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Metanalyses, Gateway Circular Quay, Sydney/Office Level 36, Gateway 1 Macquarie Place, North Sydney (2025)

07/10/2025

🅜🅔🅣🅐 Published Today (20 January 2024, accessible in the Philippines) - This meta-analysis shows that sustained high levels of Procalcitonin and C-Reactive Protein are reliable indicators for predicting infection in severe pancreatitis.
TITLE: PERSISTENTLY HIGH PROCALCITONIN AND C-REACTIVE PROTEIN ARE GOOD PREDICTORS OF INFECTION IN ACUTE NECROTIZING PANCREATITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.3390/ijms25021273

🅼 Key Findings:

’This review analyzed procalcitonin (PCT) and C-reactive protein (CRP) as predictors of infection in acute necrotizing pancreatitis (ANP).

’Persistently high serum PCT is a strong predictor for the development of infected necrosis in patients with ANP.

’Sustained elevation of CRP is also a reliable indicator for identifying patients at high risk of infectious complications.

’Monitoring biomarker trends is key, as persistent elevation is more telling than a single high reading.

’Using these markers helps in early diagnosis of infection, guiding timely interventions like antibiotics or drainage.

’This non-invasive monitoring improves patient risk stratification and may reduce mortality in infected ANP.

🅼 Clinical Relevance

This research provides strong evidence for clinicians to use serial measurements of PCT and CRP, common lab tests, to predict life-threatening infections in severe pancreatitis. This enables earlier, targeted treatment for high-risk patients, potentially improving survival and reducing complications.

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07/10/2025

🅜🅔🅣🅐 Published Today (January 21, 2024; specific Philippines publication date not available) - A meta-analysis assessing the significant impact of placebo (improvement) and nocebo (side effects) responses in clinical drug trials for tic disorders.

TITLE: PLACEBO AND NOCEBO RESPONSES IN PHARMACOLOGICAL TRIALS OF TIC DISORDERS: A META-ANALYSIS

🅼 Link: https://doi.org/10.1002/mds.29714

🅼 Key Findings:

▫ This meta-analysis synthesized data from 24 randomized controlled trials involving a total of 2,222 participants to evaluate placebo and nocebo phenomena in tic disorder treatments.

▫ A substantial placebo response was identified, indicating a significant improvement in the severity of tic symptoms among patients who were receiving an inert placebo treatment.

▫ The nocebo response was also considerable, with the findings showing that 44% of patients in the placebo groups reported experiencing adverse events despite taking a non-active substance.

▫ Key factors of the clinical trials, such as the total sample size, the specific study design employed, and the randomization ratio (placebo vs. active drug), were found to be correlated with the magnitude of both the placebo and nocebo responses observed.

🅼 Clinical Relevance

Understanding the magnitude of placebo and nocebo responses is critical for interpreting the true efficacy and safety of new medications for tic disorders. These findings are highly relevant for designing more robust future clinical trials and for clinicians to recognize the powerful role of patient expectation and non-specific factors in therapeutic outcomes for patients with tics.

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07/10/2025

🅜🅔🅣🅐 Published Today (January 22, 2024) - This meta-analysis explores the link between low blood pressure (hypotension) in intensive care unit (ICU) patients and their increased risk of death and other serious health complications.

TITLE: HYPOTENSION DURING INTENSIVE CARE STAY AND MORTALITY AND MORBIDITY: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.1007/s00134-023-07304-4

🅼 Key Findings:

Exposure to hypotension during an ICU stay is significantly associated with an increased risk of mortality. The meta-analysis, involving over 34,000 patients, found the odds ratio for mortality was 1.45.

The severity of hypotension correlates with worse outcomes. The majority of the 122 included studies showed that the stronger the drop in blood pressure, the higher the association with mortality and acute kidney injury (AKI).

While many individual studies linked hypotension to AKI, the combined meta-analysis did not show a statistically significant association for this specific outcome.

The findings highlight a consistent trend across various patient populations within the ICU, suggesting that preventing hypotension is a crucial aspect of patient management.

🅼 Clinical Relevance

Maintaining adequate blood pressure is critical in the ICU. This study reinforces the need for vigilant hemodynamic monitoring and prompt intervention to correct hypotension. Preventing even brief episodes of low blood pressure may be a key strategy to reduce mortality risk and prevent organ damage, particularly acute kidney injury, in critically ill patients.

