Purpose. Paclitaxel and carboplatin are novel anticancer drugs that have emerged in recent years, while there is still a lack of clinical consensus on these two drugs. The study conducted a meta-analysis and systematic review to analyze the efficacy and safety of paclitaxel and carboplatin for platinum-sensitive ovarian cancer. Methods. A systematic search was carried out in three databases of the Cochrane Library, Embase, and PubMed from the inception of each database to March 2021, and defined the progression-free survival and overall survival as the primary outcomes. Data analysis was performed using STATA 15.1. Results. Altogether, five randomized controlled trials (RCTs) were included in the meta-analysis, involving 2,740 patients, including 1317 in the CD (carboplatin doxorubicin) group and 1423 in the CP (carboplatin plus paclitaxel) group. It was found that pooled OS demonstrated no significant differences between the CD group and CP group (HR = 1.02, 95% CI = 0.89–1.18, P = 0.340), and the differences were not statistically significant in progression-free survival (HR = 0.84, 95% CI = 0.71–0.99, P = 0.140), thrombocytopenia (OR = 0.23, 95% CI = 0.09−0.58, P = 0.775), and grade II alopecia between the two groups (OR = 9.41, 95% CI = 6.57–13.47, P = 0.215). Conclusion. Current evidence suggests that paclitaxel and carboplatin do not produce more satisfactory results with respect to overall survival and reduction of side effects in treating platinum-sensitive ovarian cancer, and further studies are needed.
{"title":"Efficacy and Safety of Paclitaxel and Carboplatin for Platinum-Sensitive Ovarian Cancer: A Systematic Review and Meta-Analysis","authors":"Yan Zhou, Wei Guo","doi":"10.1155/2023/1951412","DOIUrl":"https://doi.org/10.1155/2023/1951412","url":null,"abstract":"Purpose. Paclitaxel and carboplatin are novel anticancer drugs that have emerged in recent years, while there is still a lack of clinical consensus on these two drugs. The study conducted a meta-analysis and systematic review to analyze the efficacy and safety of paclitaxel and carboplatin for platinum-sensitive ovarian cancer. Methods. A systematic search was carried out in three databases of the Cochrane Library, Embase, and PubMed from the inception of each database to March 2021, and defined the progression-free survival and overall survival as the primary outcomes. Data analysis was performed using STATA 15.1. Results. Altogether, five randomized controlled trials (RCTs) were included in the meta-analysis, involving 2,740 patients, including 1317 in the CD (carboplatin doxorubicin) group and 1423 in the CP (carboplatin plus paclitaxel) group. It was found that pooled OS demonstrated no significant differences between the CD group and CP group (HR = 1.02, 95% CI = 0.89–1.18, \u0000 \u0000 P\u0000 \u0000 = 0.340), and the differences were not statistically significant in progression-free survival (HR = 0.84, 95% CI = 0.71–0.99, \u0000 \u0000 P\u0000 \u0000 = 0.140), thrombocytopenia (OR = 0.23, 95% CI = 0.09−0.58, P = 0.775), and grade II alopecia between the two groups (OR = 9.41, 95% CI = 6.57–13.47, \u0000 \u0000 P\u0000 \u0000 = 0.215). Conclusion. Current evidence suggests that paclitaxel and carboplatin do not produce more satisfactory results with respect to overall survival and reduction of side effects in treating platinum-sensitive ovarian cancer, and further studies are needed.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":"1 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41349736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. The main objective of this study is to evaluate the clinical efficacy of antithyroid drugs combined with antioxidant supplementation represented by selenium in the treatment of Graves’ disease. Methods. Relevant randomized controlled trials (RCTs) were searched in PubMed, MEDLINE, Embase, the Cochrane Library databases, and the Chinese Medical Association. The search was conducted from the time of library construction to December 20, 2022. Three writers gradually examined, evaluated, and graded the literature and then used RevMan 5.3 to analyze the data and develop conclusions. Results. A total of seven papers were screened according to the search requirements. The results showed that free triiodothyronine (FT3) (WMD = −2.29, 95% CI: −3.55 to −1.02, P = 0.0004 ), free thyroxine (FT4) (WMD = −0.62, 95% CI: −1.05 to −0.18, P = 0.0005 ), thyrotropin receptor antibody (TRAb) (WMD = −1.31, 95% CI: −1.63 to −0.99, P < 0.00001 ), and thyroid peroxidase antibody (TPOAb) (WMD = −9.8, 95% CI: −16.57 to −3.03, P = 0.005 ) in the observation group (selenium supplementation combined with antithyroid drugs) were significantly lower than those in the control group (antithyroid drugs combined with or without placebo). In addition, selenium supplementation can increase serum selenium (WMD = 33.29, 95% CI: 30.7 to 35.87, P < 0.00001 ), selenoprotein levels (WMD = 1.3, 95% CI: 0.8 to 1.8, P < 0.00001 ), and blood lipid levels (WMD = 32.3, 95% CI: 17.87 to 46.74, P < 0.0001 ). It cannot be excluded that the process of selenium supplementation treatment will affect the patient’s lipid levels. Conclusion. Selenium is a trace mineral that is crucial for human health. In patients with Graves’ disease, the use of antithyroid medications along with selenium supplementation can considerably enhance thyroid function. It has the potential to drastically lower TPOAb and TRAb levels as well as FT3 and FT4 levels, which is crucial for the treatment, recovery, and prognosis of hyperthyroid patients. Further research is required to determine whether the impact of antioxidant supplementation on blood lipids will restrict the use of this medication.
