Daniela A. Rodrigues MSc , Ana I. Plácido PhD , Ana Bárbara Tavares PharmD , Daniela Azevedo MSc , Ramona Mateos-Campos PharmD, PhD , Adolfo Figueiras PharmD, PhD , Maria Teresa Herdeiro PharmD, PhD , Fátima Roque PharmD, PhD
{"title":"Potentially Inappropriate Medication Prescribing in Older Adults According to EU(7)-Potentially Inappropriate Medication List: A Nationwide Study in Portugal","authors":"Daniela A. Rodrigues MSc , Ana I. Plácido PhD , Ana Bárbara Tavares PharmD , Daniela Azevedo MSc , Ramona Mateos-Campos PharmD, PhD , Adolfo Figueiras PharmD, PhD , Maria Teresa Herdeiro PharmD, PhD , Fátima Roque PharmD, PhD","doi":"10.1016/j.curtheres.2022.100681","DOIUrl":"10.1016/j.curtheres.2022.100681","url":null,"abstract":"<div><h3>Background</h3><p>Portugal has among the highest rates of dependency among older adults in Europe. Older adults with aging-related comorbidities are prone to the use of potentially inappropriate medication (PIM).</p></div><div><h3>Objective</h3><p>The aim of this study was to analyze PIM prescriptions in older Portuguese adults, as well as the change rate of PIM prescriptions over time, and assess the geographical variability between the different regions of mainland Portugal.</p></div><div><h3>Methods</h3><p>Using a national database, PIM prescriptions were analyzed for older adults (aged 65 years and older) between 2019 and 2021 from 2 perspectives: PIM-defined daily dose (DDD) frequency (%) and DDD per 1000 inhabitants per day (DID).</p></div><div><h3>Results</h3><p>Overall, mainland Portugal presented a PIM DDD frequency of 9.20%, which was relatively higher in Alentejo and Centro and lower in the North. Alprazolam, fluoxetine, and rivaroxaban were PIM with higher DDD frequency values. Over the years, the DID change rates for these three PIM were –3.80%, –14.86%, and +18.54%, respectively, depending on the geographic region. Alprazolam and fluoxetine were mostly prescribed to older women, whereas rivaroxaban was mostly prescribed to older men.</p></div><div><h3>Conclusions</h3><p>These results emphasize the need to implement initiatives and interventions to decrease PIM prescriptions in older adults.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"97 ","pages":"Article 100681"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/94/main.PMC9350873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40591073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diabetic Foot Ulcer Among Adults Attending Follow-Up Diabetes Clinics in Wolaita Zone, Southern Ethiopia: An Unmatched, Case-Control Study","authors":"Lielt Gebreselassie Gebrekirstos MSc , Mulugeta Tsegay Abadi MSc , Meron Hadis Gebremedhin MSc , Eyasu Alem Lake MSc , Tsiyon Birhanu Wube MSc","doi":"10.1016/j.curtheres.2022.100673","DOIUrl":"10.1016/j.curtheres.2022.100673","url":null,"abstract":"<div><h3>Background</h3><p>Diabetic foot ulcer is a major public health problem, and among the leading causes of this complication in Ethiopian patients with diabetes. Despite the magnitude of this problem, data regarding the determinants of diabetic foot ulcers are limited.</p></div><div><h3>Objective</h3><p>This study aimed to assess the determinants of diabetic foot ulcers among adults attending follow-up visits in diabetes clinics in the Wolaita Zone, southern Ethiopia.</p></div><div><h3>Methods</h3><p>An institution-based case-control study was done from September 10 to December 28, 2020, in southern Ethiopia. We recruited 137 patients with diabetic foot ulcers and 408 patients without any diabetic foot ulcers using a consecutive sampling method. EpiData version 3.1.1 (EpiData Association, Odense, Denmark) and SPSS version 25 (IBM-SPSS Inc, Armonk, New York) were used for data entry and analysis. Descriptive statistics were calculated followed by a multivariate logistic regression analysis.</p></div><div><h3>Results</h3><p>Having a low wealth index (adjusted odds ratio [AOR] = 2.6; 95% CI, 1.177–5.662); being obese (AOR = 3.6; 95% CI, 1.380–9.547; <em>P =</em> 0.003), being overweight (AOR = 3.1; 95% CI, 1.480–6.436; <em>P =</em> 0.009), having peripheral neuropathy (AOR = 3.9; 95% CI, 1.641–9.430; <em>P =</em> 0.002), living with diabetes for >10 years (AOR = 2.3; 95% CI, 1.191–4.475; <em>P =</em> 0.013), and practicing poor diabetic foot self-care (AOR = 6.0; 95% CI, 3.156–11.312<em>; P =</em> 0.000) were significantly associated with having a diabetic foot ulcer.</p></div><div><h3>Conclusions</h3><p>This study suggests there is a need for education and counseling of patients on decreasing weight and improving foot-care practice, especially in those who are economically disadvantaged, have peripheral neuropathy, and have lived with diabetes for more than 10 years. (<em>Curr Ther Res Clin Exp</em>. 2022; 83:XXX–XXX)</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"96 ","pages":"Article 100673"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0011393X22000121/pdfft?md5=798903aaa4fbd1b5025a9d8556951816&pid=1-s2.0-S0011393X22000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83832715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary Beth Yacyshyn PhD , James Collins PhD , Michelle Chua PhD , Angela Siegwald MSN , Sara Yacyshyn MD , Valerie Briones-Pryor MD , Bruce Yacyshyn MD
