Systematic Reviews & Meta-analysis
M-A: Cardiovascular benefits of SGLT2 inhibitors in patients without diabetes
22 Mar, 2024 | 11:07h | UTCStudy Design and Population: This meta-analysis investigated the cardiovascular (CV) outcomes associated with sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients without diabetes mellitus (DM). By systematically reviewing online databases, the authors identified and included six randomized controlled trials (RCTs) in their analysis. These trials compared SGLT2i with placebo/control in a total of 12,984 participants, who were followed for an average duration of 17.7 months. The study population comprised mainly patients with heart failure (HF), chronic kidney disease, or myocardial infarction, with a mean age of 64 years, where 72% were men and the mean hemoglobin A1C level was 5.7%.
Main Findings: The use of SGLT2i was associated with a significant reduction in composite CV death or hospitalization for HF, with an odds ratio (OR) of 0.77 (95% confidence interval [CI], 0.68 to 0.87, p < 0.0001), primarily due to a decrease in hospitalization for HF (OR 0.70, 95% CI 0.60 to 0.81, p < 0.00001). No significant differences were observed in CV death, all-cause death, or major adverse CV events when comparing SGLT2i to placebo. Notably, serious adverse events were lower with the use of empagliflozin compared to placebo.
Implications for Practice: This meta-analysis highlights the significant CV benefits of SGLT2i treatment in reducing CV death or hospitalization for HF in patients without DM, compared with placebo. These findings suggest the potential for broader use of SGLT2i in populations without diabetes to improve cardiovascular outcomes.
Reference: Sahib Singh et al. (2024). Cardiovascular Outcomes With Empagliflozin and Dapagliflozin in Patients Without Diabetes. The American Journal of Cardiology, Published: February 29, 2024. DOI: https://doi.org/10.1016/j.amjcard.2024.02.039. Access the study here: [Link]
Meta-Analysis: Efficacy of exercise modalities in major depressive disorder treatment
20 Mar, 2024 | 17:54h | UTCStudy Design and Population: This article presents a systematic review and network meta-analysis of randomized controlled trials to assess the optimal dose and modality of exercise for treating major depressive disorder, comparing its effects to psychotherapy, antidepressants, and control conditions such as usual care or placebo. The review included 218 unique studies encompassing 495 arms with a total of 14,170 participants who met the clinical cutoffs for major depression.
Main Findings: The findings revealed moderate reductions in depression symptoms for several exercise modalities when compared to active controls. Notably, walking or jogging, yoga, and strength training demonstrated the most significant effects. The effectiveness of exercise was found to be proportional to the intensity of the activity prescribed. Among these, yoga and strength training were identified as the most acceptable modalities for participants. However, the overall confidence in these results is low due to the high risk of bias in the included studies, with only one study meeting the criteria for a low risk of bias.
Implications for Practice: The study concludes that exercise, particularly walking or jogging, yoga, and strength training at sufficient intensities, can be an effective treatment for major depressive disorder. These modalities could be recommended alongside traditional treatments such as psychotherapy and antidepressants. Future research should focus on blinding participants and staff to mitigate expectancy effects and improve the reliability of findings. The inclusivity of exercise as a core treatment for depression could significantly impact treatment strategies and patient outcomes.