{"title":"Effects of Antioxidant Supplementation on Graves’ Disease: A Meta-Analysis","authors":"Qi Song, Xiaoxue Ji, Ying Xie","doi":"10.1155/2023/5587361","DOIUrl":"https://doi.org/10.1155/2023/5587361","url":null,"abstract":"Objective. The main objective of this study is to evaluate the clinical efficacy of antithyroid drugs combined with antioxidant supplementation represented by selenium in the treatment of Graves’ disease. Methods. Relevant randomized controlled trials (RCTs) were searched in PubMed, MEDLINE, Embase, the Cochrane Library databases, and the Chinese Medical Association. The search was conducted from the time of library construction to December 20, 2022. Three writers gradually examined, evaluated, and graded the literature and then used RevMan 5.3 to analyze the data and develop conclusions. Results. A total of seven papers were screened according to the search requirements. The results showed that free triiodothyronine (FT3) (WMD = −2.29, 95% CI: −3.55 to −1.02, \u0000 \u0000 P\u0000 =\u0000 0.0004\u0000 \u0000 ), free thyroxine (FT4) (WMD = −0.62, 95% CI: −1.05 to −0.18, \u0000 \u0000 P\u0000 =\u0000 0.0005\u0000 \u0000 ), thyrotropin receptor antibody (TRAb) (WMD = −1.31, 95% CI: −1.63 to −0.99, \u0000 \u0000 P\u0000 <\u0000 0.00001\u0000 \u0000 ), and thyroid peroxidase antibody (TPOAb) (WMD = −9.8, 95% CI: −16.57 to −3.03, \u0000 \u0000 P\u0000 =\u0000 0.005\u0000 \u0000 ) in the observation group (selenium supplementation combined with antithyroid drugs) were significantly lower than those in the control group (antithyroid drugs combined with or without placebo). In addition, selenium supplementation can increase serum selenium (WMD = 33.29, 95% CI: 30.7 to 35.87, \u0000 \u0000 P\u0000 <\u0000 0.00001\u0000 \u0000 ), selenoprotein levels (WMD = 1.3, 95% CI: 0.8 to 1.8, \u0000 \u0000 P\u0000 <\u0000 0.00001\u0000 \u0000 ), and blood lipid levels (WMD = 32.3, 95% CI: 17.87 to 46.74, \u0000 \u0000 P\u0000 <\u0000 0.0001\u0000 \u0000 ). It cannot be excluded that the process of selenium supplementation treatment will affect the patient’s lipid levels. Conclusion. Selenium is a trace mineral that is crucial for human health. In patients with Graves’ disease, the use of antithyroid medications along with selenium supplementation can considerably enhance thyroid function. It has the potential to drastically lower TPOAb and TRAb levels as well as FT3 and FT4 levels, which is crucial for the treatment, recovery, and prognosis of hyperthyroid patients. Further research is required to determine whether the impact of antioxidant supplementation on blood lipids will restrict the use of this medication.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45518661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Wang, Yusheng Du, Yue-Shuang Tan, Y. Liu, Aiwei Wen
Background. The optimal analgesic dose of S-ketamine after laparoscopic gastrointestinal malignancy surgery remains unclear. This study aimed to evaluate the effect of S-ketamine combined with sufentanil in patient-controlled intravenous analgesia (PCIA) on postoperative pain relief in elderly patients undergoing laparoscopic surgery for gastrointestinal tumors. Methods. Elderly patients undergoing laparoscopic radical resection of gastrointestinal cancer were randomly assigned to one of three postoperative analgesia groups: F group received 2 ug/kg sufentanil in PCIA, LSF group received 0.5 mg/kg S-ketamine and 1.5 ug/kg sufentanil, and SF group received 1 mg/kg S-ketamine and 1 ug/kg sufentanil. The PCIA also contained 0.15 mg/kg of butorphanol and 0.02 mg/kg of ramosetron. Study drugs were administered via PCIA for 48 hours postoperatively. The primary outcome was the accumulated parecoxib sodium requirements within 48 hours after surgery. Results. A total of 105 patients were randomized, and 95 completed the trial (F group: n = 32, LSF group: n = 32, and SF group: n = 31). The cumulative consumption of parecoxib sodium within 48 hours postoperatively was lower in the SF group compared to that in the F group (median difference: −40 mg; 95% confidence interval: −40 to 0; P = 0.0028 ). The number of PCIA compressions within 48 hours after surgery was smaller in the SF group compared to that in the F group. NRS pain scores at 6 h and 12 h postoperatively were reduced in the SF group compared to that in the F group, both at rest and during movement. Compared to the F group, the incidence of postoperative mild depression was lower, the time to first flatus and time to first defecation were shorter, and the incidence of postoperative vomiting was lower in the SF group. The mechanical pain threshold, hyperalgesia area, and sedation scores were similar between the SF and F groups. No differences were observed in the abovementioned parameters between the LSF group and the F group. Conclusion. This trial demonstrated that 1.0 mg/kg S-ketamine combined with 1 ug/kg sufentanil in PCA decreased cumulative parecoxib sodium consumption within 48 hours after laparoscopic radical resection of gastrointestinal cancer in elderly patients.
