Abstract:
BACKGROUND:There is a paucity of head-to-head comparisons of the efficacy and harms of pharmacological treatments for systemic sclerosis-related interstitial lung disease (SSc-ILD). METHODS:We conducted a network meta-analysis (NMA) in order to compare the effects of different treatments with the placebo on change in forced vital capacity (FVC), change in diffusion lung capacity for CO (DLCO), serious adverse events (SAEs), discontinuation for adverse events and mortality in SSc-ILD. Standardized mean difference (SMD) and log odds ratio were estimated using NMA with fixed effects. RESULTS:Nine randomized clinical trials (926 participants) comparing eight interventions and the placebo for an average follow-up of one year were included. Compared to the placebo, only rituximab significantly reduced FVC decline (SMD (95% CI) = 1.00 (0.39 to 1.61)). Suitable data on FVC outcome for nintedanib were not available for the analysis. No treatments influenced DLCO. Safety and mortality were also not different across treatments and the placebo, although there were few reported events. Cyclophosphamide and pomalidomide were less tolerated than the placebo, mycophenolate, and nintedanib. CONCLUSION:Only rituximab significantly reduced lung function decline compared to the placebo. However, direct head-to-head comparison studies are required to confirm these findings and to better determine the safety profile of various treatments.
journal_name
J Clin Medjournal_title
Journal of clinical medicineauthors
Erre GL,Sebastiani M,Fenu MA,Zinellu A,Floris A,Cavagna L,Renzoni E,Manfredi A,Passiu G,Woodman RJ,Mangoni AAdoi
10.3390/jcm9082560subject
Has Abstractpub_date
2020-08-07 00:00:00issue
8issn
2077-0383pii
jcm9082560journal_volume
9pub_type
杂志文章,评审abstract::The relationship between bruxism and tooth wear is contentious in the literature. The pathophysiological processes of tooth wear may be complicated by the relationship between bruxism and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate the associations among bruxism, GERD, and tooth...
journal_title:Journal of clinical medicine
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abstract::Self-management (SM) includes activities that patients initiate and perform in the interest of controlling their disease and maintaining good health and well-being. This review examines the health literacy and patient activation elements of self-management interventions for Chronic Obstructive Pulmonary Diseases (COPD...
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journal_title:Journal of clinical medicine
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更新日期:2019-12-09 00:00:00
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