Meta-analysis Of Clinical Trials Research Articles

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

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.

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.

Meta-analysis of the Therapeutic Impact of Cannabinoids in Inflammatory Bowel Disease.

With the increasing legalization of medical and recreational cannabis, patients and providers have growing interest in the role of cannabinoids in treating inflammatory bowel disease. Prior meta-analysis has shown inconclusive evidence for efficacy of cannabinoids. We sought to produce an up-to-date meta-analysis that pools new data to evaluate the therapeutic effects of cannabinoids in both Crohn's disease (CD) and ulcerative colitis (UC). PubMed, Embase, CENTRAL and CINAHL were queried for randomized-controlled trials evaluating the impact cannabinoids in CD or UC. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2. Eight studies, including 4 studies of CD, 3 studies of UC, and 1 study of both diseases met inclusion criteria. Among 5 studies of CD, a statistically significant decrease in clinical disease activity following intervention was observed (risk ratios [RR], -0.91; 95% CI, CI:1.54 to CI:0.28, I2 = 71.9%). Clinical disease activity in UC was not significantly lower in the pooled analysis (RR, -2.13; 95% CI, -4.80 to 0.55; I2 = 90.3%). Improvement in quality of life (QoL) was observed in both CD and UC combined (RR, 1.79; 95% CI, 0.92-0.2.66; I2 = 82.8%), as well as individually. No differences were observed in the analysis on endoscopic disease activity and inflammatory markers. This meta-analysis of clinical trials suggests that cannabinoids are associated with improved quality of life in both CD and UC, as well as improved disease activity but not inflammation.

CT-115 Efficacy and Safety of Dual Antigen Targeting Chimeric Antigen Receptor T-cells in Hematologic Malignancies: A Meta-analysis of Clinical Trials

CT-115 Efficacy and Safety of Dual Antigen Targeting Chimeric Antigen Receptor T-cells in Hematologic Malignancies: A Meta-analysis of Clinical Trials

Efficacy and Safety of Dual Antigen-Targeting Chimeric Antigen Receptor T-Cells in Hematologic Malignancies: A Meta-Analysis of Clinical Trials

Efficacy and Safety of Dual Antigen-Targeting Chimeric Antigen Receptor T-Cells in Hematologic Malignancies: A Meta-Analysis of Clinical Trials

MM-357 Systematic Literature Review and Meta-Analysis of Clinical Trials of Fourth Line or Higher Treatment for Relapsed/Refractory Multiple Myeloma Patients

ObjectiveTreatment options for relapsed/refractory multiple myeloma (RRMM) have expanded, but clinical burden remains high, particularly for heavily pretreated patients. This systematic literature review and meta-analysis was conducted to synthesize outcomes from clinical trials evaluating fourth line or higher (4L+) treatment regimens. MethodologySearches using Embase, MEDLINE, and CENTRAL were conducted (January 2012-March 2024), and publications from key conferences were hand-searched. Eligible studies were clinical trials that included the phase 2 dose of a National Comprehensive Cancer Network recommended intervention and whose population was ≥80% 4L+. Meta-analyses were conducted to synthesize outcomes by treatment class (CAR T-cell therapies [CAR T], bispecific antibodies [BsAb], and Other) using random effects models where possible. For outcomes where Kaplan-Meier curves were available, meta-analyses were conducted using survival function parameters fitted to each curve. ResultsThe meta-analysis included 34 trials (5 CAR T, 3 BsAb, and 26 Other). All CAR T and 2 BsAb trials investigated BCMA-targeting interventions. The estimated overall response rates for CAR T, BsAb, and Other were 85.5% (95% confidence interval: 72.7, 92.9), 67.6% (62.0, 72.8), and 40.5% (33.3, 48.1), respectively. The 1-year overall survival was 84.4% (79.1, 88.4) for CAR T, 70.4% (66.6, 73.9) for BsAb, and 59.5% (55.8, 63.1) for Other. The 1-year progression-free survival was 59.0% (53.7, 64.0) for CAR T, 48.4% (44.2, 52.3) for BsAb, and 20.9% (17.9, 24.0) for Other. Infections occurred in 67.1% (59.6, 73.8) with CAR T, 69.2% (60.9, 76.5) with BsAb, and 60.2% (48.6, 70.9) with Other. For adverse events specific to the immune effector cell therapies of CAR T and BsAb, overall neurotoxicity occurred in 18.8% (10.0, 32.3) and 10.2% (7.2, 14.2), respectively, and cytokine release syndrome (CRS) in 92.3% (85.2, 96.2) and 71.4% (63.4, 78.3). Additional outcomes data will be presented. ConclusionsThis study offers a comprehensive and up-to-date synthesis of clinical trial outcomes for recommended interventions in 4L+ treatments for RRMM. While efficacy outcomes are improving with more recently approved interventions, there remains an unmet need for durable treatments with an improved safety profile in this population.

