RESUMEN
The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.
Asunto(s)
Cistitis Intersticial/tratamiento farmacológico , Administración Intravesical , Toxinas Botulínicas Tipo A/uso terapéutico , Brasil , Sulfatos de Condroitina/uso terapéutico , Toma de Decisiones Clínicas , Dimetilsulfóxido/uso terapéutico , Diterpenos/uso terapéutico , Humanos , Ácido Hialurónico/uso terapéutico , Lidocaína/uso terapéutico , Mycobacterium bovis , Poliéster Pentosan Sulfúrico/uso terapéutico , Resultado del TratamientoRESUMEN
The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.
Asunto(s)
Humanos , Cistitis Intersticial/tratamiento farmacológico , Poliéster Pentosan Sulfúrico/uso terapéutico , Administración Intravesical , Brasil , Dimetilsulfóxido/uso terapéutico , Sulfatos de Condroitina/uso terapéutico , Resultado del Tratamiento , Toxinas Botulínicas Tipo A/uso terapéutico , Diterpenos/uso terapéutico , Toma de Decisiones Clínicas , Ácido Hialurónico/uso terapéutico , Lidocaína/uso terapéutico , Mycobacterium bovisRESUMEN
BACKGROUND: Vitamin D serum levels and the presence and activity of rheumatic conditions have been associated. However, many studies are merely observational, and the existent randomized clinical trials were never systematically analyzed. Therefore, this study aims to provide a systematic review and meta-analysis of such a topic. METHODS: MEDLINE, EMBASE, LILACS, COCHRANE, and CINAHL were explored to identify randomized trials that investigated clinical repercussions of vitamin D (or analogs) supplementation for at least 3 months in rheumatic diseases. Standardized clinical and/or laboratorial outcomes related to disease activity were analyzed according to each disease before and after supplementation. RESULTS: Database searches rendered 668 results; 9 were included-5 on rheumatoid arthritis, 3 on systemic lupus erythematosus, and 1 on systemic sclerosis. Seven of the studies were meta-analyzed. After vitamin D supplementation, rheumatoid arthritis recurrence decreased; however, not significantly (risk differenceâ=â-0.10, 95% CIâ=â-0.21, 0.00, Pâ=â.05). No statistical significance was observed regarding visual analog scale (mean differenceâ=â2.79, 95% CIâ=â-1.87, 7.44, Pâ=â.24) and disease activity score28 (mean differenceâ=â-0.31, 95% CIâ=â-0.86, 0.25, Pâ=â.28). Regarding systemic lupus erythematosus, anti-dsDNA positivity was significantly reduced (risk differenceâ=â-0.10, 95% CIâ=â-0.18, -0.03; Pâ=â.005). CONCLUSION: Vitamin D supplementation reduced anti-dsDNA positivity on systemic lupus erythematosus and could possibly reduce rheumatoid arthritis recurrence, although novel randomized clinical trials are needed to confirm and extend the benefits of this hormone in immune-mediated rheumatic diseases.