{"title":"Comparing the Effectiveness of S-Ketamine Combined with Sufentanil versus Sufentanil Alone for Postoperative Pain Management in Elderly Patients Undergoing Laparoscopic Radical Resection of Gastrointestinal Cancer: A Randomized Controlled Trial","authors":"Ji Wang, Yusheng Du, Yue-Shuang Tan, Y. Liu, Aiwei Wen","doi":"10.1155/2023/1327019","DOIUrl":"https://doi.org/10.1155/2023/1327019","url":null,"abstract":"Background. The optimal analgesic dose of S-ketamine after laparoscopic gastrointestinal malignancy surgery remains unclear. This study aimed to evaluate the effect of S-ketamine combined with sufentanil in patient-controlled intravenous analgesia (PCIA) on postoperative pain relief in elderly patients undergoing laparoscopic surgery for gastrointestinal tumors. Methods. Elderly patients undergoing laparoscopic radical resection of gastrointestinal cancer were randomly assigned to one of three postoperative analgesia groups: F group received 2 ug/kg sufentanil in PCIA, LSF group received 0.5 mg/kg S-ketamine and 1.5 ug/kg sufentanil, and SF group received 1 mg/kg S-ketamine and 1 ug/kg sufentanil. The PCIA also contained 0.15 mg/kg of butorphanol and 0.02 mg/kg of ramosetron. Study drugs were administered via PCIA for 48 hours postoperatively. The primary outcome was the accumulated parecoxib sodium requirements within 48 hours after surgery. Results. A total of 105 patients were randomized, and 95 completed the trial (F group: n = 32, LSF group: n = 32, and SF group: n = 31). The cumulative consumption of parecoxib sodium within 48 hours postoperatively was lower in the SF group compared to that in the F group (median difference: −40 mg; 95% confidence interval: −40 to 0; \u0000 \u0000 P\u0000 =\u0000 0.0028\u0000 \u0000 ). The number of PCIA compressions within 48 hours after surgery was smaller in the SF group compared to that in the F group. NRS pain scores at 6 h and 12 h postoperatively were reduced in the SF group compared to that in the F group, both at rest and during movement. Compared to the F group, the incidence of postoperative mild depression was lower, the time to first flatus and time to first defecation were shorter, and the incidence of postoperative vomiting was lower in the SF group. The mechanical pain threshold, hyperalgesia area, and sedation scores were similar between the SF and F groups. No differences were observed in the abovementioned parameters between the LSF group and the F group. Conclusion. This trial demonstrated that 1.0 mg/kg S-ketamine combined with 1 ug/kg sufentanil in PCA decreased cumulative parecoxib sodium consumption within 48 hours after laparoscopic radical resection of gastrointestinal cancer in elderly patients.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44534456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fang Li, Yingli Zhu, Min Li, Yinpeng Xu, Yahui Cui, Ying Yang, Yaling Wang, H. Hao
What Is Known? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. Objective. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. Method. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. Results. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection ( p < 0.05 ), as determined by X2 test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and >10 medication types were risk factors for the occurrence of PIM ( p < 0.05 ). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% ( p < 0.001 ) in March 2021. What Is New and Conclusion. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.
{"title":"Continuous Improvement of the Rational Use of Central Nervous System Disease-Related Drugs in Elderly Inpatients","authors":"Fang Li, Yingli Zhu, Min Li, Yinpeng Xu, Yahui Cui, Ying Yang, Yaling Wang, H. Hao","doi":"10.1155/2023/1634743","DOIUrl":"https://doi.org/10.1155/2023/1634743","url":null,"abstract":"What Is Known? In elderly inpatients, potential inappropriate medication (PIM) is a prominent prescription challenge. However, there is limited information available regarding PIM in patients with central nervous system (CNS) diseases in China. Objective. To evaluate and improve the rational use of drugs for the treatment of CNS diseases in elderly inpatients. Method. A retrospective, cross-sectional study was conducted among elderly inpatients (≥65 years) admitted to the Ninth People’s Hospital of Zhengzhou in China from March 2020 to March 2021. PIM was identified based on the 2019 Beers criteria at admission and discharge. The patients recruited in March 2020 were considered a baseline group, which was used as a comparison to evaluate PIM of CNS disease-related drugs in June 2020, September 2020, December 2020, and March 2021. Results. A total of 1500 patients were included in the evaluation. There was a statistically significant difference in the number of average hospitalization days, drug varieties used, and PIM detection (\u0000 \u0000 p\u0000 <\u0000 0.05\u0000 \u0000 ), as determined by X2 test. A total of 332 cases of PIM were identified, and 226 cases were detected for the interaction with CNS disease dementia. Multifactor logistic regression analysis showed that male, length of stay ≥15 days, and >10 medication types were risk factors for the occurrence of PIM (\u0000 \u0000 p\u0000 <\u0000 0.05\u0000 \u0000 ). After clinical supervision and training based on the High-Risk Drug Replacement Program for the Elderly, the rate of irrational medication under medical advice decreased from 34.67% in March 2020 to 14.0% (\u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ) in March 2021. What Is New and Conclusion. There was certain rationality based on the High-Risk Drug Replacement Program for the Elderly, and the rates of selective serotonin reuptake inhibitor, 5-hydroxylamine/norepinephrine re-intake inhibitor, rotenone, quetiapine, and proton pump inhibitor use were improved. These results provide a reference for the continuous improvement of the PIM catalog for elderly patients.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49603738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What is Known and Objective. The role of probiotics, especially the different genera of probiotics, in managing necrotizing enterocolitis (NEC) is controversial. Thus, we performed a meta-analysis with trial sequential analysis (TSA) to determine the efficacy and safety of probiotics for preventing NEC. Methods. Medline, Embase, CENTRAL, WorldCat, TROVE, DART-Europe, and CBM were searched from inception to May 2022. Two investigators independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4, and TSA was conducted using TSA 0.9 beta. Results and Discussion. Fifty-five studies involving 12897 newborns were eligible. The use of probiotics for preventing NEC reduced the incidence of NEC (RR 0.48, 95% CI 0.41 to 0.57, and P < 0.05) and sepsis (RR 0.77, 95% CI 0.64 to 0.94, and P < 0.05), the risk of mortality (RR 0.69, 95% CI 0.58 to 0.84, and P < 0.05), and shortened the average days of hospitalization (MD −3.12, 95% CI −4.98 to −1.26, and P < 0.05). However, subgroup analysis revealed that different genera of probiotics gave rise to different outcomes. In addition, TSA indicated that the cumulative z-curve crossed the traditional and trial sequential monitoring boundaries for benefit, providing firm evidence that multiple strains and Lactobacillus species of probiotics decreased the incidence of NEC. However, the current evidence was inconclusive for Bifidobacterium and Saccharomyces species. What is New and Conclusions. Probiotics are effective in preventing NEC and sepsis and could provide added benefits, including decreasing mortality and the number of days of hospitalization. However, considering the heterogeneity of probiotics regimens and the risk of selective reporting of RCTs, more high-quality clinical trials targeting different genera of probiotics with suitable doses and timing to prophylactic use of probiotics are needed to avoid overestimating the role of probiotics in preterm infants.
