1.
Higher Efficacy of Infliximab than Immunoglobulin on Kawasaki Disease, a Meta-analysis
Li X, Tang Y, Ding Y, Chen Y, Hou M, Sun L, Qian G, Qin L, Lv H
European journal of pharmacology. 2021;:173985
Abstract
This meta-analysis evaluated the efficacy and safety of infliximab as initial therapy for patients with Kawasaki disease (KD) and intravenous immunoglobulin (IVIG) resistant KD. Studies of infliximab in KD, published between January 2004 and December 2019, were curated from PubMed, MEDLINE, and Cochrane Library. Data were analyzed using STATA Version 12.0. Of the 8 studies considered, 4 evaluated the effect of infliximab combined with IVIG as primary therapy in KD, and the remaining investigated the effect of infliximab in IVIG resistant patients. Infliximab was more effective than the control group, with the total summary odds ratio (OR) of 0.34 (95% confidence interval (CI): 0.19-0.62). The treatment resistance of the infliximab group was lower than the IVIG group (0.36 [95% CI: 0.14-0.92]) when infliximab was combined with IVIG as the initial treatment. However, infliximab treatment for IVIG resistant KD was more effective than the IVIG group (0.28 [95% CI: 0.12-0.66]). There was no significant increase in the incidence of coronary artery lesions. The total summary OR for the incidence of coronary artery lesions and infliximab treatment was 0.88 (95% CI: 0.48-1.62). There was no statistically significant difference in adverse events (AEs) when compared between the groups (0.71 [95% CI: 0.44-1.16]).Infliximab combined with IVIG reduced treatment resistance in KD patients vs. conventional IVIG therapy. Infliximab improved clinical course in IVIG resistant KD patients. Infliximab treatment did not reduce the incidence of coronary artery lesions and did not show any significant increase in the incidence of AEs. PROSPERO REGISTRATION NUMBER CRD42020218554.
2.
Chinese herbal medicines for the treatment of non-structural abnormal uterine bleeding in perimenopause: A systematic review and a meta-analysis
Shang Y, Lu S, Chen Y, Sun X
Complementary therapies in medicine. 2018;41:252-260.
Abstract
OBJECTIVE Chinese herbal medicines (CHM) have been the mainstream therapy in Asia for thousands of years and become more popular as the alternative treatment recently. The objective of this study is to evaluate the efficacy and safety of CHM for non-structural abnormal uterine bleeding (AUB) in perimenopause. METHODS Seven databases were searched from inception to December 31 st, 2017. Randomized controlled trials (RCTs) which compared CHM versus western therapy in treating non-structural AUB in perimenopause were extracted. The primary outcome measures were hemostasis rate, normalization rate of menstruation, hemoglobin count, and improvement of menopausal symptoms. The secondary outcome measures were adverse effects and recurrence rate. The methodological quality of included trials was assessed in line with the criteria of the Cochrane Risk of Bias assessment tool. Data analyses were performed by Review Manager 5.3 software. The results were expressed as risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI). RESULTS Fifteen RCTs with 1344 participants were analyzed. Compared with Western therapies, CHM showed advantages in normalization rate of menstruation (RR 1.20; 95% CI 1.06-1.34;P = 0.003), improving menopausal symptoms (RR 1.20, 95% CI 1.10-1.31, P <0.0001; MD -2.80, 95% CI -3.35 to -2.25, P <0.00001) and the hemoglobin count (MD 7.85, 95% CI 4.05-11.65, P <0.0001) with lower incidence of adverse reactions (RR 0.23, 95% CI 0.12 to 0.43, P <0.00001) and lower recurrence rate (RR 0.38, 95% CI 0.26 to 0.54, P <0.00001). However, we found insufficient evidence that CHM was any more or less effective than CWT for hemostasis rate (RR 1.02, 95% CI 0.95-1.10, P = 0.62). CONCLUSIONS The findings of our study suggest that CHM may be the effective, acceptable and safe treatment for non-structural abnormal uterine bleeding during perimenopause when compared with Western medicine. However, due to high clinical heterogeneity, low methodological quality and without a proper placebo control, the conclusion is inconclusive and limited, and it should be further examined and updated in future work.