Systematic Literature Review and Meta-Analysis of Clinical Trials of Fourth Line or Higher Treatment for Relapsed/Refractory Multiple Myeloma Patients

Systematic Literature Review and Meta-Analysis of Clinical Trials of Fourth Line or Higher Treatment for Relapsed/Refractory Multiple Myeloma Patients

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.

Therapeutic effect of fenugreek supplementation on type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials

IntroductionNumerous clinical trials have investigated the effects of fenugreek, a traditional herbal medicine, on type 2 diabetes mellitus (T2DM). However, the results from these studies have been inconsistent. Therefore, we aimed to perform a meta-analysis on the effects of fenugreek supplementation on weight, body mass index (BMI), lipid profile, and glycemic indices in patients with T2DM. MethodsWe searched PubMed, Scopus, Embase, ISI Web of Science, and Cochrane Library databases to identify clinical trial studies until October 2023. The data were analyzed using a random-effects model and presented as the weighted mean difference (WMD) along with the associated 95 % confidence interval (CI). ResultsA total of 19 studies were included in the meta-analysis. The results indicated a significant impact of fenugreek supplementation on lowering fasting plasma glucose (FPG) (WMD: 20.32 mg/dl; 95 % CI: 26.65 to −13.99), hemoglobin A1C (HbA1c) (WMD: 0.54 %; 95 % CI: 0.80 to −0.28), homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: 0.36; 95 % CI: 0.67 to −0.05), total cholesterol (TC) (WMD: 33.10 mg/dL; 95 % CI: 64.31 to −1.88), low-density lipoprotein cholesterol (LDL-C) (WMD: 29.14 mg/dL; 95 % CI: 55.45 to −2.83), BMI (WMD: 0.73 kg/m2; 95 % CI: 1.40 to −0.07), and increasing the high-density lipoprotein cholesterol (HDL-C) (WMD: 5.68 mg/dL; 95 % CI: 3.51 to 7.85). However, the effect on fasting insulin, triglycerides, and weight was not significant. ConclusionsFenugreek supplementation has been shown to improve FPG, HbA1C, HOMA-IR, TC, LDL-C, HDL-C, and BMI in patients with T2DM. The overall results suggest that fenugreek may have protective and therapeutic effects on T2DM parameters.

Efficacy of Curcuma longa in relieving pain symptoms of knee osteoarthritis patients: a systematic review and meta-analysis of clinical trials

Efficacy of <i>Curcuma longa</i> in relieving pain symptoms of knee osteoarthritis patients: a systematic review and meta-analysis of clinical trials

Efficacy and Safety of Mitapivat in Pyruvate Kinase Deficiency: A Systematic Review and Meta-analysis of Clinical Trials

Efficacy and Safety of Mitapivat in Pyruvate Kinase Deficiency: A Systematic Review and Meta-analysis of Clinical Trials

The effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy: A systematic review and meta-analysis of clinical trials.

Thyroidectomy can lead to significant challenges such as neck pain, disability, and limited range of motion. Therefore, our objective is to conduct a systematic review and meta-analysis of clinical trials to investigate the clinical effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability immediately after thyroidectomy. We systematically searched PubMed, CENTRAL, Scopus, and Web of Science from inception until July 28th, 2023. We assessed the selected trials for the risk of bias using both the RoB-2 and ROBINS-I tools. Our specific outcomes were the severity of neck pain and self-reported disability after thyroidectomy. The results were synthesized using risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) in a random-effects model using Stata software. Nine clinical trials, comprising five randomized and four non-randomized trials, were included, with a total of 1026 patients. Neck stretching exercises were significantly associated with improved mean pain scores both after 1 week (n = 625 patients, SMD = -2.43, 95% CI [-4.65, -0.22], p = 0.03, I2 = 98%) and 1 month (n = 545 patients, SMD = -4.11, 95% CI [-8.12, -0.11], p = 0.04, I2 = 99%). Similarly, neck stretching exercises were significantly associated with improved mean self-reported disability scores both after 1 week (n = 298 patients, SMD = -0.70, 95% CI [-1.36, -0.04], p = 0.04, I2 = 87%) and 1 month (n = 298 patients, SMD = -0.42, 95% CI [-0.65, -0.19], p = 0.0004, I2 = 0%). The pooled analysis showed heterogeneity (chi-square p < 0.01, I2 > 80%), except for the mean self-reported neck disability score after 1 month, which showed homogeneity (chi-square p > 0.01, I2 = 0%). This systematic review and meta-analysis, involving 1026 patients, revealed the potential benefits of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy. However, further research is required to address methodological limitations, evaluate long-term outcomes, investigate potential moderators (i.e., the duration or intensity of the exercise program), and explore patients' analgesic consumption.

