DOCSLIB.ORG

A Systematic Umbrella Review and Meta-Analysis of Alzheimer's

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Systematic Umbrella Review and Meta-Analysis of Alzheimer's European Review for Medical and Pharmacological Sciences 2016; 20: 4801-4817 Cholinesterase inhibitors and non-steroidal anti-inflammatory drugs as Alzheimer’s disease therapies: an updated umbrella review of systematic reviews and meta-analyses C.-H. WANG1, L.-S. WANG2, N. ZHU3 1Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China 2Department of Clinical Medicine, Harbin Medical University, Harbin, China 3National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China Abstract. – OBJECTIVE: Alzheimer’s Disease Key Words: (AD) is a major neurological disorder marked Risk factors, Alzheimer’s Disease, ChEI, Memantine, by an amyloid-beta plaque and neurofibrillary NSAID, Therapy. tau-tangle depositions in the brain. Cognitive dysfunction is the key manifestation of AD. In this study, we conducted an umbrella review of Introduction meta-analyses on the risk factors and therapeu- tics targeting cognitive impairment and AD. MATERIALS AND METHODS: We searched Alzheimer’s Disease (AD) is a neurodegenera- PubMed from January 2000-August, 2016, and tive disorder characterized by manifestations of screened systematic reviews and meta-analy- forgetfulness, cognitive impairment, behavioural ses of studies that examined the effects of cho- changes, confusion, language trouble and thin- linesterase inhibitors in AD patients. We also king inability1. If left untreated, symptoms of included studies on non-steroidal anti-inflam- AD worsen with time, impeding the day-to-day matory drugs and AD. The studies comprised 1 meta-analyses of randomized controlled trials normal functioning of the patient . It has been and prospective cohorts, with 95% confidence claimed by the AD-International that more than interval. We considered the heterogeneity be- 30 million people worldwide are victims of de- tween different studies, denoted by I2. mentia, and the prevalence of AD is 60-80%2. RESULTS: We scanned a total of 750 novel me- More than 5 million Americans are reported to ta-analyses on the topics, “risk factors for AD” be living with AD3, and in Japan, around 15% of and “cholinesterase inhibitors and NSAIDs” that 4,5 target the disease. The search yielded three rele- the >65-year-old population suffers from AD . vant studies on risk factors, and seven and three AD is also emerging as a major threat to the de- studies for ChEIs and NSAIDs respectively. A veloping countries, accounting for about 58% of thorough examination of the studies reinforced the total population, and is speculated to escalate the therapeutic role of ChEIs in AD. A combina- to about 70% by 20506. tion of the glutamatergic inhibitor, memantine, The key pathological hallmarks of AD are with ChEIs also proved effective in ameliorat- amyloid beta (Ab) plaques and neurofibrillary ing AD progression and occurrence. Contradict- tangles (NFT) that accumulate in the gaps betwe- ing the observational studies, therapeutic role of 7 NSAIDs in AD seemed uncertain. Nonetheless, en nerve cells and synaptic junctions . The Ab the studies showed variability in the severity of and NFTs are generally deposited within the dementia and number of patient trials. Hence, brain hippocampus, the site for memory and we claim the need for detailed meta-analyses cognition, thereby impairing neuronal commu- and superior-quality cohort studies on a larger nication and resulting in neuronal cell death8-10. patient population of AD. CONCLUSIONS: The major risk factors for AD comprise growing Overall, our umbrella system- 11-13 atic review offers a unique and immensely helpful age and family history . While aging accounts resource for researchers and clinicians in the field for more than 95% of AD cases, familial AD for- of AD, and identifies vital research gaps as well. ms around 2-3% of all cases and demonstra- Corresponding Author: Na Zhu, MD; e-mail: [email protected] 4801 C.-H. Wang, L.-S. Wang, N. Zhu tes AD-like manifestations at an early age14,15. of AD is the damaged cholinergic neurons, resul- The genetic factors, particularly Apolipoprotein, ting in decreased neuronal choline levels30. Thus, APOE-e4 gene, have an immense impact and drugs inhibiting the functions of acetylcholine- markedly increase the risk for AD pathogene- sterase enzyme that degrades acetylcholine neu- sis16,17. Additionally, the deregulated processing rotransmitter are clinically used for attenuating of amyloid precursor protein, which causes a shift AD pathology31. The main therapies that attenuate towards the amyloidogenic pathway rather than AD symptoms include cholinesterase inhibitors the non-amyloidogenic, is a major cause for Ab (ChEIs), donepezil, galantamine and rivastigmi- generation18. ne and the NMDA receptor antagonist, MEM, Altered expression of the neurotransmitters, or their combinations32,33. Meta-analysis studies especially acetylcholine