{"title":"Probiotics for Preventing Necrotizing Enterocolitis: A Meta-Analysis with Trial Sequential Analysis","authors":"Yang Zhang, Qiong Xu, Feng Zhang, Chunlei Sun","doi":"10.1155/2023/8626191","DOIUrl":"https://doi.org/10.1155/2023/8626191","url":null,"abstract":"What is Known and Objective. The role of probiotics, especially the different genera of probiotics, in managing necrotizing enterocolitis (NEC) is controversial. Thus, we performed a meta-analysis with trial sequential analysis (TSA) to determine the efficacy and safety of probiotics for preventing NEC. Methods. Medline, Embase, CENTRAL, WorldCat, TROVE, DART-Europe, and CBM were searched from inception to May 2022. Two investigators independently screened the literature, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4, and TSA was conducted using TSA 0.9 beta. Results and Discussion. Fifty-five studies involving 12897 newborns were eligible. The use of probiotics for preventing NEC reduced the incidence of NEC (RR 0.48, 95% CI 0.41 to 0.57, and \u0000 \u0000 P\u0000 \u0000 < 0.05) and sepsis (RR 0.77, 95% CI 0.64 to 0.94, and \u0000 \u0000 P\u0000 \u0000 < 0.05), the risk of mortality (RR 0.69, 95% CI 0.58 to 0.84, and \u0000 \u0000 P\u0000 \u0000 < 0.05), and shortened the average days of hospitalization (MD −3.12, 95% CI −4.98 to −1.26, and \u0000 \u0000 P\u0000 \u0000 < 0.05). However, subgroup analysis revealed that different genera of probiotics gave rise to different outcomes. In addition, TSA indicated that the cumulative z-curve crossed the traditional and trial sequential monitoring boundaries for benefit, providing firm evidence that multiple strains and Lactobacillus species of probiotics decreased the incidence of NEC. However, the current evidence was inconclusive for Bifidobacterium and Saccharomyces species. What is New and Conclusions. Probiotics are effective in preventing NEC and sepsis and could provide added benefits, including decreasing mortality and the number of days of hospitalization. However, considering the heterogeneity of probiotics regimens and the risk of selective reporting of RCTs, more high-quality clinical trials targeting different genera of probiotics with suitable doses and timing to prophylactic use of probiotics are needed to avoid overestimating the role of probiotics in preterm infants.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46734738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Zhang, Pan Hong, Saroj Rai, Ruikang Liu, Bo Liu
Background. Blocking agent for immune cytokine pathways is a novel treatment for atopic dermatitis (AD). Janus kinase (JAK) family is one of the cytoplasmic tyrosine kinases that mediate a variety of cytokines. Eight randomized controlled trials (RCTs) of JAK1 inhibitors (upadacitinib and abrocitinib) in AD have been published in the past three years. Objective. To evaluate the efficacy and safety of JAK1 inhibitors and compare upadacitinib with abrocitinib for the treatment of moderate-to-severe AD. Methods. Two independent reviewers searched Medline, Embase, Web of Science, and Cochrane databases updated on Apr 11th, 2023. We included data from phase two and three RCTs. Primary outcomes included the proportion of Investigator’s Global Assessment (IGA) responders and Eczema Area and Severity Index-75 (EASI-75) responders. Results. In all, eight RCTs were included in our study with 4634 moderate-to-severe AD patients. Both JAK1 inhibitors showed apparent therapeutic effects, but the 200 mg abrocitinib group demonstrated less efficacy than the 30 mg upadacitinib group in IGA responders (end of treatment) and EASI-75 responders (after 2 weeks of treatment). However, both JAK1 inhibitor groups demonstrated significantly higher risks of acne (9.0%) and headache (6.3%). Besides, upadacitinib showed significantly higher risks of upper respiratory tract infection (7.6%) and nasopharyngitis (9.7%), and abrocitinib showed significantly higher risks of nausea (9.6%). Conclusion. JAK1 inhibitors demonstrate promising efficacy in AD with rapid response and dose-dependent response and significantly higher risks of acne and headache. Based on existing data, oral 30 mg upadacitinib QD has better outcome than oral 200 mg abrocitinib QD and is a recommended dosage regimen for moderate-to-severe AD patients. Oral 15 mg upadacitinib QD might be an alternative dosage regimen in case of treatment-emergent adverse events.
