Network meta-analysis of first- and second-generation protease inhibitors for chronic hepatitis C genotype 1: efficacy based on RVR and SVR 24

Borba, HH; Wiens, Astrid; Steimbach, Laiza Maria; Perlin, Cássio Marques; Tonin, Fernanda S.; Pedroso, Fiona L.; Fernández-Llimós, Fernando; Pontarolo, Roberto

doi:10.1007/s00228-016-2146-6

Cited by 6 publications

(4 citation statements)

References 94 publications

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“…In most cases, the brain damage induced by metronidazole is reversible. It has been shown that symptoms normalizes within few days after drug withdrawal [14]. However, in our case, 3 days after drug cessation, the patient’s condition deteriorated.…”

Section: Discussionmentioning

confidence: 52%

A case of methylprednisolone treatment for metronidazole-induced encephalopathy

Tang

et al. 2019

BMC Neurol

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Background Metronidazole, a common antimicrobial agent, can induce encephalopathy in rare cases. After discontinuing metronidazole, most patients show clinical improvement. However, in the face of deteriorating conditions, there have done not to have reports of effective drug treatment. Case presentation A 57-year-old man was admitted to our hospital due to dysarthria and ataxic gait after taking metronidazole at the dose of about 32 g for 20 days. Neurological examination showed that his upward and outward movements of bilateral eyeballs were limited, and horizontal and vertical nystagmus were noted. The brain magnetic resonance imaging showed hyper-intensities in the bilateral cerebellar dentate nuclei, medulla oblongata, midbrain and red nuclei in T2W and FLAIR images. However, the patient’s clinical symptoms worsened after drug cessation. High-dose intravenous methylprednisolone pulse therapy was applied, and this led to a drastic improvement of his symptoms and signs. Conclusions In our case, we suggest that early methylprednisolone intervention can prevent the progression of metronidazole-induced encephalopathy and accelerate neurological recovery. We infer that the progression of encephalopathy is related to the delayed toxicity caused by high dose or concentration of metronidazole.

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Section: Discussionmentioning

confidence: 52%

A case of methylprednisolone treatment for metronidazole-induced encephalopathy

Tang

et al. 2019

BMC Neurol

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“…While network meta-analyses can provide information to guide clinical decisions, reduce the need for replication of clinical trials, and identify areas that require further study [ 36 ], some limitations of this meta-analysis should be considered. The number of included studies was relatively small, and the data and information that could be extracted from these studies were limited.…”

Section: Discussionmentioning

confidence: 99%

Comparison of twelve single-drug regimens for the treatment of type 2 diabetes mellitus

Wang

Dong

et al. 2017

Oncotarget

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We performed a network meta-analysis to compare the efficacy of 12 single-drug regimens (Glibenclamide, Glimepiride, Pioglitazone, Rosiglitazone, Repaglinide, Metformin, Sitaglitin, Exenatide, Liraglutide, Acarbose, Benfluorex, and Glipizide) in the treatment of type 2 diabetes mellitus (T2DM). Fifteen relevant randomized controlled trials (RCTs) were included; direct and indirect evidence from these studies was combined, and weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRAs) were examined to evaluate the monotherapies. Liraglutide was more effective than Glimepiride, Pioglitazone, Sitaglitin, Exenatide, and Glipizide at reducing glycated hemoglobin (HbA1c) levels. In contrast, Acarbose was less effective than Glibenclamide, Glimepiride, Pioglitazone, Rosiglitazone, Repaglinide, Metformin, and Liraglutide at decreasing HbA1c levels. Reductions in fasting plasma glucose (FPG) levels were similar after all treatments. Rosiglitazone was less effective than Glibenclamide and Repaglinide at reducing total cholesterol (TC) levels. High density lipoprotein (HDL), low density lipoprotein (LDL), and triglyceride levels did not differ after treatment with any of the monotherapies. HbA1c and FPG SUCRA values were highest for Liraglutide, while HbA1c and FPG values were lowest for Acarbose, and TC and LDL values were lowest for Rosiglitazone. These results suggest that Liraglutide may be most effective, and Acarbose least effective, at reducing blood glucose levels, while Glibenclamide, Repaglinide, and Metformin may be most effective, and Rosiglitazone least effective, at reducing lipoidemia, in T2DM patients.

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“…The landscape of HCV treatment is undergoing a revolutionary change from parenteral IFN-based to all-oral DAA-based treatment regimens in recent years. Second-generation DAAs not only provide IFN-free treatments with > 95% SVR and lower incidence of ADRs, but also decrease treatment duration by 50% to 12-24 weeks [27,28]. These new treatments are rapidly growing in the market but are costly for patients [29].…”

Section: Figmentioning

confidence: 99%

Budget impact and cost-effectiveness analyses of direct-acting antivirals for chronic hepatitis C virus infection in Hong Kong

Chan

Tam

et al. 2017

Eur J Clin Microbiol Infect Dis

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The purpose of this investigation was to evaluate the budget impact and cost-effectiveness of direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) infection in Hong Kong. A decision analytic model was developed to compare short-term costs and health outcomes of patients with chronic HCV genotype 1 infection in Hong Kong who were treated with an interferon (INF)-based treatment (dual therapy of pegylated interferon and ribavirin) or DAA-based treatments (sofosbuvir or ledipasvir/sofosbuvir or ombitasvir/paritaprevir/ritonavir plus dasabuvir). Compared to INF-based treatment, DAA-based treatments yielded an incremental cost of $24,677-$31,171 per course while improving the rate of sustained virologic response (SVR) from 59-66% to 82.3-99.8%. The incremental cost-effective ratios of DAA-based treatments ranged from $9724 to $29,189 per treatment success, which were all below the cost-effectiveness threshold of local GDP per capita ($42,423 in 2015). Introducing DAAs resulted in a 126.1% ($383.7 million) budget increase on HCV infection management over 5 years. A 50% change in DAA medication costs reflected a change in the incremental budget from $55.2 to $712.3 million. DAA-based treatments are cost-effective alternatives to INF-based treatment in Hong Kong. Introducing DAAs to the public hospital formulary yields a considerable budget increase but is still economically favorable to the local government.

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Network meta-analysis of first- and second-generation protease inhibitors for chronic hepatitis C genotype 1: efficacy based on RVR and SVR 24

Cited by 6 publications

References 94 publications

A case of methylprednisolone treatment for metronidazole-induced encephalopathy

A case of methylprednisolone treatment for metronidazole-induced encephalopathy

Comparison of twelve single-drug regimens for the treatment of type 2 diabetes mellitus

Budget impact and cost-effectiveness analyses of direct-acting antivirals for chronic hepatitis C virus infection in Hong Kong

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