{"title":"Feasibility study of Bismuth Subsalicylate (BSS) as an addition to standard of care for COVID-19 therapy","authors":"Mary Beth Yacyshyn PhD , James Collins PhD , Michelle Chua PhD , Angela Siegwald MSN , Sara Yacyshyn MD , Valerie Briones-Pryor MD , Bruce Yacyshyn MD","doi":"10.1016/j.curtheres.2022.100667","DOIUrl":"10.1016/j.curtheres.2022.100667","url":null,"abstract":"","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"96 ","pages":"Article 100667"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0011393X22000066/pdfft?md5=ae9622c8b19b6bcb3afae9e1f031a581&pid=1-s2.0-S0011393X22000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84101783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy End Points and Dose Analysis of Food and Drug Administration-Approved Novel Drugs in 2020","authors":"Albert Tang","doi":"10.1016/j.curtheres.2022.100680","DOIUrl":"10.1016/j.curtheres.2022.100680","url":null,"abstract":"<div><h3>Background</h3><p>During 2020, the Food and Drug Administration approved 53 novel drugs.</p></div><div><h3>Objective</h3><p>Biomarkers, surrogate endpoints and dosing regimens used in early and pivotal clinical stages are evaluated.</p></div><div><h3>Methods</h3><p>Information on various efficacy end points of 2020 Food and Drug Administration approved novel drugs was gathered from the Drug Approvals and Databases page of the Food and Drug Administration website. Endpoint data from efficacy end points for the 2019 approved novel drugs by Tong and Wang are used as a comparison.</p></div><div><h3>Results</h3><p>Among the 53 drugs approved during 2020, 49 were for treatment of various diseases and 4 were for diagnostics. Twenty-five drug approvals (51%, relative to 49 drugs for treatment of diseases) were based on surrogate end points, consisting of 12 accelerated approvals and 13 regular approvals. There were 19 drug approvals for cancer treatments (39%, relative to 49 drugs for treatment of diseases). During 2019, there were 48 drugs approved. Forty-four were for treatment of various diseases and 4 were for diagnostics. Fourteen drug approvals (32%, relative to 44 drugs for treatment of diseases) were based on surrogate end points, consisting of 9 accelerated approvals and 5 regular approvals. There were 10 drug approvals for cancer treatments (23%, relative to 44 drugs for treatment of diseases).</p><p>The approved doses were usually much closer to the highest dose tested in clinical trials (about 2-fold lower) compared with the lower dose tested in clinical trials (about 11-fold higher). Large and variable distances between the starting low dose in humans and the final approved doses indicate that finding the optimal dose in clinical trials is still a time-consuming and costly process. Further dose analysis for cancer drugs approved during 2020 showed that the distances between the starting dose in human beings and the final approved doses of cancer drugs were still large and variable, similar to distances in noncancer drugs. Stratification of drugs approved in 2020 by molecular weights shows that small molecular weights (<1000 Daltons) appeared to be smaller and less variable than those for drugs with large molecules (>1000 Daltons). (<em>Curr Ther Res Clin Exp</em>. 2022; 83:XXX–XXX)</p></div><div><h3>Conclusions</h3><p>Surrogate end points with accelerated approval have been widely used for approvals, with an increasing trend from 2019 to 2020 (32% vs. 51%). The approved doses usually were much higher (10-fold) than the lowest tested dose in first-in-human trials, while much closer (2-fold lower) to the highest dose tested in clinical trials.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"97 ","pages":"Article 100680"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/3c/main.PMC9310132.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40553495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md Moustafa Kamal , Tilahun Tewabe MSc , Tsheten Tsheten MPH , Syeda Z. Hossain PhD