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07/10/2025

🅜🅔🅣🅐 Published Today (23, January, 2024) - This meta-analysis evaluates whole-body vibration training's effectiveness on physical function, daily living activities, and quality of life in stroke patients.
TITLE: EFFECTS OF WHOLE-BODY VIBRATION TRAINING ON PHYSICAL FUNCTION, ACTIVITIES OF DAILY LIVING, AND QUALITY OF LIFE IN PATIENTS WITH STROKE: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.3389/fphys.2024.1295776

🅼 Key Findings:

Whole-body vibration training (WBVT) significantly reduced spasticity in stroke patients.

WBVT showed significant improvements in motor function.

The meta-analysis also revealed enhancements in balance function among patients who underwent WBVT.

No significant effects were observed for gait, activities of daily living (ADL), or quality of life (QOL).

Subgroup analyses indicated that variable frequency vibration and side-alternating vibration were particularly effective in reducing spasticity and improving motor and balance functions.

Fixed frequency vibration and vertical vibration did not show significant therapeutic benefits in the analyzed domains.

🅼 Clinical Relevance

This review suggests that whole-body vibration training can be a viable adjunct therapy for stroke rehabilitation. It is particularly beneficial for alleviating spasticity and enhancing motor and balance functions. The findings highlight the importance of using variable frequency and side-alternating vibration protocols to maximize therapeutic outcomes in stroke patients.

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07/10/2025

🅜🅔🅣🅐 Published Today (January 25, 2024) - A meta-analysis comparing four intermittent fasting types for type 2 diabetes, focusing on blood glucose and insulin sensitivity.
TITLE: THE EFFECTS OF DIFFERENT INTERMITTENT FASTING REGIMENS IN PEOPLE WITH TYPE 2 DIABETES: A NETWORK META-ANALYSIS

🅼 Link: https://doi.org/10.3389/fnut.2024.1325894

🅼 Key Findings:

Intermittent fasting (IF) is effective for weight loss and improving some cardiometabolic health markers in people with prediabetes or type 2 diabetes (T2D).

IF regimens (twice-per-week fasting, fasting-mimicking diet, time-restricted eating, and periodic fasting) were better than a conventional diet.

There was no significant difference in the intervention effect among the different intermittent fasting regimens.

Twice-per-week fasting was ranked as the best for overall improvement.

IF significantly reduced body weight, BMI, body fat mass, insulin resistance (HOMA-IR), LDL cholesterol, and triglycerides.

No significant reductions in waist circumference, total cholesterol, HDL cholesterol, fasting glucose, or blood pressure were found.

🅼 Clinical Relevance

From the perspective of fasting blood glucose, glycated hemoglobin, and insulin resistance, the twice-per-week fasting intervention has a good effect. This can be a reference for patients with type 2 diabetes when choosing an intermittent fasting regimen.

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07/10/2025

🅜🅔🅣🅐 Published Today (26, January, 2024) - This meta-analysis assesses how mind-body exercises like yoga and Tai Chi can improve risk factors associated with metabolic syndrome, including insulin resistance.
TITLE: EFFECT OF MIND-BODY EXERCISE ON RISK FACTORS FOR METABOLIC SYNDROME INCLUDING INSULIN RESISTANCE: A META-ANALYSIS

🅼 Link: https://doi.org/10.3389/fendo.2024.1289254

🅼 Key Findings:

• Mind-body exercise significantly improved insulin resistance, waist circumference, body mass index (BMI), and systolic blood pressure in patients with metabolic syndrome.
• The analysis, which included 14 randomized controlled trials with 1,148 patients, demonstrated statistically significant reductions in key metabolic risk factors.
• Subgroup analysis highlighted that fitness qigong, performed 6-7 times per week for a duration of 24-48 weeks, showed significant improvements across all risk factors.
• Mind-body practices were also found to reduce diastolic blood pressure, fasting glucose, and triglycerides, while increasing HDL (good) cholesterol.
• The exercises studied included various forms of yoga, Tai Chi, and Qigong (such as Wuqinxi, Baduanjin, and Yijinjing), suggesting a range of effective options for patients.

🅼 Clinical Relevance

Mind-body exercise serves as an effective, non-pharmacological intervention for managing metabolic syndrome. Current evidence supports recommending low to moderate intensity fitness qigong, 6-7 sessions per week for 24-48 weeks, to improve the health of patients with this condition. This offers a simple and feasible approach with minimal side effects.