{"title":"Upadacitinib Is a Better Choice than Abrocitinib for Patients with Moderate-to-Severe Atopic Dermatitis: An Updated Meta-Analysis","authors":"Ying Zhang, Pan Hong, Saroj Rai, Ruikang Liu, Bo Liu","doi":"10.1155/2023/9067797","DOIUrl":"https://doi.org/10.1155/2023/9067797","url":null,"abstract":"Background. Blocking agent for immune cytokine pathways is a novel treatment for atopic dermatitis (AD). Janus kinase (JAK) family is one of the cytoplasmic tyrosine kinases that mediate a variety of cytokines. Eight randomized controlled trials (RCTs) of JAK1 inhibitors (upadacitinib and abrocitinib) in AD have been published in the past three years. Objective. To evaluate the efficacy and safety of JAK1 inhibitors and compare upadacitinib with abrocitinib for the treatment of moderate-to-severe AD. Methods. Two independent reviewers searched Medline, Embase, Web of Science, and Cochrane databases updated on Apr 11th, 2023. We included data from phase two and three RCTs. Primary outcomes included the proportion of Investigator’s Global Assessment (IGA) responders and Eczema Area and Severity Index-75 (EASI-75) responders. Results. In all, eight RCTs were included in our study with 4634 moderate-to-severe AD patients. Both JAK1 inhibitors showed apparent therapeutic effects, but the 200 mg abrocitinib group demonstrated less efficacy than the 30 mg upadacitinib group in IGA responders (end of treatment) and EASI-75 responders (after 2 weeks of treatment). However, both JAK1 inhibitor groups demonstrated significantly higher risks of acne (9.0%) and headache (6.3%). Besides, upadacitinib showed significantly higher risks of upper respiratory tract infection (7.6%) and nasopharyngitis (9.7%), and abrocitinib showed significantly higher risks of nausea (9.6%). Conclusion. JAK1 inhibitors demonstrate promising efficacy in AD with rapid response and dose-dependent response and significantly higher risks of acne and headache. Based on existing data, oral 30 mg upadacitinib QD has better outcome than oral 200 mg abrocitinib QD and is a recommended dosage regimen for moderate-to-severe AD patients. Oral 15 mg upadacitinib QD might be an alternative dosage regimen in case of treatment-emergent adverse events.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Is Known and Objective. Elevated serum uric acid (SUA) is one of the most common adverse reactions during the administration of pyrazinamide, but patients exhibit significant individual differences. This study aimed to evaluate the relationship between gene polymorphisms and pyrazinamide-induced SUA elevation in Han Chinese tuberculosis patients. Methods. Tuberculosis patients treated with pyrazinamide were genotyped for the following three candidate genes: SLC22A12, SLC2A9, and ABCG2. Patients were divided into low-risk and high-risk groups according to the change of SUA after treatment. Intergroup comparisons were performed on clinical characteristics, allele and genotype frequencies, and haplotype distributions, and logistic regression analysis was used to explore the relevant risk factors. Results. In total, 143 patients were enrolled, including 83 in the high-risk groups and 60 in the low-risk groups. We observed a significant association between SLC2A9 polymorphism and pyrazinamide-induced SUA elevation. The G allele was significantly lower in the high-risk group than in the low-risk group (27.7% vs. 48.3%, OR = 0.410, 95% CI: 0.250–0.671, p < 0.001 ). Patients with the GA and GG genotypes were less likely to have SUA elevation than those with the AA genotype (OR = 0.125, 95% CI: 0.053–0.293, p < 0.001 and OR = 0.252, 95% CI: 0.074–0.851, p = 0.026 , respectively). Regarding SLC2A9 rs13129697, the frequency of the G allele was significantly lower in the high-risk group than in the low-risk group (26.1% vs. 40.8%, OR = 0.531, 95% CI: 0.312–0.842, p = 0.008 ). In the low-risk group, the proportion of patients with the TG genotype was significantly higher than that with the TT genotype (81.7% vs. 18.3%, OR = 0.279, 95% CI: 0.127–0.611, p = 0.001 ). Haplotype analysis revealed that patients with the SLC2A9 (rs1014290–rs13129697) GG haplotype had lower risk of SUA elevation than those with the AT haplotype (27.11% vs. 63.25%, p = 0.005 ). Furthermore, logistic regression analysis showed that drinking history was an independent risk factor for elevated SUA caused by PZA (OR = 3.943, 95% CI = 1.18–13.175, p = 0.026 ) and that the rs1014290 GA genotype might be a protective factor (OR = 0.094, 95% CI = 0.023–0.386, p = 0.001 ) after correction. What Is New and Conclusion. We found that SLC2A9 genetic polymorphisms were associated with elevated SUA caused by pyrazinamide. The G>A variant of rs1014290 and drinking history might be risk factors.
