and Wanfang, and studies published before May 2019 focusing on dietary total phytosterols, β-sitosterol, campesterol, stigmasterol, β-sitostanol, and campestanol, as well as their relationships with cancer risk, were included in this meta-analysis. Summaries of the relative risks from 11 case-control and case-cohort studies were eventually estimated by randomized or fixed effects models. Results. The summary relative risk for the highest versus the lowest intake was 0.63 (95% confidence interval [CI] = 0.49–0.81) for total phytosterols, 0.74 (95% CI = 0.54–1.02) for β-sitosterol, 0.72 (95% CI = 0.51–1.00) for campesterol, 0.83 (95% CI = 0.60–1.16) for stigmasterol, 1.12 (95% CI = 0.96–1.32) for β-sitostanol, and 0.77 (95% CI = 0.65–0.90) for campestanol. In a dose-response analysis, the results suggested a linear association for campesterol and a nonlinear association for total phytosterol intake. Conclusion. Our findings support the hypothesis that high phytosterol intake is inversely related to risk of cancer. Further studies with prospective designs that control for vital confounders and investigate the important anticancer effects of dietary phytosterols are warranted.

Treatment Emergent Sexual Dysfunction Related to Antidepressants: A Meta-analysis

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Chiesa ◽  
A. Serretti ◽  
R. Calati ◽  
D. de Ronchi
Keyword(s):  
Sexual Dysfunction ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Cochrane Collaboration ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Open Label ◽  
Significant Difference ◽  
Total Treatment ◽  
The Cochrane Collaboration

Objective:Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.Methods:A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.Results:Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.Discussion:Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.

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