{"title":"Individual- and Community-Level Factors Associated with Diarrhea in Children Younger Than Age 5 Years in Bangladesh: Evidence from the 2014 Bangladesh Demographic and Health Survey","authors":"Md Moustafa Kamal , Tilahun Tewabe MSc , Tsheten Tsheten MPH , Syeda Z. Hossain PhD","doi":"10.1016/j.curtheres.2022.100686","DOIUrl":"10.1016/j.curtheres.2022.100686","url":null,"abstract":"<div><h3>Background</h3><p>Diarrheal disease is among the leading causes of morbidity and mortality among children younger than age 5 years in Bangladesh.</p></div><div><h3>Objective</h3><p>The objective of this study is to assess the prevalence of diarrhea among children younger than age 5 years and its associated risk factors.</p></div><div><h3>Methods</h3><p>Data were sourced from the Bangladesh Demographic and Health Survey, a nationally representative study conducted in 2014. We used multilevel logistic regression models to identify factors associated with diarrheal disease.</p></div><div><h3>Results</h3><p>Children aged 6 to11 months (odds ratio = 2.26; 95% CI, 1.50–3.42), and 12 to 23 months (odds ratio = 2.31; 95% CI, 1.62–3.31) were more likely to have diarrhea than older children. Other significant risk factors for diarrheal infection included households without access to drinking water (odds ratio = 1.39; 95% CI, 1.03–1.88) and mothers lacking mass media access (odds ratio = 1.32; 55% CI, 1.01–1.73).</p></div><div><h3>Conclusions</h3><p>Childhood diarrhea in Bangladesh was associated with individual- and community-level factors. The finding of this study suggests that diarrhea prevention programs in the country can effectively be delivered by targeting young children through expanding community-based education and increasing access to health information through mass media.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"97 ","pages":"Article 100686"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/be/main.PMC9576538.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40647950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michel Archange Fokam Tagne PhD , Blaise Kom PhD , Angèle Foyet Fondjo PhD , Paul Aimé Noubissi PhD , Benjamin Talom Tangue PhD , Estelle Flora Gaffo MSc , Gaëtan Olivier Fankem PhD , Henri Wambe PhD , Joseph Ngakou Mukam MSc , René Kamgang HDR
{"title":"Evaluation of Anticolitis and Antioxidant Properties of Bixa orellana (Bixaceae) Leaf Hydroethanolic Extract on Acetic Acid-Induced Ulcerative Colitis in Rats","authors":"Michel Archange Fokam Tagne PhD , Blaise Kom PhD , Angèle Foyet Fondjo PhD , Paul Aimé Noubissi PhD , Benjamin Talom Tangue PhD , Estelle Flora Gaffo MSc , Gaëtan Olivier Fankem PhD , Henri Wambe PhD , Joseph Ngakou Mukam MSc , René Kamgang HDR","doi":"10.1016/j.curtheres.2022.100685","DOIUrl":"10.1016/j.curtheres.2022.100685","url":null,"abstract":"<div><h3>Background</h3><p>Ulcerative colitis is an idiopathic inflammatory bowel disease characterized by tissue damage, diarrhea, anemia, and loss of body weight. Tissue damage occurs as a result of uncontrolled activation of the immune response and an increase in free radicals, which have a strong effect on the pathogenesis of inflammatory bowel disease. The incidence and prevalence of this inflammatory disease continue to increase worldwide. Maceration of <em>Bixa orellana</em> leaves in palm wine is used in traditional medicine to treat diarrhea, dysentery, and hemorrhoids in the Adamaoua region of Cameroon.</p></div><div><h3>Objective</h3><p>The present work evaluated the preclinical effects (ie, antioxidant, hematological, and histological activities) of the hydroethanolic extract of <em>Bixa orellana</em> leaves in an in vivo, rat acetic acid-induced ulcerative colitis model.</p></div><div><h3>Methods</h3><p>Thirty-six female rats weighing between 165 and 180 g were fasted for 18 hours and then anesthetized with ether. A dose of 1 mL acetic acid (5%) was administered rectally through a catheter in all rats except the normal control group, which received distilled water (1 mL) instead. Treatments began 48 hours after rectal administrations of acetic acid or water, and all animals were treated twice daily for 7 days. The normal control group and the colitis control group received PO distilled water (10 mL/kg), the positive control received orally loperamide (5 mg/kg, and the 3 test groups received orally the hydroethanolic extract of <em>Bixa orellana</em> at 100, 200, and 400 mg/kg, respectively. During treatment, the number of diarrheal stools and weight change were assessed. At the end of the treatment, the animals were put to death under ether anesthesia. Blood was collected postmortem for evaluation of hematological and antioxidant parameters. The abdomen was opened via a midline incision and the colon was removed and emptied of all contents to assess histological and antioxidant parameters.