Meta-analysis Of Clinical Trials Research Articles

Curcumin Attenuates Hyperglycemia and Inflammation in Type 2 Diabetes Mellitus: Quantitative Analysis of Randomized Controlled Trial

Controlling hyperglycemia and inflammation in type 2 diabetes (T2D) remains an important approach to control diabetes. The use of phytochemicals found in natural herbs has been investigated widely, and there are inconsistent findings in clinical trials, likely associated with a small sample size. A meta-analysis of clinical trials was performed by conducting a comprehensive literature search on PubMed, Scopus, EBSCOHost, and Web of Sciences. The search terms included Curcumin longa, turmeric, curcumin, curcuma xanthorrhiza, diferuloylmethane, and type 2 diabetes. Data were analyzed using an online meta-analysis tool, Jamovi version 2.4.8 and IBM SPSS statistics version 29. The data were reported as either mean difference (MD) or standard mean difference (SMD) and 95% confidence intervals. The evidence from 18 trials with 1382 T2D with a mean age of 55.9 years was analyzed. Supplementation with curcumin led to a significant decrease in fasting blood glucose, MD = −11.48 mg/dL, 95%CI (−14.26, −8.70), p < 0.01 and glycated hemoglobin, MD = −0.54%, 95%CI (−0.73, −0.35), p < 0.01. Additionally, there was a significant decrease in C-Reactive Protein in curcumin compared to a placebo, SMD = −0.59, 95%CI (−1.11, −0.07), p = 0.03. The findings observed in this study suggest that curcumin can ameliorate hyperglycemia and inflammation in T2D compared to a placebo. While the potential benefits were observed, it is recommended that future trials focus on finding a suitable dose and duration of intervention and incorporate formulation in curcumin to enhance its absorption.

Defining the Position of [177Lu]Lu-PSMA Radioligand Therapy in the Treatment Landscape of Metastatic Castration-Resistant Prostate Cancer: A Meta-analysis of Clinical Trials.

In recent years, theranostics has become a promising approach for treating metastatic castration-resistant prostate cancer (mCRPC), with trials investigating targeted radioligand therapy, particularly using prostate-specific membrane antigen labeled with lutetium-177 ([177Lu]Lu-PSMA). The proper position of [177Lu]Lu-PSMA in the therapeutic algorithm of mCRPC is yet to be identified. We conducted a systematic review and meta-analysis of phase II/III randomized controlled trials to assess the efficacy of [177Lu]Lu-PSMA in treating mCRPC. Study endpoints included radiographic progression-free survival (rPFS), prostate-specific antigen-PFS, objective response rate, and overall survival. Data were extracted according to the PRISMA statement. Summary hazard ratios (HRs) were calculated using random- or fixed-effects models. Statistical analyses were performed with RevMan software (v.5.2.3). [177Lu]Lu-PSMA reduced the risk of rPFS (HR 0.55; 95% confidence interval [CI] 0.43-0.71; p < 0.00001) and prostate-specific antigen-PFS (HR 0.53; 95% CI 0.41-0.67; p < 0.00001), and improved the objective response rate compared with control therapies (response rate 3.55; 95% CI 1.91-6.60; p < 0.0001), whereas no significant cumulative effect on overall survival was documented (HR 0.92; 95% CI 0.65-1.31; p = 0.63). Notably, in a dedicated subanalysis, comparable effects on rPFS were observed when [177Lu]Lu-PSMA was compared with active therapy. [177Lu]Lu-PSMA has a favorable impact on the radiographic and biochemical control of mCRPC and represents a potential treatment in a scenario where other valuable options are available. Further efforts are required to identify clinical and molecular markers necessary for proper patient stratification.