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07/10/2025

🅜🅔🅣🅐 Published Today (27 January 2024) - This network meta-analysis assesses and ranks various drugs for treating idiopathic pulmonary fibrosis (IPF) based on their safety and effectiveness, using data from multiple clinical trials.
TITLE: A COMPREHENSIVE COMPARISON OF THE SAFETY AND EFFICACY OF DRUGS IN THE TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS: A NETWORK META-ANALYSIS BASED ON RANDOMIZED CONTROLLED TRIALS

🅼 Link: https://doi.org/10.1186/s12890-024-02861-w

🅼 Key Findings:

• Nintedanib combined with pirfenidone showed the highest efficacy in slowing the decline of Forced Vital Capacity (ΔFVC) in patients with idiopathic pulmonary fibrosis (IPF).

• Pirfenidone, nintedanib, and pamrevlumab monotherapies were also significantly more effective than placebo in preserving lung function.

• In terms of safety, most drug treatments were associated with a higher risk of adverse events compared to placebo, with nintedanib having the highest risk of treatment discontinuation.

• Pirfenidone demonstrated a favorable balance between efficacy (slowing FVC decline) and safety (lower discontinuation rates due to adverse events) among the evaluated treatments.

• The analysis suggests combination therapy is potent, but pirfenidone monotherapy offers a robust risk-benefit profile for IPF management.

🅼 Clinical Relevance

This analysis provides clinicians with a ranked hierarchy of drug treatments for IPF, clarifying the trade-offs between slowing lung function decline and managing side effects. It supports evidence-based drug selection and facilitates informed discussions with patients about the most suitable therapeutic strategy.

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07/10/2025

🅜🅔🅣🅐 Published Today (28 January 2024) - This meta-analysis compares Prostatic Artery Embolization (PAE) with gold-standard surgical and other minimally invasive treatments for benign prostatic hyperplasia (BPH) and its associated symptoms.

TITLE: COMPARING PROSTATIC ARTERY EMBOLIZATION TO SURGICAL AND MINIMALLY INVASIVE PROCEDURES FOR THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.1186/s12894-023-01397-1

🅼 Key Findings:

• Prostatic Artery Embolization (PAE) is a safe and effective treatment that significantly improves lower urinary tract symptoms (LUTS), as measured by the International Prostate Symptom Score (IPSS), and enhances patient quality of life.

• Compared to Transurethral Resection of the Prostate (TURP) and Open Simple Prostatectomy (OSP), PAE is associated with fewer adverse events and a lower risk of major complications, including sexual side effects like erectile dysfunction.

• Surgical interventions like TURP and OSP lead to more significant improvements in objective urodynamic measures, such as peak urinary flow rate (Qmax), and have lower long-term retreatment rates than PAE.

• While both PAE and TURP show comparable improvements in symptom scores and quality of life, PAE offers the distinct advantage of a shorter hospital stay and preservation of sexual function.

🅼 Clinical Relevance

PAE is a valuable, minimally invasive alternative for BPH, especially for patients who are poor surgical candidates, have large prostates, or prioritize avoiding the sexual side effects and complications associated with traditional surgeries like TURP. It offers substantial symptom relief with a superior safety profile, though patients should be counseled on the potentially higher need for future retreatment compared to surgery.

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07/10/2025

🅜🅔🅣🅐 Published Today (29 January 2024) - This network meta-analysis compares various GLP-1 receptor agonists to determine which are most effective for managing blood sugar, weight, and lipid levels in adults with type 2 diabetes.

TITLE: COMPARATIVE EFFECTIVENESS OF GLP-1 RECEPTOR AGONISTS ON GLYCAEMIC CONTROL, BODY WEIGHT, AND LIPID PROFILE FOR TYPE 2 DIABETES: SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS

🅼 Link: https://doi.org/10.1136/bmj-2023-076410

🅼 Key Findings:

• Tirzepatide (5, 10, and 15 mg doses) demonstrated the most significant reductions in HbA1c levels, marking it as a superior option for glycaemic control.

• For weight management, high-dose tirzepatide (15 mg) was the most effective agent, followed closely by subcutaneous semaglutide (2.0 mg).

• Regarding lipid profiles, oral semaglutide (14 mg) was most effective at lowering total cholesterol and LDL ("bad" cholesterol).

• Subcutaneous semaglutide (2.0 mg) was found to be the best for reducing triglyceride levels.

• Dulaglutide (1.5 mg) showed the greatest efficacy in increasing HDL ("good" cholesterol) levels among all the compared treatments.

• Newer agents and higher doses provide superior, multifaceted benefits for T2D management.

🅼 Clinical Relevance

This evidence provides a clear hierarchy of GLP-1 RAs, enabling clinicians to tailor treatment to patient-specific goals. It guides the selection of the optimal agent for prioritizing either potent glucose lowering (tirzepatide), maximum weight loss (tirzepatide), or specific lipid profile improvements (semaglutide, dulaglutide), thereby advancing personalized diabetes care.