</p></div><div><h3>Results</h3><p>During treatment, the number of diarrheal stools was significantly decreased from day 3 in animals treated with 100 (<em>P</em> < 0.05), 200 (<em>P</em> < 0.05), and 400 (<em>P</em> < 0.01) mg/kg extract compared with the colitis control group. The change in body weight of all extract-treated rats decreased significantly from day 3 (–5.55%; <em>P</em> < 0.05) to day 8 (–13.80%; <em>P</em> < 0.01) compared with the normal control. In the colitis control, this change ranges from –6.15% on day 2 to –15.13% on day 8. Extract treatment with 100, 200, and 400 mg/kg significantly reduced (<em>P</em> < 0.05) the number of lesions and the relative weight of the colon. The levels of red blood cells, neutrophils, and total white blood cells decreased in the colitis control group, whereas treatment with the extract at doses of 100, 200, and 400 mg/kg was associated with a significant increase in these hematolo","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"97 ","pages":"Article 100685"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/85/main.PMC9539784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Triptolide Alleviates Oxidized LDL-Induced Endothelial Inflammation by Attenuating the Oxidative Stress-Mediated Nuclear Factor-Kappa B Pathway","authors":"Shiyu Zhang MD, Shiyang Xie MD, Yuan Gao MD, Youping Wang MD, PhD","doi":"10.1016/j.curtheres.2022.100683","DOIUrl":"10.1016/j.curtheres.2022.100683","url":null,"abstract":"<div><h3>Background</h3><p>Endothelial inflammation triggered by oxidized LDL (ox-LDL) is a crucial mechanism involved in atherosclerosis. Triptolide (TP), a primary active ingredient of the traditional Chinese medicine <em>Tripterygium wilfordii</em> Hook F, possesses antioxidant and anti-inflammatory properties in vivo. However, limited information is available regarding these effects on endothelial inflammation occurring in atherosclerosis.</p></div><div><h3>Objectives</h3><p>This study investigated the effects and possible mechanisms of action of TP on ox–LDL-induced inflammatory responses in human umbilical vein endothelial cells.</p></div><div><h3>Methods</h3><p>Human umbilical vein endothelial cells were preincubated with TP at the indicated concentrations for 1 hour and then incubated with ox-LDL (50 µg/mL) for the indicated times.</p></div><div><h3>Results</h3><p>Preincubation of cultured human umbilical vein endothelial cells with TP inhibited ox–LDL-induced cytokine and chemokine production, adhesion molecule expression, and monocyte adhesion in a concentration-dependent manner. The concentrations of 8-isoprostane, malondialdehyde, and superoxide increased after human umbilical vein endothelial cells were exposed to ox-LDL, which were associated with decreased activities of total superoxide dismutase and its isoenzyme (ie, CuZn- superoxide dismutase). Preincubation with TP reversed ox–LDL-induced effects in all events. Moreover, preincubation with TP also attenuated ox–LDL-induced nuclear factor-kappa B transcriptional activation in a concentration-dependent manner, via the suppression of inhibitor of kappa Balpha (IκBα) phosphorylation and subsequent nuclear factor-kappa B DNA binding.</p></div><div><h3>Conclusions</h3><p>These data indicate that TP inhibits ox–LDL-induced endothelial inflammation, possibly via suppression of the oxidative stress-dependent activation of the nuclear factor-kappa B signaling pathway.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"97 ","pages":"Article 100683"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/aa/main.PMC9385561.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40430982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Global Research and Scientific Publications on Dexmedetomidine Use in Adults for Anesthesia Care between 2001 and 2021: A Bibliometric Analysis","authors":"Rojnarin Komonhirun MEd, Narut Ruananukun MD","doi":"10.1016/j.curtheres.2022.100677","DOIUrl":"10.1016/j.curtheres.2022.100677","url":null,"abstract":"<div><h3>Background</h3><p>An increasing number of studies on dexmedetomidine use in adults have been published, but the effectiveness of dexmedetomidine remains contentious.</p></div><div><h3>Objective</h3><p>This study aimed to describe the changing trends and structural relationships of scientific achievements regarding dexmedetomidine over the past 2 decades and provide researchers with information to help them explore better research opportunities.