{"title":"SLC2A9 Gene Polymorphism Is Associated with Elevated Serum Uric Acid Caused by Pyrazinamide","authors":"Yuyang Dai, Yunyun Wang, Wanfeng Wu, Shaojie Guo, Xiuli Zhao","doi":"10.1155/2023/6677236","DOIUrl":"https://doi.org/10.1155/2023/6677236","url":null,"abstract":"What Is Known and Objective. Elevated serum uric acid (SUA) is one of the most common adverse reactions during the administration of pyrazinamide, but patients exhibit significant individual differences. This study aimed to evaluate the relationship between gene polymorphisms and pyrazinamide-induced SUA elevation in Han Chinese tuberculosis patients. Methods. Tuberculosis patients treated with pyrazinamide were genotyped for the following three candidate genes: SLC22A12, SLC2A9, and ABCG2. Patients were divided into low-risk and high-risk groups according to the change of SUA after treatment. Intergroup comparisons were performed on clinical characteristics, allele and genotype frequencies, and haplotype distributions, and logistic regression analysis was used to explore the relevant risk factors. Results. In total, 143 patients were enrolled, including 83 in the high-risk groups and 60 in the low-risk groups. We observed a significant association between SLC2A9 polymorphism and pyrazinamide-induced SUA elevation. The G allele was significantly lower in the high-risk group than in the low-risk group (27.7% vs. 48.3%, OR = 0.410, 95% CI: 0.250–0.671, \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ). Patients with the GA and GG genotypes were less likely to have SUA elevation than those with the AA genotype (OR = 0.125, 95% CI: 0.053–0.293, \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 and OR = 0.252, 95% CI: 0.074–0.851, \u0000 \u0000 p\u0000 =\u0000 0.026\u0000 \u0000 , respectively). Regarding SLC2A9 rs13129697, the frequency of the G allele was significantly lower in the high-risk group than in the low-risk group (26.1% vs. 40.8%, OR = 0.531, 95% CI: 0.312–0.842, \u0000 \u0000 p\u0000 =\u0000 0.008\u0000 \u0000 ). In the low-risk group, the proportion of patients with the TG genotype was significantly higher than that with the TT genotype (81.7% vs. 18.3%, OR = 0.279, 95% CI: 0.127–0.611, \u0000 \u0000 p\u0000 =\u0000 0.001\u0000 \u0000 ). Haplotype analysis revealed that patients with the SLC2A9 (rs1014290–rs13129697) GG haplotype had lower risk of SUA elevation than those with the AT haplotype (27.11% vs. 63.25%, \u0000 \u0000 p\u0000 =\u0000 0.005\u0000 \u0000 ). Furthermore, logistic regression analysis showed that drinking history was an independent risk factor for elevated SUA caused by PZA (OR = 3.943, 95% CI = 1.18–13.175, \u0000 \u0000 p\u0000 =\u0000 0.026\u0000 \u0000 ) and that the rs1014290 GA genotype might be a protective factor (OR = 0.094, 95% CI = 0.023–0.386, \u0000 \u0000 p\u0000 =\u0000 0.001\u0000 \u0000 ) after correction. What Is New and Conclusion. We found that SLC2A9 genetic polymorphisms were associated with elevated SUA caused by pyrazinamide. The G>A variant of rs1014290 and drinking history might be risk factors.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46572435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alaa S. Babonji, Sara J. Alshehri, Abdulrahman Alturaiki
Background. Community acquired pneumonia (CAP) is a common serious infection that is usually treated with a macrolide with a β-lactam while doxycycline is considered an alternative due to limited evidence. Hence, we aimed to evaluate azithromycin versus doxycycline containing regimen in achieving clinical stability for inpatients with CAP. Materials and Methods. a retrospective cohort of inpatients with CAP receiving either azithromycin or doxycycline combined with a β-lactam. The primary endpoint was the percentage of patients who achieved clinical stability within 3 days, while secondary endpoints were the average days required to achieve clinical stability. Results. A total of 447 were included of which 379 received azithromycin while 68 received doxycycline containing regimen. The average age of the study population was 65.4 ± 21.1, of which 49% were females. Ceftriaxone was the most prescribed β-lactam. Majority of this cohort had a length of hospital stay of 5 days or less. Total percentage of patients who achieved clinical stability within 3 days were 257 (57.5%), of which 222 (58.6%) were in azithromycin group versus 35 (51.5%) in doxycycline containing regimen group; p = 0.275 . While the average day required to achieve clinical stability in both groups was 3.8 ± 3.2, in which 3.8 ± 3.3 in azithromycin versus 3.9 ± 2.7 in doxycycline containing regimen; (95% CI −0.98–0.68; p = 0.727 ) Conclusions. These findings support that doxycycline is comparable in efficacy to macrolides with a β-lactam for inpatients with CAP as supported by current guideline recommendations.