Efficacy of angiotensin receptor neprilysin inhibitor in hypertension management: A systematic review and meta-analysis of clinical trials

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension. The primary outcomes were systolic and diastolic blood pressure (BP) control, along with the incidence of adverse events. A systematic review and meta-analysis was conducted according following PRISMA guidelines. A comprehensive literature search was performed across five databases: PubMed, ScienceDirect, EBSCO, Cochrane, and ProQuest, with studies identified up until 3 October 2024. The study included nine clinical trials that met the predefined eligibility criteria: (1) randomized clinical trials; (2) adult patients diagnosed with hypertension; and (3) comparison of ARNI versus control, reporting either BP control or adverse events. Quality appraisal using RoB 2.0 revealed that eight studies had a low risk of bias, and one had a high risk of bias. The pooled analysis demonstrated that ARNI is significantly more efficacious in achieving targeted systolic BP as compared to the control group (OR: 1.80; 95%CI: 1.41-2.30; p&lt;0.001; I²=0%), and there was no statistical difference for the efficacy on diastolic BP compared to control (OR: 0.92; 95%CI: 0.75–1.13; p=0.45; I²=75%). The incidence of adverse events was not associated with ARNI (OR: 1.07; 95%CI: 0.90–1.27; p=0.46; I²=72%). In conclusion, ARNI demonstrated a favorable outcome only in systolic BP, but in diastolic BP which could be associated with inadequate duration of observation. Further studies are warranted to assess BP-lowering effect and safety profile of ARNI in a longer observation time.

The effects of propolis supplementation on blood pressure in adults: a systematic review and meta-analysis of clinical trials

Purpose Recent trials have found that propolis supplementation can beneficially reduce blood pressure (BP) in adults, but there is no definitive consensus on this topic. The purpose of this study is to provide an overview and update the current documents regarding the effects of propolis supplementation on BP by presenting a systematic review and meta-analysis. Design/methodology/approach The systematic search was conducted, considering all studies published up to July 2024, in the following databases: PubMed, Scopus, Cochrane Library and ISI Web of Science. Data were pooled by using the random-effects model, and weighted mean difference (WMD) was considered as the summary effect size. Findings In this systematic review and meta-analysis, eight clinical trials were included. The obtained results show that propolis supplementation caused a significant decrease in systolic BP (WMD = −3.93 mmHg, 95% CI = −7.05 to −0.82, p = 0.01 and I2 = 45.2%). However, the meta-analysis results showed that propolis supplementation did not significantly change the levels of diastolic BP (WMD = −1.64 mmHg, 95% CI = −4.60 to 1.32, p = 0.27 and I2 = 74.0%). Originality/value The findings of this study suggest that propolis supplementation may be used as a dietary supplement to improve systolic BP, but further studies are needed to confirm these results.

Impact of allulose on blood glucose in type 2 diabetes: A meta-analysis of clinical trials

ObjectiveThis meta-analysis aims to evaluate the impact of allulose on blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Primary outcomes include postprandial blood glucose, while secondary outcomes are time in range (TIR), time above range (TAR), fasting plasma glucose (FPG), and insulin area under the curve (AUC). MethodsA systematic search was conducted across PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library until May 20, 2024. Randomized controlled trials assessing the effect of allulose on glycemic parameters in T2DM patients were included. Data were synthesized using a random-effects meta-analysis model, and the quality of studies was assessed using the Cochrane Risk of Bias tool. ResultsSix studies involving 126 participants were included. Allulose significantly reduced glucose AUC (SMD: −0.6662, 95 % CI [-1.1360, −0.1964], p = 0.0054) with moderate heterogeneity (I2 = 58.3 %). Insulin AUC showed a non-significant reduction (SMD: −0.3648, 95 % CI [-0.7783, 0.0488], p = 0.0839). FPG demonstrated a non-significant reduction (MD: −5.8925, 95 % CI [-20.4892, 8.7043], p = 0.4288), while TAR significantly decreased (MD: −8.8204, 95 % CI [-14.4101, −3.2307], p = 0.0020). No significant changes were observed in TIR (MD: 7.1211, 95 % CI [-1.6028, 15.8450], p = 0.1096). ConclusionAllulose demonstrated a significant reduction in postprandial glucose levels and TAR, supporting its role as a dietary intervention for glycemic control in T2DM patients. The findings are robust, though further research is needed to confirm its long-term effects on insulin sensitivity and metabolic health.

