Dengzhanxixin injection for cerebral infarction: A systematic review and meta-analysis of randomized controlled trials.
Ontology highlight
ABSTRACT:
SUBMITTER: Wang J
PROVIDER: S-EPMC5556216 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
Similar Datasets
Project description:IntroductionAs a common chronic disease with high morbidity and recurrent rate, acute cerebral infarction (ACI) affects the life quality of patients and gives them heavy psychological burden. And Danshen class injections (DSCIs) are commonly adopted in treating ACI. So, this network meta-analysis (NMA) was designed to assess the clinical efficacy of eight kinds of DSCIs.MethodsA systematic literature search was performed in PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure Database, the China Biomedical Literature Service System, the Chinese Scientific Journals Full-text Database, and Wanfang database from their inception to 16th Dec. 2017 aiming to collect related randomized controlled trials (RCTs). And then data were analyzed through Stata and WinBUGS software based on the Bayesian statistical model. The results were reported as odds ratio (OR) and mean difference (MD) with 95% credible intervals (CIs). The consistency test between direct and indirect comparisons was also evaluated and inconsistency factor was presented to manifest the heterogeneity among them. Meanwhile, the surface under the cumulative ranking probabilities (SUCRA) was utilized to rank the treatments in different outcomes.ResultsFinally, 157 RCTs with 15570 patients were included. A total of eight types DSCIs were identified. Based on the results, Sodium Tanshinone IIA Sulfonate injection (STS) plus western medicine (WM) had better effect on the clinical effectiveness rate, neurological impairment, and activities of daily living function than others. Meanwhile, Danhong injection (DS) and Danshen Salvianolic Acids injection (DSSA) had excellent performance in perfecting hemorheological indexes.ConclusionsIn conclusion, STS plus WM may be the optimum treatment for ACI. The following therapies were DS plus WM and DSSA plus WM. Nevertheless, in terms of the limitations of the study, more large samples, multicenter, and double-blind RCTs are still needed for validating our findings.
| S-EPMC6377994 | biostudies-literature
Project description:In 2012, the United States Food and Drug Administration (FDA) issued a warning regarding potential adverse effects of HMG-CoA reductase inhibitors (statins) on cognition, based on the Adverse Events Reporting System and a review of the medical literature. We aimed to synthesize randomized clinical trial (RCTs) evidence on the association between statin therapy and cognitive outcomes.We searched MEDLINE, EMBASE, and Cochrane CENTRAL through December 2012, and reviewed published systematic reviews of statin treatment. We sought RCTs that compared statin treatment versus placebo or standard care, and reported at least one cognitive outcome (frequency of adverse cognitive events or measurements using standard neuropsychological cognitive test scores). Studies reporting sufficient information to calculate effect sizes were included in meta-analyses. Standardized and unstandardized mean differences were calculated for continuous outcomes for global cognition and for pre-specified cognitive domains. The main outcome was change in cognition measured by neuropsychological tests; an outcome of secondary interest was the frequency of adverse cognitive events observed during follow-up.We identified 25 RCTs (all placebo-controlled) reporting cognitive outcomes in 46,836 subjects, of which 23 RCTs reported cognitive test results in 29,012 participants. Adverse cognitive outcomes attributable to statins were rarely reported in trials involving cognitively normal or impaired subjects. Furthermore, meta-analysis of cognitive test data (14 studies; 27,643 participants) failed to show significant adverse effects of statins on all tests of cognition in either cognitively normal subjects (standardized mean difference 0.01, 95% confidence interval, CI, -0.01 to 0.03, p?=?0.42) or Alzheimer's disease subjects (standardized mean difference -0.05, 95% CI -0.19 to 0.10, p?=?0.38).Statin therapy was not associated with cognitive impairment in RCTs. These results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.
| S-EPMC4351273 | biostudies-other
Project description:BackgroundBiologic agents are emerging as an important treatment option for immune-mediated diseases. Injection site reactions following subcutaneous injection of biologic agents is not well described in the literature.ObjectiveTo summarize injection site reaction data in phase 3 trials of all biologic agents.MethodsMEDLINE, Embase, and CENTRAL databases were systematically searched on February 8, 2022. Proportional meta-analysis was conducted to summarize injection site reaction prevalence for each biologic.ResultsThere were 158 articles included in the review. The most common types of injection site reactions were erythema (42.8%), unspecified reaction (23.3%), pain (12.4%), and pruritus (5.7%). No patients discontinued their treatment due to injection site reactions in 39 of the 48 studies that reported on discontinuation data. There were 16 biologics included in meta-analysis across 80 eligible studies. The biologics with the highest point prevalence of patients reporting injection site reactions were Canakinumab (15.5%; 294 patients), Dupilumab (11.4%; 1888 patients), Etanercept (11.4%; 4363 patients), and Ixekizumab (11.2%; 2205 patients). The biologics with the lowest point prevalence of injection site reactions were Risankizumab (0.8%; 707 patients), Brodalumab (1.3%; 1365 patients), Guselkumab (1.3%; 1852 patients), Secukinumab (1.9%; 1277 patients).ConclusionsThe prevalence of injection site reaction in response to biologics ranges from 0.08 to 15.5%. Canakinumab, Dupilumab, Etanercept, and Ixekizumab had the highest prevalence of injection site reactions. Risankizumab, Brodalumab, Guselkumab, and Secukinumab had the lowest prevalence of injection site reactions. Recommendations are made regarding the improvement of adverse event reporting to better understand the epidemiology of injection site reactions.
