ABSTRACT
Atopic dermatitis remains a widespread problem affecting various populations globally. While numerous treatment options have been employed, pimecrolimus remains a potent and viable option. Recently, there has been increasing interest in comparing the safety and efficacy of pimecrolimus with its vehicle. Methods: The authors conducted a comprehensive search of several databases, including PubMed, COCHRANE, MEDLINE, and Cochrane Central, from inception to May 2022, using a wide search strategy with Boolean operators. The authors also employed backward snowballing to identify any studies missed in the initial search. The authors included randomized controlled trials in our meta-analysis and extracted data from the identified studies. The authors used Review Manager (RevMan) Version 5.4 to analyze the data, selecting a random-effects model due to observed differences in study populations and settings. The authors considered a P-value of 0.05 or lower to be statistically significant. Results: The authors initially identified 211 studies, of which 13 randomized controlled trials involving 4180 participants were selected for analysis. Our pooled analysis revealed that pimecrolimus 1% was more effective at reducing the severity of atopic dermatitis than its vehicles. However, no significant difference was observed in adverse effects between pimecrolimus and vehicle, except for pyrexia, nasopharyngitis, and headache, which were increased with pimecrolimus. Conclusion: Our meta-analysis showed that pimecrolimus 1% is more effective than vehicle, although the safety profile remains inconclusive. Pimecrolimus reduced the Investigator's Global Assessment score, Eczema Area and Severity Index score, and severity of pruritus when compared to its vehicle, indicating a higher efficacy profile. This is one of the first meta-analyses to assess the efficacy and safety profile of pimecrolimus 1% against a vehicle and may assist physicians in making informed decisions.
ABSTRACT
BACKGROUND: Sleeve gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) are the two procedures used in the management of patient with obesity and type 2 diabetes mellitus (T2DM); however, it is still unclear which of the two is more efficient in the remission of type-2 diabetes mellitus. METHODS: The aim of this study was to analyze the efficiency of RYGB and SG in the remission of type-2 diabetes mellitus after 1, 3 and 5 years of surgery. Three databases (i.e., PubMed, Scopus, Central and Web of Science) were searched. All randomized control trial studies with at least 12-year follow-up were selected with type-2 diabetes mellitus in patients undergoing Roux-en-Y Gastric Bypass or sleeve gastrectomy. The broad and the narrow criteria were lined with individual patients reported, being analyzed and pooled using the random-effects model. RESULTS: The 15 selected articles, including 707 obese type 2 diabetes patients, met the eligibility criteria for this meta-analysis. RYGB when compared with SG shows increased broad remissions (RR=1.43, 95% CI: 1.13-1.80; P=0.003) and narrow remissions (RR=1.32, 95% CI: 1.15-1.58; P=0.003) after one year of surgery, and broad remissions 5 years after surgery (RR=1.58, 95% CI: 0.97-2.56; P=0.06). No significant difference was identified between the two groups in broad and narrow remissions 3 years after surgery and narrow remissions 5 years after surgery. CONCLUSIONS: Our results suggest that RYGB was more effective in the remission of type-2 diabetes mellitus at 1 year and 5 years considering the broad and narrow criteria, while there was no difference found 3 years after surgery.
