Current medical research and opinion
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Network meta-analysis was used to derive estimates of the relative efficacy of inclisiran, evolocumab, alirocumab, bempedoic acid, and ezetimibe in patients with hypercholesterolemia and/or at increased cardiovascular risk due to elevated low-density lipoprotein cholesterol taking maximum tolerated dose statins. ⋯ This study provides insight regarding the comparative efficacy of drugs for which no head-to-head trials exist and suggests that inclisiran, alirocumab, and evolocumab are expected to provide similar clinically meaningful improvements in low-density lipoprotein cholesterol in patients with hypercholesterolemia on maximally tolerated statins who are at increased cardiovascular risk.
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Review Meta Analysis
Comorbidities and autopsy findings of COVID-19 deaths and their association with time to death: a systematic review and meta-analysis.
Examination of postmortem findings can help establish effective therapeutic strategies to reduce mortality. The aim of this study was therefore to review complete autopsy cases and their postmortem findings and comorbidities associated with death caused by COVID-19, in order to establish a profile of the deceased and the likelihood of time to death. ⋯ Given that accurate information of complete autopsies findings is still scarce, it is necessary to perform complete autopsies by examining organs other than the lungs in order to provide information to improve new treatment strategies in patients with a high risk of mortality.
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Meta Analysis
Conducting and critically appraising a high-quality systematic review and meta-analysis pertaining to COVID-19.
With constantly emerging new information regarding the epidemiology, pathogenesis, diagnosis and management of Coronavirus Disease 2019 (COVID-19), reviewing literature related to it has become increasingly complicated and resource-intensive. In the setting of this global pandemic, clinical decisions are being guided by the results of multiple pertinent studies; however, it has been observed that these studies are often heterogenous in design and population characteristics and results of initial trials may not be replicated in subsequent studies. The resulting clinical conundrum can be resolved by high-quality systematic review and meta-analysis with a robust and reliable methodology, encapsulating and critically appraising all the available literature relevant to the clinical scenario under scrutiny. ⋯ It can identify optimal diagnostic algorithms, assess efficacy of treatment strategies, and analyze inherent factors influencing the efficacy of treatment for COVID-19. The current review aims to provide a basic guide to plan and conduct a high-quality systematic review and meta-analysis pertaining to COVID-19, describing the main steps and addressing the pitfalls commonly encountered at each step. Knowledge of the basic steps would also allow the reader to critically appraise published systematic review and meta-analysis and the quality of evidence provided therein.
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Pentasa (prolonged-release mesalazine [5-ASA]) has been available for >30 years as an effective treatment for mild-to-moderate ulcerative colitis (UC). A systematic literature review and meta-analysis was undertaken to provide an up-to-date evaluation of oral Pentasa efficacy and safety for induction and maintenance of remission. ⋯ This study confirms oral Pentasa is efficacious and well-tolerated in treating active UC and maintaining remission. The availability of multiple forms of Pentasa supports physicians' ability to individualize treatment and optimize dosing to improve outcomes.
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To assess the efficacy, safety, and tolerability of retosiban-a novel tocolytic unavailable in the US-in the management of preterm labor. ⋯ With the limited high quality evidence available, retosiban demonstrates no clear benefit over placebo in the management of preterm labor. Nevertheless, its favorable safety profile, oral bioavailability, and novel mechanism of action and the limited number of studies available for review warrant further analysis.