Drug Safety
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Review Meta Analysis Comparative Study
Tolerability and safety of ropinirole versus other dopamine agonists and levodopa in the treatment of Parkinson's disease: meta-analysis of randomized controlled trials.
Dopamine agonists have a well established role in the treatment of Parkinson's disease. The choice of a particular dopamine agonist requires assessing the benefit-risk balance of each available medication. ⋯ In all the included studies, dopamine agonists, including ropinirole, exhibited a higher incidence of adverse events than placebo. Ropinirole showed an adverse event profile similar to other dopamine agonists. Consideration of the clinical characteristics of each patient and the differences in the incidence of adverse events related to each dopamine agonist, may help to optimize the dopamine agonist therapy.
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Meta Analysis
An evaluation of the cardiovascular safety profile of duloxetine: findings from 42 placebo-controlled studies.
In recent years, new classes of medication, such as the serotonin-noradrenaline reuptake inhibitors (SNRIs), have been developed for use in the treatment of major depressive disorder (MDD). For many years, treatment options were largely limited to the use of monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). However, there have been published reports of orthostatic hypotension, arrhythmias and corrected QT (QTc) interval changes in patients treated with TCAs. As new medications become available, it is important to understand how their cardiovascular safety profile compares with that of more established agents to aid clinicians and patients in choosing the best treatment options. This study was designed to evaluate the cardiovascular safety profile of the SNRI duloxetine through evaluation of cardiovascular-related parameters and adverse events (AEs). ⋯ Overall, the findings presented here support our conclusions that use of duloxetine does not appear to be associated with significant cardiovascular risks in patients with conditions for which the drug has been approved or studied.
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Meta Analysis
A meta-analysis to assess the incidence of adverse effects associated with the transdermal nicotine patch.
To estimate the frequency of adverse effects associated with the use of the transdermal nicotine patch, we abstracted and analysed data from 47 reports of 35 clinical trials. The meta-analysis presented here represents a synthesis of data from 41 groups of nicotine patch recipients totalling 5501 patients, and 33 groups of placebo recipients totalling 3752 patients. Smoking abstinence was the primary outcome in 32 of the trials, and relief of colitis symptoms was the primary outcome in 2 of the trials; 1 study of contact sensitisation was included in the skin irritation analysis. ⋯ The incidence of nausea or vomiting appeared to be lowest when the patch dose was tapered. The results of this meta-analysis indicate that very large studies would be needed to assess the effect of the patch, if any, on serious, rare outcomes. These results also suggest that the rate of minor adverse effects might be lowered by modifying patch-use protocols.