and N-methyl-D-aspar- showed the combination therapy of MEM and do- tate (NMDA), and neuro-inflammation are major nepezil to be quite effective in treating moderate mechanisms inducing AD pathogenesis19,20. Hen- to severe stages of AD34,35. However, there have ce, cholinesterase inhibitors (ChEIs) and drugs been contradictions in this concept, and several targeting the NMDA receptor, and the non-steroi- studies hardly claimed any difference between the dal anti-inflammatory drugs (NSAID) are usual- ChEI+MEM-treated patients and placebo exami- ly used to attenuate the progression of AD21-23. ned through the Alzheimer’s Disease Assessment Anti-amyloid agents that reduce inflammation, Scale-cognitive subscale (ADAS-cog; Rosen et oxidative stress, hypercholesterolaemia and cho- al36) or the standardized Mini-Mental State Exa- linergic dysfunction are known to block Ab ge- mination (SMMSE; Molloy and Standish, 1997)35. neration and aggregation24. Drugs that promote Similarly, meta-analysis studies that determined cholinergic neurotransmission are also useful in the relation between classical NSAIDs and AD attenuating AD pathogenesis25. These agents may appeared to have contradictions as well. While reduce apoptosis in the hippocampal neurons, few scores failed to show any impact of NSAID and thereby inhibit AD progression26. Enhanced treatment, several others demonstrated an asso- functioning of growth factors and neurotrophins ciation28,37,38. Thus, heterogeneity in the results that function via the tropomyosin receptor kinase demanded the need for an umbrella review and A contribute in protecting against AD-induced meta-analysis that include all these meta-analy- neuronal damage27. ses. Hence, the present systematic review and Some documented research studies21-23 are meta-analysis included the data on modifiable available that demonstrate the role of neuro- risk factors for AD. It comprised results obtained transmitters and inflammation in AD. Choliner- from cognitive assessments following treatments gic neuromodulators, such as tacrine, donepezil, with the cholinesterase inhibitors, NMDA recep- rivastigmine and galantamine, NMDA-receptor tor antagonists and NSAIDs in AD. The methods antagonist, memantine (MEM), and NSAIDs ha- of assessment mainly included Severe Impair- ve also been reported to affect AD pathogene- ment Battery. The data included precise details sis. Additionally, systematic review and meta-a- about the disease condition, study population, nalyses28,29 on the effects of the therapeutics on study design, results, significant observations and AD features, particularly cognitive impairments, the limitations as well. have been carried out. However, to the best of knowledge, an umbrella review of the systematic reviews and meta-analyses of AD risk factors Materials and Methods and targeted therapies has not been done so far. In the current study, we performed a systematic Umbrella Review Concept overview of meta-analyses and an exploratory We carried out an umbrella systematic re- collective analysis of previous meta-analyses to view on the meta-analysis studies to identify assess the risk factors of AD and the effects of the modifiable risk factors for AD. Rather than neurotransmitter modulators and NSAIDs in AD executing the systematic reviews from the be- pathology. ginning, the current umbrella review combines the available reviews and meta-analyses of the Umbrella Meta-analysis Design risk factors of AD and the potential therapies. The central cholinergic system significantly We particularly selected cholinergic damage and regulates cognition and learning-memory perfor- inflammation as the two major factors promo- mances30. One of the major pathological features ting AD, and examined the effects of ChEIs and 4802 A systematic umbrella review and meta-analysis of Alzheimer’s disease therapies Table I. Essential factors examined for meta-analysis. Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Kobayashi et al Y Y Y Y Y Y Y Y Y Y N Xu et al Y Y Y Y NA Y Y N Y Y N Tariot et al Y Y Y Y Y Y Y N Y N N Jansen et al Y Y Y Y Y Y Y N Y N Y Jiang et al Y Y Y Y Y Y Y N Y N Y Leinonen et al Y Y Y Y Y Y Y N Y N Y Matsunaga et al Y Y Y Y Y Y Y N Y Y N Miguel-Alvarez et al Y Y Y Y Y Y Y N Y Y N Gupta et al Y Y Y Y Y Y Y N Y N Y Szekely et al Y Y Y Y Y Y Y N Y Y Y Tsoi et al Y Y Y Y Y Y Y N Y Y Y Wang et al Y Y Y Y Y Y Y Y Y Y Y Abbreviations used: Y-Yes; N-No and NA-Not applicable Q1: Is the objective of the review and meta-analysis article precise and prominent? Q2: Was the article relevant in terms of the search? Q3: Was the study population well defined? Q4: Was the strategy of the study relevant and proper? Q5: Were the techniques appropriate? Q6: Were the data reliable? Q7: Was the study statistically significant? Q8: Were there too many limitations in the study? Q9: Did the study offer any new view on the concept? Q10: Was there any bias assessment? Q11: Were there any future directions for the study? NSAIDs on the disease progression.
