Safety and Efficacy of Mavrilimumab For Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease characterized by progressive swelling and stiffness in the joints. Mavrilimumab is a human monoclonal antibody that may block the autoimmune mechanism of the antibodies causing RA. OBJECTIVE: We aim to assess the safety and efficacy of Mavrilimumab in treating rheumatoid arthritis. METHODS: We conducted an online search using PubMed, Scopus, Web of Science, and Cochrane CENTRAL till June 2019, and updated the search in May 2020, using relevant keywords. We screened studies for eligibility. Data were extracted from eligible studies and pooled as Risk ratio (RR) with a 95% confidence interval (CI), using Review Manager software (ver.3.5). RESULTS: Five studies (with 1145 patients) were eligible to our criteria. Pooled result from three trials showed a significant reduction in Disease Activity Score 28 based on C-reactive protein (DAS28-CRP) remission < 2.6 after 12 weeks (RR = 3.31, 95% CI [1.53, 7.18], P = 0.002), American College of Rheumatology (ACR) 20, after 12 weeks (RR = 2.38, 95% CI [1.80, 3.16], P < 0.00001), ACR 50, after 12 weeks (RR = 2.93, 95% CI [1.67, 5.15], P = 0.0002), ACR 70, after 12 weeks (RR = 4.90, 95% CI [1.60, 15.00], P = 0.005). Mavrilimumab not associated with a significant adverse event (RR = 1.22, 95% CI [0.89, 1.68], P = 0.22). CONCLUSION: We found that subcutaneous Mavrilimumab was effective and well-tolerating in treating RA patients, with no significant adverse events.

Efficacy and Safety of Intraperitoneal Local Anesthetics in Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis.

Intraperitoneal local anesthetics have been increasingly used nowadays. However, they are not routinely given in laparoscopic appendectomy and a lot of controversies are found about their administration in this procedure. The goal of this study is to review effectiveness and safety of intraperitoneal local anesthetics in laparoscopic appendectomy. We conducted a computer search of four authentic databases. We included randomized controlled trials (RCTs) which compared intraperitoneal local anesthetics versus control group in laparoscopic appendectomy. Data were extracted from eligible studies and pooled in a meta-analysis model using RevMan software. We evaluated post-operative pain in different periods and safety outcomes including postoperative nausea and vomiting (PONV) and shoulder pain. Furthermore, we assessed the length of hospital stay and postoperative opioid consumption within 24 hours. Seven RCTs were included with a total of 579 patients in this review. Our analysis indicated a significant difference in postoperative pain at different durations preferring intraperitoneal local anesthetics compared to control. Moreover, intraperitoneal local anesthetics were significantly linked to fewer patients experienced PONV and shoulder pain respectively (RR= 0.28, 95% CI [0.16, 0.50], p < 0.0001), (RR= 0.32, 95% CI [0.17, 0.58], p = 0.0002). We found less hospital stay duration in intraperitoneal local anesthetics group after removal of the heterogeneity (MD= -0.39, 95% CI [-0.63, -0.16], p = 0.001). Intraperitoneal local anesthetics were significantly linked to less postoperative opioid consumption (SMD = -0.60, 95% CI [-0.96, -0.24], p = 0.001). Intraperitoneal local anesthetics can be routinely used in laparoscopic appendectomy as it is associated with less postoperative pain and reduction in different adverse events postoperatively.

Efficacy and safety of single dose of oral secnidazole 2 g in treatment of bacterial vaginosis: A systematic review and meta-analysis.

BACKGROUND: Bacterial vaginosis (BV) is a common disease characterized by vaginal discharge. OBJECTIVE: To evaluate the evidence from published randomized clinical trials (RCTs) about the efficacy and safety of single dose of oral secnidazole 2 g in comparison with other drugs. SEARCH STRATEGY: Electronic databases were searched using the following MeSH terms (bacterial vaginosis OR vaginosis) AND (secnidazole OR secnol OR sabima OR secnidal OR minovage). SELECTION CRITERIA: All RCTs assessing effect of secnidazole in treatment of BV were considered for this meta-analysis. Two-hundred thirty two studies were identified of which six studies were deemed eligible for this review. DATA COLLECTION AND ANALYSIS: The extracted data were entered into RevMan software. The relative risk (RR) and 95% confidence interval (CI) were calculated. The extracted outcomes were the clinical cure and adverse effects. MAIN RESULTS: The pooled estimate showed that ornidazole is superior to a single dose of oral secnidazole in clinical cure at the 4th week after treatment (RR = 0.81; 95% CI [0.73- 0.89], p < 0.0001, I2 = 0%). There were no difference between secnidazole and metronidazole (RR = 0.97; 95% CI [0.90-1.05], I2 = 0%, p = 0.5). CONCLUSIONS: Single oral dose of secnidazole 2 g doesn't differ from metronidazole regimen however, it may be inferior to ornidazole in treatment of BV.