Assessment of clinical performance of universal adhesives versus other adhesive systems: A systematic review and meta-analysis of clinical trials

Universal adhesives (UAs) often exhibit comparable or even superior bond strength to traditional adhesive systems, ensuring reliable and long-lasting adhesion between the resin composite and the tooth structure. Therefore, this study aimed to assess the clinical performance of UAs compared to other adhesive systems in direct resin composite restorations through a systematic review and meta-analysis. Two reviewers executed a literature search in five electronic databases: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Clinical trials comparing the clinical evaluation of resin composite restorations in Class I, Class II, or Class V cavities placed with an universal adhesive (UA) system against resin composite restorations placed with another non-UA system were included in the review. An analysis was carried out using Review Manager software version 5.3.5 (London, England, United Kingdom). Standardized effect sizes with 95% confidence intervals were calculated to allow comparisons between different interventions and different outcomes. The methodological quality of each study was assessed using the Cochrane RoB2 tool for randomized clinical trials. A total of 2331 potentially relevant studies were identified. After title and abstract examination, 14 studies remained in the systematic review. From these, a total of 11 studies were included in the meta-analysis. The retention rates of resin composite restorations after 6 months showed no significant difference between total-etch (TE, p=0.83), or self-etch (SE, p=0.78) adhesives and UAs applied in TE and SE modes (p&gt;0.05). However, UAs applied in selective-enamel etching (SEE) mode demonstrated superior clinical performance compared to other adhesives (p=0.01), particularly TE adhesives (p=0.02). Similarly, after &gt;12 months of follow-up, there were no significant differences in retention rates among different adhesive modes (p&gt;0.05). Additionally, the incidence of secondary caries did not significantly differ across adhesive modes at both 6-month and &gt;12-month evaluations (p&gt;0.05). This systematic review and meta-analysis suggested that UAs demonstrate comparable clinical performance to TE and SE adhesive systems in direct resin composite restorations, particularly in terms of restoration retention rates and the incidence of secondary caries. UAs applied in SEE mode exhibited superior clinical outcomes compared to other adhesive systems. These findings indicate that UAs can be considered a viable alternative to traditional adhesive systems in clinical practice, offering flexibility in application while maintaining comparable long-term outcomes.

The Landscape of Randomized Clinical Trial Meta-analyses on Statins for Aneurysmal Subarachnoid Hemorrhage: A Scoping Review.

Aneurysmal subarachnoid hemorrhage (aSAH) is a type of non-traumatic SAH that can have detrimental effects on the central nervous system, resulting in severe disability or death. Early nimodipine is currently the only strongly recommended pharmacological treatment that has shown efficacy in improving neurological/functional outcomes in aSAH patients. Whether statin treatment is of benefit to aSAH patients is an issue that has generated considerable interest and debate. In the present scoping review, we mapped and analyzed the available literature on metaanalyses of randomized clinical trials (RCTs) examining the effect of statins on aSAH. Seventeen meta-analyses of RCTs, published between 2008 and 2023, were identified. Treatments in included meta-analyses were based on various regimens of simvastatin, pravastatin, pitavastatin or atorvastatin for up to 21 days. Eleven of the included reports indicated some beneficial effect of statin treatment, reducing rates of at least one of the following: cerebral vasospasm, delayed cerebral ischemia/delayed ischemic neurologic deficit, mortality or functional/ neurological outcome. In contrast, six meta-analyses, showed no such effects. The limitations reported by several meta-analyses, included low patient numbers or disproportionate representation of patients from certain RCTs, differences in drug treatment, patient diagnostic criteria and outcome evaluation between RCTs, as well as poor data quality or lack of RCTs data. Knowledge of the reported limitations may aid the design of future clinical trials and/or their meta-analyses.

Comparative Analysis of Resmetirom vs. FGF21 Analogs vs. GLP-1 Agonists in MASLD and MASH: Network Meta-Analysis of Clinical Trials.