Load more

Recommended publications
  • Health Economics & Decision Science
    School of Health And Related Research Health Economics & Decision Science (HEDS) Discussion Paper Series Factors influencing the use of research for policy-making: an umbrella review protocol Authors: Erika E. Atienzo, Eva Kaltenthaler, Susan K. Baxter Corresponding author: Erika E. Atienzo ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA Fax: (+44) (0)114 222 0749 Email: [email protected] No. 16.07 Disclaimer: This series is intended to promote discussion and to provide information about work in progress. The views expressed in this series are those of the authors. Comments are welcome, and should be sent to the corresponding author. This paper is also hosted on the White Rose Repository: http://eprints.whiterose.ac.uk/ FACTORS INFLUENCING THE USE OF RESEARCH FOR POLICY-MAKING: AN UMBRELLA REVIEW PROTOCOL Erika E. Atienzoa*, Eva Kaltenthalera, Susan K. Baxterb a Health Economics and Decision Science, School of Health and Related Research, University of Sheffield b Public Health, School of Health and Related Research, University of Sheffield *Corresponding author: Erika E. Atienzo ScHARR, University of Sheffield Regent Court, 30 Regent Street Sheffield, S1 4DA (UK) [email protected] March 2016 ABSTRACT Over the last two decades, there has been an emphasis on the concept of evidence-based policy. However, evidence-based policy remains a major challenge and a gap exists in the systematic translation of scientific knowledge into policies. The awareness of this evidence- policy gap has led to a proliferation of research. As the demand for evidence-informed policy-making escalates, so does the need to unveil the mechanisms by which we can influence the process of research uptake.
    [Show full text]
  • Are Nsaids Useful to Treat Alzheimer's Disease Or Mild Cognitive
    REVIEW ARTICLE published: 21 May 2010 AGING NEUROSCIENCE doi: 10.3389/fnagi.2010.00019 Are NSAIDs useful to treat Alzheimer’s disease or mild cognitive impairment? Bruno P. Imbimbo1*, Vincenzo Solfrizzi 2 and Francesco Panza 3 1 Research and Development Department, Chiesi Farmaceutici, Parma, Italy 2 Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy 3 Department of Medical Sciences, Geriatric Unit and Gerontology-Geriatrics Research Laboratory, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy Edited by: Several epidemiological studies suggest that long-term use of non-steroidal anti-infl ammatory Elena Galea, Universitat Autònoma de drugs (NSAIDs) may protect subjects carrying one or more ε4 allele of the apolipoprotein E Barcelona, Spain (APOE ε4) against the onset of Alzheimer’s disease (AD). The biological mechanism of this Reviewed by: Mathieu Lichtenstein, Universitat protection is not completely understood and may involve the anti-infl ammatory properties of Autònoma de Barcelona, Spain NSAIDs or their ability of interfering with the β-amyloid (Aβ) cascade. Unfortunately, long-term, Merce Boada, Institut Català de placebo-controlled clinical trials with both non-selective and cyclooxygenase-2 (COX-2) selective Neurociències Aplicades, Spain inhibitors in mild-to-moderate AD patients produced negative results. A secondary prevention Elena Galea, Universitat Autònoma de Barcelona, Spain study with rofecoxib, a COX-2 selective inhibitor, in patients with mild cognitive impairment *Correspondence: was also negative. A primary prevention study (ADAPT trial) of naproxen (a non-selective COX Bruno P. Imbimbo, Research and inhibitor) and celecoxib (a COX-2 selective inhibitor) in cognitively normal elderly subjects with Development Department, Chiesi a family history of AD was prematurely interrupted for safety reasons after a median period Farmaceutici, Via Palermo 26/A, 43100 of treatment of 2 years.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2012/0202780 A1 Gavin Et Al