{"title":"Clinical Effectiveness and Outcomes of Azithromycin versus Doxycycline Containing Regimen in Inpatients with Community Acquired Pneumonia: A Retrospective Cohort Study","authors":"Alaa S. Babonji, Sara J. Alshehri, Abdulrahman Alturaiki","doi":"10.1155/2023/8861376","DOIUrl":"https://doi.org/10.1155/2023/8861376","url":null,"abstract":"Background. Community acquired pneumonia (CAP) is a common serious infection that is usually treated with a macrolide with a β-lactam while doxycycline is considered an alternative due to limited evidence. Hence, we aimed to evaluate azithromycin versus doxycycline containing regimen in achieving clinical stability for inpatients with CAP. Materials and Methods. a retrospective cohort of inpatients with CAP receiving either azithromycin or doxycycline combined with a β-lactam. The primary endpoint was the percentage of patients who achieved clinical stability within 3 days, while secondary endpoints were the average days required to achieve clinical stability. Results. A total of 447 were included of which 379 received azithromycin while 68 received doxycycline containing regimen. The average age of the study population was 65.4 ± 21.1, of which 49% were females. Ceftriaxone was the most prescribed β-lactam. Majority of this cohort had a length of hospital stay of 5 days or less. Total percentage of patients who achieved clinical stability within 3 days were 257 (57.5%), of which 222 (58.6%) were in azithromycin group versus 35 (51.5%) in doxycycline containing regimen group; \u0000 \u0000 p\u0000 =\u0000 0.275\u0000 \u0000 . While the average day required to achieve clinical stability in both groups was 3.8 ± 3.2, in which 3.8 ± 3.3 in azithromycin versus 3.9 ± 2.7 in doxycycline containing regimen; (95% CI −0.98–0.68; \u0000 \u0000 p\u0000 =\u0000 0.727\u0000 \u0000 ) Conclusions. These findings support that doxycycline is comparable in efficacy to macrolides with a β-lactam for inpatients with CAP as supported by current guideline recommendations.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43255071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liting Cui, Kun Shu, Panpan Zhang, Qihao Cui, Huifang Yun
Current Knowledge and Objective. Remimazolam tosilate is a novel intravenous sedative of benzodiazepines with no tissue accumulation, which offers a faster onset of action and recovery time than midazolam. The aim of this trial was to compare the efficacy and safety of remimazolam (RM) combined with propofol and traditional propofol in painless digestive endoscopy with painless gastroscopy and colonoscopy. Methods. Patients were randomised into three groups: RM combined with propofol (RMP group, n = 35), RM (RM group, n = 40), and propofol (P group, n = 38). Each group received 0.1 μg/kg sufentanyl analgesia. An induction dose of 0.1 mg/kg RM and 1 mg/kg propofol was administered to the RMP group, 0.3 mg/kg RM to the RM group, and 2 mg/kg propofol to the P group. Per 5 min, the RMP and RM groups received an additional dose of 0.05 mg/kg RM, while the P group received an extra 0.5 mg/kg propofol. The comparisons involved induction regimen success rate, incidence of hypotension, low pulse rate, injection pain, grade of low oxygen saturation (SpO2), and postoperative adverse reactions. Results and Discussion. The RMP and P groups’ composition powers were 100%, and the RM group’s composition power was 95% ( P = 0.113 ). The incidence rates of hypotension were 40.0%, 18.4%, and 44.7% in the RMP, RM, and P groups, respectively ( P = 0.037 ). The low pulse incidence rates were 5.7%, 2.6%, and 5.3% in the RMP, RM, and P groups, respectively ( P = 0.771 ). The incidence rates of injection pain were 11.4%, 2.6%, and 26.3% in the RMP, RM, and P groups, respectively ( P = 0.007 ). There was no significant difference in low SpO2 severity scores ( P = 0.148 ). New Findings and Conclusion. Remimazolam tosilate combined with propofol can be used for painless endoscopy, with almost the same safety as propofol. Remimazolam tosilate produces a low incidence of adverse reactions and is a safe anaesthetic option for painless endoscopies.
{"title":"Efficacy and Safety of Remimazolam Tosilate Combined with Propofol in Digestive Endoscopy: A Randomised Trial","authors":"Liting Cui, Kun Shu, Panpan Zhang, Qihao Cui, Huifang Yun","doi":"10.1155/2023/9955312","DOIUrl":"https://doi.org/10.1155/2023/9955312","url":null,"abstract":"Current Knowledge and Objective. Remimazolam tosilate is a novel intravenous sedative of benzodiazepines with no tissue accumulation, which offers a faster onset of action and recovery time than midazolam. The aim of this trial was to compare the efficacy and safety of remimazolam (RM) combined with propofol and traditional propofol in painless digestive endoscopy with painless gastroscopy and colonoscopy. Methods. Patients were randomised into three groups: RM combined with propofol (RMP group, n = 35), RM (RM group, n = 40), and propofol (P group, n = 38). Each group received 0.1 μg/kg sufentanyl analgesia. An induction dose of 0.1 mg/kg RM and 1 mg/kg propofol was administered to the RMP group, 0.3 mg/kg RM to the RM group, and 2 mg/kg propofol to the P group. Per 5 min, the RMP and RM groups received an additional dose of 0.05 mg/kg RM, while the P group received an extra 0.5 mg/kg propofol. The comparisons involved induction regimen success rate, incidence of hypotension, low pulse rate, injection pain, grade of low oxygen saturation (SpO2), and postoperative adverse reactions. Results and Discussion. The RMP and P groups’ composition powers were 100%, and the RM group’s composition power was 95% (\u0000 \u0000 P\u0000 =\u0000 0.113\u0000 \u0000 ). The incidence rates of hypotension were 40.0%, 18.4%, and 44.7% in the RMP, RM, and P groups, respectively (\u0000 \u0000 P\u0000 =\u0000 0.037\u0000 \u0000 ). The low pulse incidence rates were 5.7%, 2.6%, and 5.3% in the RMP, RM, and P groups, respectively (\u0000 \u0000 P\u0000 =\u0000 0.771\u0000 \u0000 ). The incidence rates of injection pain were 11.4%, 2.6%, and 26.3% in the RMP, RM, and P groups, respectively (\u0000 \u0000 P\u0000 =\u0000 0.007\u0000 \u0000 ). There was no significant difference in low SpO2 severity scores (\u0000 \u0000 P\u0000 =\u0000 0.148\u0000 \u0000 ). New Findings and Conclusion. Remimazolam tosilate combined with propofol can be used for painless endoscopy, with almost the same safety as propofol. Remimazolam tosilate produces a low incidence of adverse reactions and is a safe anaesthetic option for painless endoscopies.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42278067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Previous studies have reported inconsistent findings regarding the association between elevated plasma homocysteine (Hcy) levels and new antiepileptic drugs (AEDs). In this meta-analysis, we aimed to assess the effects of new AEDs on Hcy. Methods. PubMed, Embase, Cochrane, and Web of Science databases were searched from inception to June 2022 for articles that focused on the effects of new AEDs on Hcy. A meta-analysis was performed using Stata 16.0 software. The results were presented as the mean difference (MD) and corresponding to 95% confidence intervals (CIs) comparing epileptic patients with new AEDs to the control subjects. Results. A total of 11 studies were included in the meta-analysis. Hcy was markedly increased in the new AEDs group compared with the control group (MD = 2.220, 95% CI: 0.596–3.844, P = 0.007 ), with a high degree of heterogeneity (I2 = 99.5%). In the drugs subgroup, the oxcarbazepine (OXC) (MD = 2.30, 95% CI: −1.11–5.72, P = 0.187 ) and lamotrigine (LTG) (MD = 1.14, 95% CI: −0.209–2.482, P < 0.001 ) groups had no significant differences when compared with the control group. The levetiracetam (LEV) (MD = 1.81, 95% CI: 1.03–2.18, P < 0.001 ) and topiramate (TPM) (MD = 6.922, 95% CI: 0.788–13.055, P = 0.027 ) groups were significantly higher than the control group. Conclusions. The new AEDs, especially TPM and LEV, may increase the plasma of Hcy. The role of Hcy in patients with epilepsy who are given TPM and LEV should not be ignored in clinical situations. Patients with epilepsy who also have a high-risk vascular profile are recommended to use OXC and LTG.
