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Context Krill oil is a good source of n-3 phospholipids and has greater bioavailability than fish oil, which contains n-3 triglycerides. However, it is unclear whether krill oil affects circulating lipid concentrations more beneficially than fish oil. Objective A network meta-analysis was conducted to compare the lipid-modifying effects of krill oil and fish oil. Data Sources PubMed and Embase databases were searched. Study Selection A total of 64 randomized controlled trials that determined the lipid-modifying effects of krill oil or fish oil were selected. Data Extraction The MetaXL program was used for meta-analysis. A subgroup analysis and a network meta-regression were conducted to investigate the dose-response effect of the n-3 fatty acid content of fish oil and krill oil. Results Krill oil was associated with significantly lower triglyceride levels than control supplements (weighted mean difference [WMD] −23.26 [95%CI, −38.84 to −7.69]). However, the net differences in triglycerides (WMD −4.07 [95%CI, −15.22 to 7.08]), low-density lipoprotein cholesterol (WMD 3.01 [95%CI, −5.49 to 11.51]), high-density lipoprotein cholesterol (WMD 1.37 [95%CI, −3.73 to 6.48]), and total cholesterol (WMD 1.69 [95%CI, −6.62 to 10.01]) were not significantly different between the krill oil and fish oil groups. One gram of n-3 fatty acids contained in fish oil and krill oil lowered median triglycerides by 8.971 mg/dL (95% credible interval [CrI], 2.27 to 14.04) and 9.838 mg/dL (95%CrI, 0.72 to 19.40), respectively. Conclusions The lipid-modifying effects of krill oil and fish oil do not differ. The reduction in triglycerides depends on the dose of n-3 fatty acids consumed.

This meta-analysis was conducted to derive an integrated conclusion about the influence of glutathione S-transferase (GST) genetic polymorphisms on busulfan pharmacokinetic (PK) parameters and veno-occlusive disease (VOD). Studies which analysed the effect of GST genetic polymorphisms on area under the curve (AUC), clearance (CL) or VOD were searched for and selected. A pooled analysis was conducted using Comprehensive Meta-Analysis programme. Nineteen studies were included in this meta-analysis. GSTA1*B and GSTM1 null genotypes significantly decreased CL IV of busulfan (standardized difference in means (SDM) = −1.103; P = 0.019 and SDM = −0.418; P = 0.002, respectively). GSTA1*B significantly increased AUC IV of busulfan (SDM = 0.832; P = 0.046), whereas GSTM1 did not (SDM = 0.155; P = 0.478). The PK parameters of oral busulfan did not differ according to GST genotype. GSTA1, GSTM1 and GSTP1 were not significantly associated with VOD occurrence. GSTA1 and GSTM1 genotypes affected CL IV of busulfan, but only GSTA1 affected AUC IV . There was no significant difference in the PK parameters of oral busulfan (CL PO and AUC PO ) and VOD when only GST genotypes were considered. K E Y W O R D Sbusulfan, genetic polymorphisms, glutathione S-transferase, pharmacokinetics, veno-occlusive disease

This systematic review examined the varied studies that have assessed the economic impact of pharmacist-participated medication management for nursing home residents older than 65 years of age. The articles published during 1990–2017 were found through PubMed, EMBASE and Ovid Medline. After the selection process by independent reviewers, a total of 12 studies were included. The quality of the selected articles was assessed using the Effective Public Health Practice Project checklist for economic studies. The articles were highly heterogeneous in terms of study design, pharmacist participation type, and measures of economic outcome. Therefore, the results are presented narratively according to the type of pharmacist involvement featured in the articles: interprofessional networks, interprofessional coordination, or interprofessional teamwork. Of the eight studies performing statistical comparison analyses, one study of interprofessional coordination and three of interprofessional teamwork showed statistically significant positive economic outcomes. The remaining four studies showed non-significant tendencies towards favorable economic outcomes. This review provides insights into the essential features of successful pharmacist-participated medication management for elderly patients in nursing homes.