| S-EPMC10486173 | biostudies-literature
Project description:BackgroundAcupoint injection has currently received increasing attention as a treatment for primary osteoporosis (POP). A number of randomized controlled trials (RCTs) have reported that acupoint injection have some advantages in treatment of POP. However, no article has summarized the existing evidence. This study will evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP, so as to provide an important reference for clinical decision-making.MethodsRCTs of acupoint injection compared with conventional non-acupoint injection for POP were identified in searches of 7 databases from their inception to March 2019. All data were assessed and extracted by 2 authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. Review Manager 5.3 (Cochrane Collaboration) was used to conduct meta-analysis for the efficacy and safety of acupoint injection.ResultThe results of this systemic review and meta-analysis will be submitted to a recognized journal for publication.ConclusionThis systemic review and meta-analysis will evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP. We hope this study can make a definitive conclusion for acupoint injection in the treatment of POP.RegistrationPROSPERO (registration number CRD42019130890).
| S-EPMC6709080 | biostudies-literature
Project description:MethodsPubMed Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, VIP, and Wanfang databases were searched. The primary outcome was treatment response. The secondary outcomes included changes in clinical and laboratory indicators and incidence of AP-related complications. Meta-analyses were performed by using a random-effect model. Risk ratios (RRs) with 95% confidence intervals (CIs) or weighted mean differences (WMDs) with 95% CIs were calculated.ResultsOverall, 23 RCTs were included. The rates of overall (RR = 1.16; 95% CI = 1.12 to 1.20; P < 0.00001) and complete (RR = 1.40; 95% CI = 1.30 to 1.50; P < 0.00001) responses were significantly higher in the Xuebijing injection group. After treatment, the levels of interleukin-6 (WMD = -18.22; 95% CI = -23.36 to -13.08; P < 0.00001), tumor necrosis factor-α (WMD = -16.44; 95% CI = -20.49 to -12.40; P < 0.00001), serum amylase (WMD = -105.61; 95% CI = -173.77 to -37.46; P=0.002), white blood cell (WMD = -1.51; 95% CI = -1.66 to -1.36; P < 0.00001), and C-reactive protein (WMD = -11.05; 95% CI = -14.32 to -7.78; P < 0.00001) were significantly lower in the Xuebijing injection group. Abdominal pain (WMD = -1.74; 95% CI = -1.96 to -1.52; P < 0.00001), abdominal distension (WMD = -1.56; 95% CI = -2.07 to -1.04; P < 0.00001), gastrointestinal function (WMD = -2.60; 95% CI = -3.07 to -2.13; P < 0.00001), body temperature (WMD = -2.16; 95% CI = -2.83 to -1.49; P < 0.00001), serum amylase level (WMD = -1.81; 95% CI = -2.66 to -0.96; P < 0.0001), and white blood cell (WMD = -2.16; 95% CI = -2.99 to -1.32; P < 0.00001) recovered more rapidly in the Xuebijing injection group. The incidence of multiple organ dysfunction syndrome (RR = 0.18; 95% CI = 0.05 to 0.62; P=0.006), pancreatic pseudocyst (RR = 0.17; 95% CI = 0.04 to 0.77; P=0.02), and renal failure (RR = 0.16; 95% CI = 0.05 to 0.60; P=0.006) was significantly lower in the Xuebijing injection group.ConclusionsXuebijing injection added on the basis of conventional treatment has a potential benefit for improving the outcomes of AP.
| S-EPMC8214658 | biostudies-literature
Project description:Objective. The randomized controlled trials (RCTs) on Guanxinning injection (GXN) in treating angina pectoris were published only in Chinese and have not been systematically reviewed. This study aims to provide a PRISMA-compliant and internationally accessible systematic review to evaluate the efficacy of GXN in treating angina pectoris. Methods. The RCTs were included according to prespecified eligibility criteria. Meta-analysis was performed to evaluate the symptomatic (SYMPTOMS) and electrocardiographic (ECG) improvements after treatment. Odds ratios (ORs) were used to measure effect sizes. Subgroup analysis, sensitivity analysis, and metaregression were conducted to evaluate the robustness of the results. Results. Sixty-five RCTs published between 2002 and 2012 with 6064 participants were included. Overall ORs comparing GXN with other drugs were 3.32 (95% CI: [2.72, 4.04]) in SYMPTOMS and 2.59 (95% CI: [2.14, 3.15]) in ECG. Subgroup analysis, sensitivity analysis, and metaregression found no statistically significant dependence of overall ORs upon specific study characteristics. Conclusion. This meta-analysis of eligible RCTs provides evidence that GXN is effective in treating angina pectoris. This evidence warrants further RCTs of higher quality, longer follow-up periods, larger sample sizes, and multicentres/multicountries for more extensive subgroup, sensitivity, and metaregression analyses.