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07/10/2025

🅜🅔🅣🅐 Published Today (January 30, 2024, Philippines) - A meta-analysis of real-world studies comparing Lenvatinib monotherapy against Atezolizumab plus Bevacizumab for unresectable liver cancer (uHCC) first-line treatment.

TITLE: LENVATINIB VERSUS ATEZOLIZUMAB PLUS BEVACIZUMAB IN THE FIRST-LINE TREATMENT FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA: A META-ANALYSIS OF REAL-WORLD STUDIES

🅼 Link: https://doi.org/10.1007/s11523-024-01035-2

🅼 Key Findings:

• This comprehensive analysis found that both Lenvatinib monotherapy and the combination of Atezolizumab plus Bevacizumab showed comparable efficacy in treating patients with unresectable hepatocellular carcinoma.

• There was no statistically significant difference in Overall Survival (OS) between the two treatment groups. The pooled median OS was 18.4 months for the Lenvatinib group and 18.5 months for the Atezolizumab plus Bevacizumab group.

• Similarly, Progression-Free Survival (PFS) was comparable, with a pooled median of 6.9 months for Lenvatinib and 7.3 months for the combination therapy group.

• The Objective Response Rate (ORR) and Disease Control Rate (DCR) were also found to be similar between the two regimens, suggesting both are effective options in a real-world setting.

🅼 Clinical Relevance

This meta-analysis provides valuable real-world evidence for clinicians, suggesting that Lenvatinib monotherapy is a non-inferior alternative to the Atezolizumab plus Bevacizumab combination for the first-line treatment of uHCC. This allows for more personalized treatment decisions based on patient profiles, potential side effects, and healthcare resource availability, without compromising on survival outcomes.

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07/10/2025

🅜🅔🅣🅐 Published Today (January 31, 2024) - A meta-analysis comparing osimertinib with and without bevacizumab for EGFR-mutated non-small-cell lung cancer, assessing efficacy and safety of the combination therapy.
TITLE: COMPARISON OF OSIMERTINIB PLUS BEVACIZUMAB AGAINST OSIMERTINIB ALONE IN NSCLC HARBORING EGFR MUTATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.1177/17588359241227677

🅼 Key Findings:

The addition of bevacizumab to osimertinib did not result in a prolongation of progression-free survival (PFS) or overall survival (OS) in the overall patient population.

No significant improvement was observed in the objective response rate (ORR) with the combination therapy compared to osimertinib monotherapy.

A noteworthy finding was that the combination treatment did significantly prolong PFS specifically in the subgroup of patients who were smokers.

While not statistically significant, a slight trend towards a PFS benefit was observed in patients with brain metastases and in those receiving the combination as a first-line treatment.

The combination of osimertinib and bevacizumab was associated with a higher incidence of adverse events, although these were generally considered manageable.

🅼 Clinical Relevance

Based on this meta-analysis, the addition of bevacizumab to osimertinib does not confer additional survival benefits for the majority of patients with EGFR-mutant NSCLC. Consequently, osimertinib monotherapy continues to be the recommended and prioritized treatment approach for this patient population.

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07/10/2025

🅜🅔🅣🅐 Published Today (01 February 2024) - A meta-analysis examining the controversial link between caffeine consumption and the risk of developing anxiety, summarizing evidence from multiple international studies.
TITLE: CAFFEINE INTAKE AND ANXIETY: A META-ANALYSIS

🅼 Link: https://doi.org/10.3389/fpsyg.2024.1270246

🅼 Key Findings:

‣ This meta-analysis, which included 10 studies and 1,939 participants, found no overall significant association between total caffeine intake and the general risk of anxiety (OR=1.13).

‣ However, in subgroup analyses, a significant link was discovered. Cross-sectional studies showed that caffeine consumption was associated with an increased risk of anxiety (OR=1.23).

‣ Geographic location played a role. Caffeine intake was linked to a higher anxiety risk in the Americas (OR=1.18), but no significant association was found in Asian or European populations.

‣ Dose-response analysis indicated a linear relationship, suggesting that as caffeine intake increases, the risk of anxiety may also increase proportionally.

🅼 Clinical Relevance

The findings suggest that while a general link isn't established, specific contexts matter. Clinicians should consider a patient's caffeine intake, especially in the Americas, as a potential contributing factor to anxiety symptoms. The dose-response relationship highlights the importance of moderation for at-risk individuals.

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