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic-Dysfunction Associated Steatohepatitis (MASH) are linked to obesity, type 2 diabetes, and metabolic syndrome, increasing liver-related morbidity and cardiovascular risk. Recent therapies, including Resmetirom, FGF21 analogs, and GLP-1 agonists, have shown promise. This network meta-analysis evaluates their comparative efficacy and safety. A literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library. Included clinical trials addressed MASLD or MASH with Resmetirom, FGF21 analogs, or GLP-1 agonists. Statistical analyses used a random-effects model, calculating mean differences (MD) and relative risks (RR), with heterogeneity assessed using τ2, I2, and Q statistics. MASH resolution was significantly higher for FGF21 (RR 4.84, 95% CI: 2.59 to 9.03), Resmetirom showed the most significant reduction in MRI-PDFF (MD -18.41, 95% CI: -23.60 to -13.22) and >30% fat reduction (RR 3.56, 95% CI: 2.41 to 5.26). Resmetirom significantly reduced ALT (MD -15.71, 95% CI: -23.30 to -8.13), AST (MD -12.28, 95% CI: -21.07 to -3.49), and GGT (MD -19.56, 95% CI: -34.68 to -4.44). FGF21 and GLP-1 also reduced these markers. Adverse events were significantly higher with Resmetirom (RR 1.47, 95% CI: 1.24 to 1.74), while GLP-1 and FGF21 showed non-significant trends towards increased risk. Resmetirom and FGF21 show promise in treating MASLD and MASH, with Resmetirom particularly effective in reducing liver fat and improving liver enzymes. GLP-1 agonists also show benefits but to a lesser extent. Further long-term studies are needed to validate these findings and assess cost-effectiveness.

A protocol for the systematic review and meta-analysis of clinical trials of interventions to improve sleep in people with mild cognitive impairment or dementia.

Background While sleep disturbance is common in advanced dementia, leading to negative outcomes, there is growing evidence that sleep disturbance begins early in prodromal dementia and may contribute to cognitive decline. Sleep is therefore an important treatment target throughout the natural history of dementia. The existing literature regarding interventions for sleep in people with cognitive impairment is beset by wide heterogeneity in the sleep measurement tools used and outcome measures reported, which limits data synthesis and impedes the development of a robust evidence base for these interventions. Aim We propose to undertake a systematic review and meta-analysis to assess the evidence base from clinical trials for both pharmacological and non-pharmacological interventions to improve sleep in people with cognitive impairment. We will also extract data regarding the sleep measurement tools and outcome measures used in these studies to underpin the development of a core outcome set for future clinical trials in the area. Methods This systematic review and meta-analysis will include randomised and non-randomised controlled clinical trials that assess interventions to improve sleep in participants with mild cognitive impairment or dementia. Medline, CINAHL, PsycINFO, and the Cochrane CENTRAL database will be searched from inception to present. A flow chart will illustrate the study selection process in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The methodological quality and risk of bias of included studies will be assessed. Heterogeneity will be tested. A narrative synthesis will be undertaken where meta-analysis is not feasible. Conclusion This systematic review and meta-analysis will help inform clinical practice by evaluating the available evidence for interventions to improve sleep in people with mild cognitive impairment or dementia. It will also facilitate the development of a core outcome set that will improve the coherence and utility of data emerging from future clinical trials.

Gestational diabetes mellitus management according to ultrasound fetal growth versus strict glycemic treatment in singleton pregnancies: A systematic review and meta-analysis of clinical trials.

The objective of this meta-analysis was to evaluate obstetric outcomes in gestational diabetes mellitus (GDM) patients treated with flexible management based on intrauterine ultrasound fetal growth (FMIUFG) or strict maternal glycemic adjustment (SMGA). We performed a comprehensive systematic review of electronic databases for randomized clinical trials (RCTs) comparing obstetrics outcomes of singleton GDM patients managed according to FMIUFG or SMGA. The review protocol was registered in PROSPERO (CRD497888). Searches were conducted in PubMed, Embase, Cochrane, and LILACS. Primary outcomes were gestational age at delivery and birth weight. Random-effect model meta-analyses were used to minimize the effects of uncertainty associated with inter-study variability. Results are reported as standardized mean differences (SMDs) or as odds ratios (ORs) and their 95% confidence interval (CI). Heterogeneity between studies was estimated using the I2 statistic. The Cochrane Risk of Bias Scale was used to assess the quality of studies. There were five RCTs with low to moderate risk of bias, including 450 patients managed according to the FMIUFSG and 381 according to the SMGA. The macrosomia (birthweight >4000 g) rate was lower in pregnancies managed according to FMIUFG than SMGA adjustments (OR: 0.34; 95%CI: 0.16, 0.71). There were no significant differences in hypertensive disorder, cesarean section, neonatal intensive care unit admission, and large newborn for gestational age rates. The macrosomia rate was lower in women managed with the FMIUFG. There were no significant differences in other obstetric and neonate outcomes.