| S-EPMC3619549 | biostudies-literature
Project description:To evaluate systematically the clinical effectiveness and safety of Danhong injection (DI) and Salvia miltiorrhiza injection (SMI) in the treatment of cerebral infarction.A literature search was conducted for retrieving randomized controlled trials (RCTs) on cerebral infarction treated by Danhong injection and SMI in the Cochrane Library, PubMed, Embase, China Biology Medicine disc, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang Database up to January 22, 2017. Two reviewers extracted information and independently assessed the quality of included RCTs by the Cochrane Risk of Bias Assessment Tool; then data were analyzed with Review Manager 5.3 software.Twelve RCTs involving 1044 patients were included. The result of DI group was about 27% superior to SMI group in the clinical total effective rate (relative risk 1.27, 95% confidence interval 1.19-1.35, P?<?.00001). In addition, DI could prefect neurologic impairment (standardized mean difference -1.22, 95% confidence interval -1.90 to -0.54, P?=?.0004), and adjust hemorheological parameters. Three RCTs occurred 4 cases of adverse drug reactions/adverse drug events, but there were no serious adverse drug reactions/adverse drug events.Comparing with SMI combined with western medicine, DI combined with conventional therapy is more effective in improving the clinical total effective rate and neurologic impairment, but more evidence-based medicine research needed to support our study further.
| S-EPMC5459743 | biostudies-other
Project description:Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs.The present study was a systematic review and network meta-analysis of RCTs. All RCTs must meet the following criteria to be included in the analysis: patients with body mass index (BMI) ?30?kg/m, reported at least 1 outcome of interest, compared at least 2 of the 3 bariatric procedures, and had follow-ups of at least 1 year. Primary outcome was weight loss, expressed as differences in mean BMI reduction and percentage excess weight loss (%EWL) following 1 year after the surgery. Network meta-analysis was based on Bayesian framework with Markov Chain Monte Carlo simulation approach.Eleven RCTs that met the criteria were included in the review. Of 9 trials (n?=?765), the differences in mean BMI reduction were -0.76 (95% CI: -3.1 to 1.6) for RYGB versus SG, -5.8 (95% CI: -9.2 to -2.4) for RYGB versus LAGB, and -5.0 (95% CI: -9.0 to -1.0) for SG versus LAGB. Eight RCTs (n?=?656) reported percentage excess weight-loss (%EWL), the mean differences between RYGB and SG, RYGB and LAGB, and SG and LAGB were 3.8% (95% CI: -8.5% to 13.8%), -22.2% (95% CI: -34.7% to -6.5%), and -26.0% (95% CI: -40.6% to -6.4%), respectively. The meta-analysis indicated low heterogeneity between studies, and the node splitting analysis showed that the studies were consistent between direct and indirect comparisons (P?>?.05).The RYGB and SG yielded similar in weight-loss effect and both were superior to LAGB. Other factors such as complications and patient preference should be considered during surgical consultations.
| S-EPMC5704829 | biostudies-other
Project description:Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], -0.54; 95% confidence intervals [CI], -0.77 to -0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, -0.81; 95% CI, -1.11 to -0.52; P < 0.05) and osteoporosis (SMD, -0.83; 95% CI, -1.37 to -0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.
| S-EPMC4850460 | biostudies-other
Project description:High prevalence of cerebral desaturation is associated with postoperative neurological complications in cardiac surgery. However, the evidence use of cerebral oximetry by correcting cerebral desaturation in the reduction of postoperative complications remains uncertain in the literature. This systematic review and meta-analysis aimed to examine the effect of cerebral oximetry on the incidence of postoperative cognitive dysfunction in cardiac surgery. Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception until April 2021. All randomized controlled trials comparing cerebral oximetry and blinded/no cerebral oximetry in adult patients undergoing cardiac surgery were included. Observational studies, case series, and case reports were excluded. A total of 14 trials (n = 2,033) were included in this review. Our pooled data demonstrated that patients with cerebral oximetry were associated with a lower incidence of postoperative cognitive dysfunction than the control group (studies = 4, n = 609, odds ratio [OR]: 0.15, 95% confidence interval [CI]: 0.04 to 0.54, P = 0.003, I2 = 88%; certainty of evidence = very low). In terms of postoperative delirium (OR: 0.75, 95%CI: 0.50-1.14, P = 0.18, I2 = 0%; certainty of evidence = low) and postoperative stroke (OR: 0.81 95%CI: 0.37-1.80, P = 0.61, I2 = 0%; certainty of evidence = high), no significant differences (P > 0.05) were reported between the cerebral oximetry and control groups. In this meta-analysis, the use of cerebral oximetry monitoring in cardiac surgery demonstrated a lower incidence of postoperative cognitive dysfunction. However, this finding must be interpreted with caution due to the low level of evidence, high degree of heterogeneity, lack of standardized cognitive assessments, and cerebral desaturation interventions.
| S-EPMC9732949 | biostudies-literature