RESUMEN
To investigate the efficacy and safety of Fuzheng Huayu Jiaonang (FZ) and Anluo Huaxian Wan (AL) in the treatment of chronic hepatitis B liver fibrosis. Jadad scoring method was adopted to evaluate the quality of literature, Rev Man 5.3 software was used for Meta-analysis, and indirect comparison was carried out by ITC software. The randomized controlled trials (RCTs) were collected for comparing FZ and AL in treatment of chronic hepatitis B with liver fibrosis. With ETV as the common control, they were compared through indirect Meta-analysis (ITC). Finally, 15 articles (10 FZ, 5 AL) involving 1 316 patients were included. According to the indirect comparison, FZ combined with ETV had significant improvements in hyaluronic acid, laminin, procollagen type Ⅲ, and collagen type Ⅳ. AL combined with ETV had significant improvements in laminin, procollagen type Ⅲ, collagen type Ⅳ, but with no difference in hyaluronic acid. The safety of AL was higher than that of FA. The limited evidences in this study showed that Anluo Huaxian Wan had a higher safety than Fuzheng Huayu Jiaonang, but a lower total efficiency. Due to the low quality of the included RCTs, these two medicines shall be comprehensively compared in further high-quality clinical trials.
RESUMEN
This study was designed to evaluate the efficacy, tolerability, and sequential administration of abiraterone acetate (AA) and enzalutamide (Enz) for metastatic castration-resistant prostate cancer (mCRPC). A literature search was performed with PubMed, Embase, and Web of Science databases to identify relevant studies. Reviewed literature included published phase III trials of AA or Enz in mCRPC and studies regarding their sequential administration. Given the difference in control arms in AA (active comparator) and Enz (true placebo) randomized phase III studies, indirect comparisons between AA and Enz in mCRPC showed no statistically significant difference in overall survival in prechemotherapy and postchemotherapy settings (HR: 0.90, 95% CI, 0.73-1.11; HR: 0.85, 95% CI, 0.68-1.07). Compared with AA, Enz may better outperform control arms in treating mCRPC both before and after chemotherapy regarding secondary endpoints based on indirect comparisons: time to prostate-specific antigen (PSA) progression (HR: 0.34, 95% CI, 0.28-0.42; HR: 0.40, 95% CI, 0.30-0.53), radiographic progression-free survival (HR: 0.37, 95% CI, 0.28-0.48; HR: 0.61, 95% CI, 0.50-0.74), and PSA response rate (OR: 18.29, 95% CI, 11.20-29.88; OR: 10.69, 95% CI, 3.92-29.20). With regard to the effectiveness of Enz following AA or AA following Enz, recent retrospective case series reported overall survival and secondary endpoints for patients with mCRPC progression after chemotherapy. However, confirmatory head-to-head trials are necessary to determine the optimal sequencing of these agents.
RESUMEN
Erigeron breviscapus injection(DZXI) and Breviscapus injection(DZSI) are two popular injections in treatment of acute ischemic stroke in China. Both of them are manufactured from a same herbal medicine, E. breviscapus, but DZXI is an herbal extract(mixture) preparation and DZSI is a pure compound injection. This article was aimed to systemically evaluate and compare their efficacy and safety in treatment of acute ischemic stroke. The randomized controlled trials(RCTs) were collected for comparing DZXI and DZSI with Salvia miltiorrhiza injection(FDI) as the medium, and they were compared with indirect Meta-analysis(ITC). Thirty-nine RCTs with 4 180 patients were included. Meta-analysis results showed that both DZXI and DZSI had better efficacy than FDI in acute ischemic stroke. In the indirect comparison, DZSI had a higher total efficacy than DZXI, with significantly statistical differences[OR=0.634, 95%CI = (0.432,0.928), P<0.000 01], but there was no significant difference in improvement of neurological deficit [MD=-1.19, 95%CI=(－3.57,1.19), P=0.953]. On the safety aspect, adverse reaction rate of DZXI was 1.14%, mainly including head swelling, fever and chills while DZSI had no significant adverse reactions. The limited evidences in this study showed that Breviscapine injection had higher total efficiency and safety than E. breviscapine injection, but due to the low quality of the included RCTs, these two medicines should be comprehensively compared in further high-quality clinical trials.