</p></div><div><h3>Methods</h3><p>Quantitative data of publications were retrieved from the Scopus database. Analyses of co-occurrence and collaboration among authors, countries, and key words were conducted using VOSviewer 1.6.17 software. Weighted occurrence and average publications per year were calculated.</p></div><div><h3>Results</h3><p>The 1868 publications retrieved showed an increasing trend of annual publications on dexmedetomidine use in adults between 2001 and 2021. China accounted for the largest contribution to publications in the world (n = 577 [30.89%]). Four key word clusters indicating research hotspots were identified using VOSviewer. The number of articles published in the top 10% of journals in the United States was the highest among all publications from the country (97 out of 201 [48.26%]). Journals from the United Kingdom obtained the highest CiteScore (16.56). <em>Journal of Anaesthesiology Clinical Pharmacology</em> published the highest number of articles on this topic (n = 56). Wang authored the highest number of published articles (n = 42). Recent publications focused on the theme of cytokines and immunomodulation. <em>Sufentanil</em> attracted particular interest as a drug-related key word. Moreover, meta-analysis is becoming an increasingly popular research method in this field.</p></div><div><h3>Conclusions</h3><p>The increasing number of publications on dexmedetomidine use reflects growing interest in this topic. Future research should focus on meta-analyses to identify the most effective therapeutic methods. The immunomodulatory effect of dexmedetomidine on health and disease is of particular interest.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"96 ","pages":"Article 100677"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/62/main.PMC9253480.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shu-Jie Dong MSc , Cong-Yan Luo MSc , Cui-Lan Xiao BSc , Feng-Zhe Zhang BSc , Lei Li MD , Zhong-Ling Han MSc , Suo-Di Zhai BSc
{"title":"Efficacy and Safety Profile of Novel Oral Anticoagulants in the Treatment of Left Atrial Thrombosis: A Systematic Review and Meta-Analysis","authors":"Shu-Jie Dong MSc , Cong-Yan Luo MSc , Cui-Lan Xiao BSc , Feng-Zhe Zhang BSc , Lei Li MD , Zhong-Ling Han MSc , Suo-Di Zhai BSc","doi":"10.1016/j.curtheres.2022.100670","DOIUrl":"10.1016/j.curtheres.2022.100670","url":null,"abstract":"<div><h3>Background</h3><p>The presence of left atrial/left atrial appendage thrombosis is associated with a higher risk of thromboembolic events in patients with atrial fibrillation. The optimal antithrombotic strategy is not established to date.</p></div><div><h3>Objective</h3><p>Our aim was to compare the efficacy and safety profile of novel oral anticoagulants with warfarin in the treatment of left atrial/left atrial appendage thrombosis.</p></div><div><h3>Methods</h3><p>We conducted a systematic search in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and 3 Chinese databases for all randomized controlled trials and cohort studies (PROSPERO, CRD42021238952) from inception to 7 May 2021. Two authors independently performed the articles selection, data extraction, and quality assessment. The efficacy outcome was the resolution of left atrial/left atrial appendage thrombosis, and the safety outcomes were bleeding and stroke/transient ischemic attack.</p></div><div><h3>Results</h3><p>One randomized controlled trial and 5 cohort studies were included, with a total of 353 patients. Compared with warfarin, novel oral anticoagulants were associated with increased probability of left atrial/left atrial appendage thrombosis resolution (OR = 2.20; 95% CI, 1.35–3.60; <em>I</em><sup>2</sup> = 0%). Compared with warfarin, novel oral anticoagulants had a similar risk of bleeding (OR = 0.91; 95% CI, 0.39–2.13; <em>I</em><sup>2</sup> = 0%). There was no evidence of increased risk of stroke/transient ischemic attack (OR = 0.42; 95% CI, 0.12–1.45; <em>I</em><sup>2</sup> = 0%).</p></div><div><h3>Conclusions</h3><p>Novel oral anticoagulants were more effective than warfarin in promoting the resolution of left atrial/left atrial appendage thrombosis, without increased risks of bleeding and stroke/transient ischemic attack. Our study provides valuable insight into clinical practice. Further well-designed randomized controlled trials are needed to fully evaluate the benefits and risks in these patients. PROSPERO Registration No.: CRD42021238952.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"96 ","pages":"Article 100670"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0011393X22000091/pdfft?md5=68631cc4ff31f3bf19ba1e7ac16551de&pid=1-s2.0-S0011393X22000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78904674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}