    US 20120202780A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2012/0202780 A1 Gavin et al. (43) Pub. Date: Aug. 9, 2012 (54) CARRIER COMPOSITION Publication Classification (76) Inventors: Paul David Gavin, Chadstone (51) Int. Cl. (AU); Mahmoud El-Tamimy, A6II 47/24 (2006.01) Meadow Heights (AU); Jeremy A6II 3/196 (2006.01) James Cottrell, Caulfield South A6IP5/00 (2006.01) (AU); Giacinto Gaetano, South A 6LX 3/573 (2006.01) Melbourne (AU); Nicholas John A6IP 23/00 (2006.01) Kennedy, Boronia (AU) A6IP 29/00 (2006.01) A6II 3/167 (2006.01) (21) Appl. No.: 13/501,494 A63L/407 (2006.01) (22) PCT Fled: Dec. 22, 2010 (52) U.S. Cl. ......... 514/180: 514/785: 514/788: 514/772: 514/626; 514/567; 514/413: 514/179 (86) PCT NO.: S371 (c)(1), (57) ABSTRACT (2), (4) Date: Apr. 12, 2012 A carrier composition of the present invention comprises a phosphate compound of an electron transfer agent and a rela Related U.S. Application Data tively high concentration of a polar protic solvent. A biologi (60) Provisional application No. 61/289,507, filed on Dec. cally active compound may be formulated with a carrier com 23, 2009. position of the present invention to provide a formulation. Patent Application Publication Aug. 9, 2012 Sheet 1 of 5 US 2012/0202780 A1 - - if solvent E. -ie-20% solvent 3. ". S. .t E FGURE 1 Patent Application Publication Aug. 9, 2012 Sheet 2 of 5 US 2012/0202780 A1 -H 10 LC2 s -C- 20 ulcm2 . - a 30 ulcm2 t E re FIGURE 2A HO licm2 80i -o- 20 ul/cm2 'i -A-30 ul/cm2 140 EO 10 8 8 4) O O FIGURE 2B Patent Application Publication Aug.
    [Show full text]
  • A Meta-Review of Transparency and Reproducibility-Related Reporting Practices in Published Meta- Analyses on Clinical Psychological Interventions (2000-2020)
    A meta-review of transparency and reproducibility-related reporting practices in published meta- analyses on clinical psychological interventions (2000-2020). Rubén López-Nicolás1, José Antonio López-López1, María Rubio-Aparicio2 & Julio Sánchez- Meca1 1 Universidad de Murcia (Spain) 2 Universidad de Alicante (Spain) Author note: This paper has been published at Behavior Research Methods. The published version is available at: https://doi.org/10.3758/s13428-021-01644-z. All materials, data, and analysis script coded have been made publicly available on the Open Science Framework: https://osf.io/xg97b/. Correspondence should be addressed to Rubén López-Nicolás, Facultad de Psicología, Campus de Espinardo, Universidad de Murcia, edificio nº 31, 30100 Murcia, España. E-mail: [email protected] 1 Abstract Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved with the aim to provide some recommendations to carry out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2020. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines.
    [Show full text]
  • Review on Evaluating the Role of Nsaids for the Treatment of Alzheimer's Disease
    International Journal of Applied Pharmaceutics ISSN- 0975-7058 Vol 13, Issue 1, 2021 Review Article REVIEW ON EVALUATING THE ROLE OF NSAIDS FOR THE TREATMENT OF ALZHEIMER'S DISEASE KRISHNENDU P. R.a, ARJUN B.a, VIBINA K.b, NIVEA CLEO T. S.c, DRISYA N. K.c, RADHIKA MOHANDASb, SUBIN MARY ZACHARIAHd* a,dDepartment of Pharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, AIMS Health Sciences Campus, Amrita Vishwa Vidyapeetham, AIMS, Kochi 682041, Kerala, India, bDepartment of Pharmaceutical Chemistry, Lecturer, Crescent College of Pharmaceutical Science, Madayipara, P O. Payangadi (R. S.), 670358, Kannur, Kerala, India, cDepartment of Pharmaceutical Chemistry, Lecturer, KMCT College of Pharmaceutical Sciences, Technical Campus, Kallanthode, NITC, Calicut,673601, Kerala, India *Email: [email protected] Received: 05 Oct 2020, Revised and Accepted: 27 Nov 2020 ABSTRACT Recently, several studies have been reported that nonsteroidal anti-inflammatory drugs can fight against neurodegenerative disorders by various mechanisms. Currently, available therapies of neurodegenerative disorders (NDs) provide only symptomatic relief. This is the point at which we need an alternative that acts on the root cause of disease. Parkinson’s disease and Alzheimer’s disease are the two NDs concentrated here. Since the drug profile is already known, drug repurposing is a promising technique in research, thereby reducing the cost and period effectively. Epidemiological studies on various nonsteroidal anti-inflammatory drugs (NSAIDs) showed good results, but when it came to clinical studies the results are found to be poor. Hence, it can be concluded that NSAIDs provide its neuroprotective activity on its long-term use only, as the brain accessibility of this kind of drug is poor due to its lower lipophilicity.