Assessing the efficacy of Laser pulpotomy versus conventional pulpotomy in primary teeth: A systematic review and meta-analysis of clinical trials.

This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment. An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05. Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy. Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.

Impact of very low carbohydrate ketogenic diets on cardiovascular risk factors among patients with type 2 diabetes; GRADE-assessed systematic review and meta-analysis of clinical trials

ObjectiveThis study was designed to evaluate the impact of VLCKD on cardiovascular risk factors in patients with T2DM.MethodsUntil March 2024, extensive searches were conducted on PubMed, Scopus, Web of Science, Embase, and other relevant databases. The purpose was to identify clinical trials examining the impact of VLCKD on glycemic control, lipid profile, and blood pressure. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method was used to assess the evidence’s degree of certainty.ResultsOur initial search found a total of 2568 records and finally 29 trials were included in final analysis. Our results showed that adherence from VLCKD led to significant reduction in fasting blood sugar (WMD= -11.68 mg/dl; 95% CI: -18.79, -4.56; P = 0.001), HbA1c (WMD= -0.29; 95% CI: -0.44, -0.14; P < 0.001), HOMA-IR(WMD= -0.71; 95% CI: -1.14, -0.29; P = 0.001), insulin (WMD= -1.45; 95% CI: -2.54, -0.36; P = 0.009), triglyceride (WMD= -17.95; 95% CI: -26.82, -9.07; P < 0.001), systolic blood pressure (WMD= -2.85, 95% CI: -4.99, -0.71; P = 0.009) and diastolic blood pressure (WMD= -1.40; 95% CI: -2.66, -0.13; P = 0.03). We also found a significant increase in high-density lipoprotein (HDL) level after adherence from VLCKD diet (WMD = 3.93, 95% CI: 2.03, 5.84; P = 0.000). We couldn’t find any significant differences between groups in term of LDL and total cholesterol levels.ConclusionPeople following a VLCKD experience a more significant improvement in cardiovascular risk factors when compared to individuals on control diets.

Safety and Efficacy of Trastuzumab Deruxtecan for Metastatic HER2+ and HER2-low Breast Cancer: An Updated Systematic Review and Meta-Analysis of Clinical Trials.

Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug conjugate (ADC) promising in treating metastatic HER2+ and HER2-low breast cancer. This updated systematic review and meta-analysis, integrating data from the latest clinical trials, aimed to evaluate the safety and efficacy of T-DXd in this patient population. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, Scopus, and Web of Science up to January 2024, focusing on clinical trials that assessed T-DXd's efficacy and safety. Eligibility criteria were based on the PICOS framework, and selected studies underwent rigorous quality assessment and data extraction. The primary outcomes were progression-free survival (PFS), overall survival (OS), and the incidence of adverse events. A random-effects meta-analysis was performed to synthesize the data. Seven studies involving 2,201 patients met the inclusion criteria. The pooled analysis revealed that T-DXd significantly improved PFS (OR=0.37, 95% CI: 0.27-0.52), indicating a robust efficacy in slowing disease progression. However, treatment was associated with an increased risk of anemia (OR=2.10, 95% CI: 1.36-3.25), fatigue (OR=1.56, 95% CI: 1.21-2.02), nausea (OR=6.42, 95% CI: 4.37-9.42), vomiting (OR=6.21, 95% CI: 3.14-12.25), constipation (OR=2.26, 95% CI: 1.53-3.34), and notably, drug-related interstitial lung disease (OR=10.89, 95% CI: 3.81-31.12). The efficacy outcomes demonstrated significant heterogeneity, which was addressed through sensitivity analysis. T-DXd shows significant efficacy in treating metastatic HER2+ and HER2-low breast cancer, offering a valuable therapeutic option for patients with advanced disease. However, the treatment is associated with notable adverse events, including a heightened risk of ILD. These findings underscore the need for careful patient selection, monitoring, and management strategies to mitigate risks. Future research should focus on optimizing treatment protocols and exploring methods to enhance safety profiles.