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Prevalence of antiphospholipid antibodies in Behcet's disease: A systematic review and meta-analysis.

ABSTRACT: Behçet's disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)-including anticardiolipin (aCL), anti-?2-glycoprotein I (?2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg's and Egger's tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15-28.41, p<0.00001) and anti-?2-GPI antibodies (OR: 23.57, 95% CI: 1.31-423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65-293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg's and Egger's tests. This meta-analysis established that there is a significantly high prevalence of aPLs (i.e., aCL and anti-?2-GPI antibodies) in patients with BD when compared to controls.

SUBMITTER: Islam MA

PROVIDER: S-EPMC6957187 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis.

Islam Md Asiful MA Alam Sayeda Sadia SS Kundu Shoumik S Prodhan A H M Safayet Ullah AHMSU Khandker Shahad Saif SS Reshetnyak Tatiana T Kotyla Przemysław J PJ Hassan Rosline R Hossan Tareq T

PloS one 20200113 1

Behçet's disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)-including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evalu ...[more]

PMID: 31929597

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Project description:BackgroundBehcet's disease (BD) is an autoimmune disease of systemic vasculitis with an unclear pathogenesis. Although western medicines remain the mainstay interventions, effectiveness and safety are significant challenges. Complementary and alternative medicine, including herbal medicine, are gaining more attention. Chinese medicine decoctions, which have been used for centuries, are the most common form of traditional therapies.ObjectiveThe purpose of the review was to evaluate the effectiveness and safety of Chinese medicine decoctions in the treatment of BD.MethodsRandomized controlled trials (RCTs) for BD treatment with Chinese medicine decoctions were searched in six electronic databases until March 2021. Primary outcomes were total effective rate, recovery rate, and recurrence rate. Secondary outcomes were clinical feature scores (oral ulcers, eye lesions, genital ulcers, skin lesions, arthropathies, fever, and pathergy reactions) and laboratory index levels (erythrocyte sedimentation rate, C-reactive protein, and immunoglobulin A). The risk of bias was assessed with the Cochrane Handbook, and a meta-analysis was performed with RevMan 5.4.1.ResultsSixteen RCTs with 924 patients were included in the review. The meta-analysis indicated that Chinese medicine decoctions were effective for BD when compared with control groups for all the primary outcomes and 7/10 of the secondary outcomes. Adverse events were reported in 11 of the 16 RCTs, with the Chinese medicine decoctions possibly having fewer adverse events than western drugs. This review included a range of classical prescriptions. An additional meta-analysis of modified Gancao Xiexin Decoction for BD treatment was conducted. Gancao Xiexin decoction is also discussed as a representative prescription, as well as high-frequency herbs, and warrants further exploration for individualized medicine and pharmacology.ConclusionChinese medicine decoctions have the potential to be effective and safe for treating BD. However, additional well-designed RCTs are needed to confirm the findings because of the unsatisfactory quality of the included studies.

Project description:Aims and objectivesThis systematic review and meta-analysis reports the seroprevalence of SARS-CoV-2 antibodies among nurses.BackgroundWith a growing body of literature reporting the positive serology for SARS-CoV-2 antibodies among healthcare workers, it remains unclear whether staff at the point of direct patient care are more prone to developing and transmitting the virus. Given nurses make up the majority of the global health workforce, outbreaks among these workers could severely undermine a health system's capability to manage the pandemic. We aimed to summarise and report the seroprevalence of SARS-CoV-2 antibodies among nurses globally.DesignSystematic review and meta-analyses.MethodsThis systematic review was developed, undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We searched the electronic medical literature databases: MEDLINE; CINAHL; and EMBASE for studies reporting the seroprevalence of SARS-CoV-2 antibodies among nursing staff. Studies that reported nursing specific data were included in this review. Study quality was evaluated using the Joanna Briggs Institute checklist for studies reporting prevalence data. Studies were stratified according to the World Health Organisation region classifications, and results were presented using forest plots and summary prevalence and variance was estimated using a random effects model.ResultsOur electronic search identified 1687 potential studies, of which 1148 were screened for eligibility after duplicates were removed, and 51 of the studies were included in our meta-analysis. The overall seroprevalence of SARS-CoV-2 antibodies among nurses was estimated to be 8.1% (95% CI 6.9%-9.4%) among the 60,571 participants included in the studies. Seropositivity was highest in the African region (48.2%, 95% CI 39.2%-57.3%), followed by the European region (10.3%, 95% CI 8.0%-12.5%), the Region of the Americas (8.4%, 95% CI 6.0%-10.7%), the South-East Asia region (3.0%, 95% CI 0.00%-6.5%) and the Western Pacific region (0.5%, 95% CI 0.0%-1.0%). Pooled estimates were unable to be calculated in the Eastern Mediterranean region due to insufficient studies.ConclusionThe seroprevalence of SARS-CoV-2 antibodies among nurses is comparable to other healthcare workers, and possibly similar to the general population. Early adoption and adherence to personal protective equipment and social distancing measures could explain these similarities, meaning the majority of staff contracted the virus through community transmission and not in a healthcare setting.Relevance to clinical practiceFear and uncertainty have been features of this pandemic, including among nurses. This meta-analysis should provide some comfort to nurses that risks are similar to community exposure when adequate PPE is available and there is an adherence to infection control measures.

Dataset Information

Prevalence of antiphospholipid antibodies in Behcet's disease: A systematic review and meta-analysis.

Publications

Prevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis.

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