P88-3 Effectiveness and safety of trastuzumab emtansine in patients with breast cancer: meta-analysis of clinical trials

P88-3 Effectiveness and safety of trastuzumab emtansine in patients with breast cancer: meta-analysis of clinical trials

In advanced CKD, ACEis or ARBs reduce kidney failure vs. placebo or non-RAAS inhibitors at 34 mo.

Ku E, Inker LA, Tighiouart H, et al. Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers for advanced chronic kidney disease: a systematic review and retrospective individual participant-level meta-analysis of clinical trials. Ann Intern Med. 2024;177:953-963. 38950402.

Functional and radiological sinonasal outcomes of CFTR modulators for sinus disease in cystic fibrosis: A meta-analysis.

Cystic fibrosis transmembrane conductance regulator (CFTR) modulators improve pulmonary outcomes in cystic fibrosis (CF) by stabilizing the CFTR protein on respiratory epithelial surfaces. To determine the efficacy of CFTR modulators on sinonasal outcomes in patients with CF, we performed a meta-analysis of clinical trials to date that include functional and radiographic evidence of sinus disease. English full-text articles were searched in PubMed, Embase, and Scopus databases. Two reviewers screened articles and a third reviewer resolved disagreements. Articles were included if they reported functional or radiological sinonasal outcomes in patients with CF before and after CFTR modulator therapies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the risk of bias in non-randomized studies of interventions tool was used for quality assessment. The generic inverse variance method with random effects model was used for meta-analysis. Standardized mean difference (SMD) and mean difference (MD) were used as effect measurements. Seven prospective and two retrospective studies representing 248 patients were included in this analysis. There was a significant improvement in sinonasal outcome test-22 scores on elexacaftor‒tezacaftor‒ivacaftor (MD=12.80, [95% confidence interval, CI: 10.46‒15.13], p<0.001, n=222), with no heterogeneity detected (I2=0%, p=0.820). There was also a significant improvement in Lund‒Mackay scores (SMD=1.25, [95% CI: 0.58‒1.91], p<0.001, n=88), with heterogeneity detected (I2=67%, p=0.030). CFTR modulators improve functional and radiologic sinonasal outcomes. Given the utility of CFTR modulators, the treatment paradigm for CF-related chronic rhinosinusitis promises to evolve.

Cupping Therapy for the Treatment of Migraine Headache: a systematic review and meta-analysis of clinical trials.

Cupping therapy is a widely used complementary medicine for the treatment of migraine headaches globally. However, conflicting evidence exists on its effectiveness. To evaluate the safety and efficacy of cupping therapy in treating migraine headache disorder. Seven databases were systematically searched PubMed/MEDLINE, Clinicaltrials.gov, Cochrane CENTRAL, ScienceDirect, ProQuest, SinoMed, and the National Science and Technology Library. The primary endpoints are the treatment success and the pain intensity reduction. The secondary endpoints were adverse events (AEs) risk and improvement in quality of life (QoL), which was based on the Migraine Disability Scale (MIDAS). Subgroup analyses were performed based on the cupping techniques (wet and dry cupping) and adjunctive complementary treatments (i.e. acupuncture and/or collateral pricking). Eighteen trials out of 348 records were included, pooling 1,446 participants (n = 797 received cupping therapy). Treatment success was significantly higher among those with cupping therapy (risk ratio [RR] [95% CI] = 1.83 [1.52-2.21]); with significant improvement observed only with wet cupping (RR [95% CI] = 1.88 [1.53-2.30]). The adjunctive complementary therapy did not achieve a greater amplitude of treatment success compared to cupping therapy alone. Furthermore, cupping therapy showed significant pain reduction compared to baseline (standardized mean difference [SMD] [95% CI] = 0.55 [0.39-0.70]) and achieved fewer risks of AEs (RR [95% CI] = 1.88 [1.53-2.30]). However, cupping did not improve the overall QoL (MIDAS SMD [95% CI] = -0.79 [-3.55-1.98]). Cupping therapy was an effective complementary modality to treat migraine headaches. However, it did not demonstrate improvement in QoL (PROSPERO CRD42024514509).