    [Show full text]
  • Phenotype-Based Drug Screening Reveals Association Between Venetoclax Response and Differentiation Stage in Acute Myeloid Leukemia
    Acute Myeloid Leukemia SUPPLEMENTARY APPENDIX Phenotype-based drug screening reveals association between venetoclax response and differentiation stage in acute myeloid leukemia Heikki Kuusanmäki, 1,2 Aino-Maija Leppä, 1 Petri Pölönen, 3 Mika Kontro, 2 Olli Dufva, 2 Debashish Deb, 1 Bhagwan Yadav, 2 Oscar Brück, 2 Ashwini Kumar, 1 Hele Everaus, 4 Bjørn T. Gjertsen, 5 Merja Heinäniemi, 3 Kimmo Porkka, 2 Satu Mustjoki 2,6 and Caroline A. Heckman 1 1Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki; 2Hematology Research Unit, Helsinki University Hospital Comprehensive Cancer Center, Helsinki; 3Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland; 4Department of Hematology and Oncology, University of Tartu, Tartu, Estonia; 5Centre for Cancer Biomarkers, De - partment of Clinical Science, University of Bergen, Bergen, Norway and 6Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, Helsinki, Finland ©2020 Ferrata Storti Foundation. This is an open-access paper. doi:10.3324/haematol. 2018.214882 Received: December 17, 2018. Accepted: July 8, 2019. Pre-published: July 11, 2019. Correspondence: CAROLINE A. HECKMAN - [email protected] HEIKKI KUUSANMÄKI - [email protected] Supplemental Material Phenotype-based drug screening reveals an association between venetoclax response and differentiation stage in acute myeloid leukemia Authors: Heikki Kuusanmäki1, 2, Aino-Maija
    [Show full text]
  • Therapeutic Benefits of Glutamine: an Umbrella Review of Meta-Analyses
    576 BIOMEDICAL REPORTS 6: 576-584, 2017 Therapeutic benefits of glutamine: An umbrella review of meta-analyses MARC P. McRAE Department of Basic Science, National University of Health Sciences, Lombard, IL 60148, USA Received February 8, 2017; Accepted March 9, 2017 DOI: 10.3892/br.2017.885 Abstract. Glutamine may be an essential amino acid in and shortening of the length of stay in hospital. Furthermore, patients with catabolic disease, as it has been demonstrated glutamine supplementation appeared to reduce the rate of that circulating glutamine levels drop during critical illness in-patient mortality, but the majority of meta-analyses did and following major surgery; this may result in an increase in not reach statistical significance. However, researchers must secondary infection risk, recovery time and mortality rates. appreciate the positive results with caution in light of the However, there is much discrepancy in the literature with fact that there exists statistically significant heterogeneity for regards to randomized controlled studies, and therefore, the the majority of meta-analyses, and statistically significant present study is an umbrella review of published meta-analyses, publication bias in almost half. conducted to examine the effectiveness of glutamine's role as a therapeutic agent. A search using PubMed, Cochrane Library Introduction and CINAHL from January 1st, 1980 to December 31st, 2016 was conducted using the following strategy: ‘Glutamine AND Glutamine may be a conditionally essential amino acid in (meta-analysis OR systematic review)’ and publications were patients with catabolic disease as it has been demonstrated retrieved, which provided quantitative statistical analysis of that circulating plasma glutamine concentrations drop during pooled treatment effects on the relative risks of infectious critical illness and following major surgery (1).