背景。先前的研究报道了血浆同型半胱氨酸(Hcy)水平升高与新型抗癫痫药物(aed)之间的不一致的发现。在本荟萃分析中，我们旨在评估新型aed对Hcy的影响。方法。检索了PubMed、Embase、Cochrane和Web of Science数据库，从建立到2022年6月，检索了有关新型aed对Hcy影响的文章。采用Stata 16.0软件进行meta分析。结果以平均差值(MD)和对应的95%置信区间(ci)表示，将新发aed的癫痫患者与对照组进行比较。结果。荟萃分析共纳入了11项研究。与对照组相比，新发aed组Hcy显著升高(MD = 2.220, 95% CI: 0.596 ~ 3.844, P = 0.007)，且异质性较高(I2 = 99.5%)。在药物亚组中，奥卡西平(OXC)组(MD = 2.30, 95% CI: - 1.11 ~ 5.72, P = 0.187)和拉莫三嗪(LTG)组(MD = 1.14, 95% CI: - 0.209 ~ 2.482, P < 0.001)与对照组比较差异无统计学意义。左乙拉西坦(LEV)组(MD = 1.81, 95% CI: 1.03 ~ 2.18, P < 0.001)和托吡酯(TPM)组(MD = 6.922, 95% CI: 0.788 ~ 13.055, P = 0.027)显著高于对照组。结论。新型抗癫痫药，尤其是TPM和LEV可使Hcy血浆浓度升高。Hcy在给予TPM和LEV的癫痫患者中的作用不容忽视。同时具有高危血管特征的癫痫患者推荐使用OXC和LTG。
{"title":"Effects of New Antiepileptic Drugs on Homocysteine in Epileptic Patients: A Systematic Review and Meta-Analysis","authors":"Danyi Zheng, Y. Bao, Jiayi Gu, Tian Lv, Yue Yang","doi":"10.1155/2023/5878004","DOIUrl":"https://doi.org/10.1155/2023/5878004","url":null,"abstract":"Background. Previous studies have reported inconsistent findings regarding the association between elevated plasma homocysteine (Hcy) levels and new antiepileptic drugs (AEDs). In this meta-analysis, we aimed to assess the effects of new AEDs on Hcy. Methods. PubMed, Embase, Cochrane, and Web of Science databases were searched from inception to June 2022 for articles that focused on the effects of new AEDs on Hcy. A meta-analysis was performed using Stata 16.0 software. The results were presented as the mean difference (MD) and corresponding to 95% confidence intervals (CIs) comparing epileptic patients with new AEDs to the control subjects. Results. A total of 11 studies were included in the meta-analysis. Hcy was markedly increased in the new AEDs group compared with the control group (MD = 2.220, 95% CI: 0.596–3.844, \u0000 \u0000 P\u0000 =\u0000 0.007\u0000 \u0000 ), with a high degree of heterogeneity (I2 = 99.5%). In the drugs subgroup, the oxcarbazepine (OXC) (MD = 2.30, 95% CI: −1.11–5.72, \u0000 \u0000 P\u0000 =\u0000 0.187\u0000 \u0000 ) and lamotrigine (LTG) (MD = 1.14, 95% CI: −0.209–2.482, \u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ) groups had no significant differences when compared with the control group. The levetiracetam (LEV) (MD = 1.81, 95% CI: 1.03–2.18, \u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ) and topiramate (TPM) (MD = 6.922, 95% CI: 0.788–13.055, \u0000 \u0000 P\u0000 =\u0000 0.027\u0000 \u0000 ) groups were significantly higher than the control group. Conclusions. The new AEDs, especially TPM and LEV, may increase the plasma of Hcy. The role of Hcy in patients with epilepsy who are given TPM and LEV should not be ignored in clinical situations. Patients with epilepsy who also have a high-risk vascular profile are recommended to use OXC and LTG.","PeriodicalId":15381,"journal":{"name":"Journal of Clinical Pharmacy and Therapeutics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42668614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：