Mesenchymal stem cells for perianal fistulizing Crohn’s disease (systematic review and meta-analysis)

AIM: to compare the efficacy (fistulas healing rate) and safety (morbidity rate) of mesenchymal stem cells (MSC) and placebo in patients with perianal fistulizing Crohn’s disease (PFCD). PATIENTS AND METHODS: a systematic review and meta-analysis of clinical trials, comparing the results of treatment of PFCD with single local administration of MSCs or placebo was performed. The meta-analysis included 5 randomized clinical trials and the results of treatment of 289 patients were analyzed. RESULTS: the meta-analysis demonstrates the high efficacy of a single local administration of MSCs for PFCD compared with placebo (OR = 2.10, CI 1.28–3.46, p = 0.003). The most common postoperative complications — abscesses and fistulas — are probably associated with the natural course of the disease and do not differ significantly between the groups. The results of surgery may be affected by the type, source and concentration of MSCs, the method of delivery and the number of injections. CONCLUSION: local administration of mesenchymal stem cells is an effective and safe method for perianal fistulas in Crohn’s disease, however, the presence of significant limitations in the meta-analysis makes it cautious about the results obtained and requires further randomized trials.

Antibody-based biological antiviral drugs for the prevention and treatment of acute respiratory viral infections in immunocompromised patients: focus on safety

The safety of drug therapy is of particular importance for immunocompromised patients. This aspect acquires high importance in the context of choosing tactics for the prevention and treatment of acute respiratory viral infections. The review presents data on the features of the antiviral immune response and common cold/influenza in patients with a burdened allergic history and a brief overview of the results of clinical studies on the effectiveness and safety of innovative biological antiviral drugs based on antibodies to biological targets – Ergoferon, Anaferon for children and Anaferon. The drugs have a targeted effect on the immune system in accordance with their pharmacological targets, have a significant evidence base, including a meta-analysis of clinical trials for each drug according to the indication "acute respiratory viral infections/influenza", as well as individual studies, including double-blind placebo-controlled randomized, with this pathology in immunocompromised patients. The article also includes the results of a generalized safety analysis of the use of the above drugs for the prevention and treatment of acute respiratory viral infections/influenza in patients with concomitant allergic and autoimmune pathology. The results of the conducted studies, meta-analyses and generalized statistical analysis of data on the use of the drugs Anaferon for children, Anaferon, Ergoferon for the prevention and treatment of acute respiratory viral infections/ influenza indicate proven efficacy and a favorable safety profile and allow us to recommend drugs for wide use with preventive and therapeutic purposes in accordance with indications, including patients with allergic and autoimmune pathology.

Effect of Mediterranean diet on body mass index and fatigue severity in patients with multiple sclerosis: A systematic review and meta-analysis of clinical trials

BackgroundRecent studies imply that Mediterranean Diet (MeD) may play an important role in the management of Multiple Sclerosis (MS). This meta-analysis aimed to evaluate the effectiveness of MeD in addressing MS-related complications. MethodsA thorough search was performed in MEDLINE (PubMed), Scopus, EMBASE, ScienceDirect, Google Scholar, Web of Science, and the Central Cochrane Library, covering trials published until September 2023. The quantitative data were synthesized using random effect models through STATA14. ResultsAfter analyzing 228 entries, we found five Randomized Controlled Trials (RCTs) with a total of 540 participants, who had an average disease duration of 8.5 years. The combined effect size revealed a decrease in Body Mass Index (BMI) (Weighted Mean Difference [WMD] = −0.88 kg/m2; 95 % Confidence Interval [CI] = −1.68, −0.08; P = 0.030). There was also a non-significant marginal improvement in fatigue severity (WMD = −8.29; 95 % CI = −16.74, 0.16; P = 0.054). ConclusionAdherence to MeD may improve BMI and fatigue severity in MS patients. Further RCTs are needed to confirm the current results.