Reference: Noetel, M., et al. (2024). Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ, 384, e075847. DOI: https://doi.org/10.1136/bmj-2023-075847. Access the study here: [Link]
M-A | Pharmacist-led home BP telemonitoring enhances control over usual care
11 Aug, 2023 | 15:29h | UTC
M-A | Efficacy of vibrotactile positional therapy devices on patients with positional obstructive sleep apnea
9 Aug, 2023 | 15:30h | UTC
M-A | Absence of evidence for antipsychotics in youth unipolar depression; limited evidence in bipolar depression
9 Aug, 2023 | 15:23h | UTC
M-A | Most dengue infections are asymptomatic and could significantly contribute to the transmission of the disease
9 Aug, 2023 | 15:21h | UTC
M-A | eHealth interventions aid in smoking cessation; effect diminishes over time
9 Aug, 2023 | 15:14h | UTC
M-A | Percutaneous catheter drainage superior to needle aspiration for liver abscess treatment success
9 Aug, 2023 | 15:12h | UTC
M-A | Nearly 37% of elderly outpatients are at risk due to potentially inappropriate medication use
8 Aug, 2023 | 13:37h | UTC
M-A | Approximately 25 min/day of walking can boost function and cut adverse events in acutely hospitalized elders
8 Aug, 2023 | 13:35h | UTC
Systematic Review | Pegylated liposomal doxorubicin for relapsed epithelial ovarian cancer
8 Aug, 2023 | 13:11h | UTCPegylated liposomal doxorubicin for relapsed epithelial ovarian cancer – Cochrane Library
M-A | The global prevalence of human fascioliasis
8 Aug, 2023 | 13:10h | UTC
Systematic review informing the 2022 EULAR recommendations for the management of ANCA-associated vasculitis
7 Aug, 2023 | 14:47h | UTCGuideline: EULAR recommendations for the management of ANCA-associated vasculitis
M-A | Antenatal corticosteroid exposure linked to negative outcomes in term-born infants
4 Aug, 2023 | 11:59h | UTCRelated Study: Association between antenatal corticosteroids and risk of serious infection in children: nationwide cohort study – The BMJ
Editorial: Antenatal corticosteroids and longer term outcomes – The BMJ
News Releases:
New studies shed more light on potential risks of antenatal steroids – BMJ Newsroom
M-A | Exploring perinatal interventions and their impact on severe intraventricular hemorrhage in preterm neonates
4 Aug, 2023 | 11:56h | UTC
Commentary on Twitter
A meta-analysis by @DrAbdulRazak_MD & colleagues on perinatal interventions are associated with a reduction or increase of IVH and PVL #EBNEOalerts #neoEBM #neotwitter https://t.co/SPzNHwy3HD pic.twitter.com/KDQBSYZjdq
— Evidence-Based Neo (@EBNEO) April 26, 2023
M-A | Supine vs. nonsupine endotracheal intubation
4 Aug, 2023 | 11:45h | UTC
M-A | Uncertain benefits of blood purification techniques in severe infection or sepsis
4 Aug, 2023 | 11:41h | UTC
Systematic Review | Interstitial lung disease incidence at 11.7% in metastatic breast cancer patients using trastuzumab deruxtecan
3 Aug, 2023 | 13:36h | UTC
Systematic Review | Necrotizing enterocolitis onset typically in third week for very preterm, low birthweight infants
3 Aug, 2023 | 13:33h | UTC
M-A | Significant QOL and mental health improvements in caregivers via targeted interventions
3 Aug, 2023 | 13:28h | UTC
M-A | High-volume disease, T stage 4 show largest docetaxel benefit in prostate cancer
2 Aug, 2023 | 13:51h | UTCCommentaries:
Disease Volume and T Stage Affect Docetaxel/ADT Efficacy in Prostate Cancer – Cancer Network
Commentary on Twitter
NEW: A systematic review and meta-analysis of individual patient data from the STOPCAP M1 collaboration aims to obtain up-to-date estimates of the effects of docetaxel in patients with metastatic hormone-sensitive prostate cancer. #pcsmhttps://t.co/7mqXeIXMQ5 pic.twitter.com/A7AmjipnVq
— The Lancet Oncology (@TheLancetOncol) July 5, 2023
M-A | Updated evidence supports incisional negative pressure wound therapy for surgical site infection prevention
1 Aug, 2023 | 14:15h | UTC
M-A | Various exercise training modes reduce resting blood pressure, isometric exercise most effective
31 Jul, 2023 | 14:35h | UTCNews Release: Static isometric exercise, such as wall sits, best for lowering blood pressure – BMJ Newsroom
Commentary: Wall squats and planks best at lowering blood pressure – BBC
M-A | Cardiovascular events in patients treated with bempedoic acid versus placebo
31 Jul, 2023 | 14:06h | UTC
Commentary on Twitter
Bempedoic acid for the prevention of cardiovascular events in patients with an indication for lipid-lowering therapy: a meta-analysis of 10 randomised trials https://t.co/PswEP3vj0K @AgewallStefan @FeliceGragnano #EHJPharmacotherapy #ESCYoung pic.twitter.com/0eYyBBWrDn
— European Society of Cardiology Journals (@ESC_Journals) July 29, 2023
Systematic Review | Organizational changes likely decrease physical restraint usage in long-term care
31 Jul, 2023 | 13:53h | UTC