54331 A meta-analysis of clinical trials evaluating the benefit of dermocosmetics on itch in AD patients associated with sensitive skin

54331 A meta-analysis of clinical trials evaluating the benefit of dermocosmetics on itch in AD patients associated with sensitive skin

53537 Sensitive skin syndrome: a meta-analysis of clinical trials evaluating the benefits of dermocosmetics on itch in sensitive skin subjects

53537 Sensitive skin syndrome: a meta-analysis of clinical trials evaluating the benefits of dermocosmetics on itch in sensitive skin subjects

Comparison of Ultrasound-Guided Percutaneous Microwave Ablation and Conventional Thyroidectomy in the Treatment of Papillary Thyroid Microcarcinoma: Meta-Analysis.

Purpose: To perform a meta-analysis of clinical trials comparing percutaneous microwave ablation (PMWA) guided by ultrasound with conventional thyroidectomy for the management of papillary thyroid microcarcinoma (PTMC), analyzing feasibility, safety, and long-term efficacy, and to provide clinical guidance for the treatment selection of PTMC. Methods: Embase, PubMed, Cochrane Library, Web of Science, CNKI, VIP Database, and Wanfang Database were systematically searched to identify clinical studies of PMWA or thyroidectomy for PTMC up to December 2023. The relevant data from the articles were extracted, and the data analysis was performed using RevMan 5.4 software. Results: A total of 442 articles were identified and subsequently screened based on the inclusion and exclusion criteria, 9 clinical studies involving a total of 1577 patients were included, with 788 patients in the PMWA group and 789 patients in the surgery group. Following data extraction and statistical analysis, in comparison to the surgery group, the PMWA group had shorter operation time [mean differences (MD) = -36.36; 95% CI -55.66 to -17.06; P = .0002], shorter hospital stay (MD = -3.93; 95% CI -5.55 to -2.30; P < .00001), less intraoperative bleeding (MD = -21.25; 95% CI -27.36 to -15.15; P < .00001), and lower hospital costs (MD = -1.00; 95% CI -1.33 to -0.66; P < .00001), all with statistical significance. The comparison of postoperative complications revealed a lower incidence of complications in the PMWA group compared to the surgery group [relative risk (RR) = 0.29; 95% CI 0.21 to 0.40; P < .00001], with statistical significance. Thyroid-related hormone analysis showed that the free triiodothyronine (MD = 0.61; 95% CI 0.33 to 0.90; P < .00001) and free thyroxine (MD = 1.81; 95% CI 0.94 to 2.68; P < .0001) levels in the PMWA group were higher than those in the traditional surgery group, while the levels of thyroid-stimulating hormone were lower than those in the traditional surgery group (MD = -7.63; 95% CI -10.25 to -5.01; P < .00001), with statistically significant differences, indicating that PMWA had a smaller impact on thyroid function. In 2 studies, there were no statistically significant disparities in postoperative recurrence or lymph node metastasis (LNM) between the 2 cohorts (RR = 0.70; 95% CI 0.33 to 1.50; P = .36). There were no statistically significant differences in physiological health score between different groups and different time points before and after treatment (P > .05); However, the mental component score and the total score of the Medical Outcomes Study (MOS) item short-form health survey were significantly elevated in the ablation group compared to the excision group post-treatment (P < .05). Conclusion: For patients with low-risk PTMC with definitive diagnosis and precise risk stratification, PMWA can be selected. PMWA treatment for patients with PTMC is comparable to conventional surgical treatment and has the advantages of minimal trauma, rapid recovery, no scarring, and fewer complications, which are superior to open surgery to a certain extent. For patients with ambiguous preoperative diagnosis and uncertainty regarding LNM status, surgical intervention is the optimal choice.