    [Show full text]
  • Ozone Exposure and Health Effects: a Protocol for an Umbrella Review and Effect-­Specific Systematic Maps
    Open access Protocol BMJ Open: first published as 10.1136/bmjopen-2019-034854 on 13 August 2020. Downloaded from Ozone exposure and health effects: a protocol for an umbrella review and effect-­specific­systematic­maps Tianyu Zhao ,1,2,3,4 Iana Markevych,1,2,3,5 Christian Janßen,4 Dennis Nowak,1,2 Nadine Steckling- Muschack,1,6 Joachim Heinrich1,2,3,7 To cite: Zhao T, Markevych I, ABSTRACT Strengths and limitations of this study Janßen C, et al. Ozone Introduction Ambient ozone exposure may be adverse exposure and health effects: to health. Since the reported associations between ozone ► To the best of our knowledge, this protocol is the a protocol for an umbrella and health effects are heterogeneous and the underlying review and effect- specific first one for an umbrella review or a systematic map pathways are indistinct, the overall relationship remains systematic maps. BMJ Open focusing on ozone exposure and health outcomes. unclear. Only a few overall syntheses of the evidence 2020;10:e034854. doi:10.1136/ ► The umbrella review will provide a comprehensive regarding ozone and health effects are available to date. bmjopen-2019-034854 outline of the currently available systematic reviews Methods and analysis We plan to summarise the current on ambient ozone exposure and health outcomes, ► Prepublication history and evidence on ozone- related health effects systematically. and an epidemiological evidence reservoir accessi- additional material for this First, to identify the possible associations between paper are available online. To ble to the public. ambient ozone exposure and health outcomes, we will view these files, please visit ► The systematic map of a specific ozone-rela ted conduct an umbrella review.
    [Show full text]
  • Wo 2011/060944 A2
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date _ . ... _ 26 May 2011 (26.05.2011) WO 2011/060944 A2 (51) International Patent Classification: (74) Agents: CARVAJAL Y URQUIJO, Isabel et al; A61K 9/16 (2006.01) A61K 9/50 (2006.01) Clarke, Modet & Co., C/Goya 11, 28001 Madrid (ES). A61K 9/48 (2006.01) (81) Designated States (unless otherwise indicated, for every (21) International Application Number: kind of national protection available): AE, AG, AL, AM, PCT/EP20 10/007024 AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (22) International Filing Date: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, 19 November 2010 (19.1 1.2010) HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (25) Filing Language: English KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (26) Publication Langi English NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (30) Priority Data: SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, 200931026 20 November 2009 (20.1 1.2009) ES TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (71) Applicants (for all designated States except US): GP (84) Designated States (unless otherwise indicated, for every PHARM, S.A. [ES/ES]; Poligono Industrial Els Vinyets- kind of regional protection available): ARIPO (BW, GH, Els Fogars, Ctra.
    [Show full text]
  • Identifying Approaches for Assessing Methodological and Reporting
    Pussegoda et al. Systematic Reviews (2017) 6:117 DOI 10.1186/s13643-017-0507-6 RESEARCH Open Access Identifying approaches for assessing methodological and reporting quality of systematic reviews: a descriptive study Kusala Pussegoda1, Lucy Turner1, Chantelle Garritty1,2, Alain Mayhew1, Becky Skidmore1, Adrienne Stevens1,2, Isabelle Boutron3, Rafael Sarkis-Onofre4, Lise M. Bjerre5,6,7, Asbjørn Hróbjartsson8, Douglas G. Altman9 and David Moher10* Abstract Background: The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to ‘quality’ assessment over time. Methods: The Cochrane Library, MEDLINE®, and EMBASE® were searched from January 1990 to October 16, 2014, for reports assessing MQ and/or RQ of SRs. Title, abstract, and full-text screening of all reports were conducted independently by two reviewers. Reports assessing the MQ and/or RQ of a cohort of ten or more SRs of interventions were included. All results are reported as frequencies and percentages of reports. Results: Of 20,765 unique records retrieved, 1189 of them were reviewed for full-text review, of which 76 reports were included. Eight previously published approaches to assessing MQ or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports.
    [Show full text]
  • Summarizing Systematic Reviews: Methodological Development
    METHODOLOGY PAPER Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach Edoardo Aromataris,1 Ritin Fernandez,2 Christina M. Godfrey,3 Cheryl Holly,4 Hanan Khalil5 and Patraporn Tungpunkom6 1The Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, 2School of Nursing, University of Wollongong; Centre for Research in 05/21/2018 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3gy8G8VagVy1noQVV3wH2du7UHDCprP5m8mBdFQ69S0Y= by https://journals.lww.com/ijebh from Downloaded 3 Downloaded Nursing and Health, St George Hospital, Sydney, Australia, Queen’s Joanna Briggs Collaboration, Queen’s University School of Nursing, Kingston, Ontario, Canada, 4Northeast Institute for Evidence Synthesis and Translation Rutgers, University School of Nursing Newark, New Jersey, USA, 5 6 from Monash University, School of Rural Health, Victoria, Australia, and Thailand Centre for Evidence Based Nursing, Midwifery, and Health Science: https://journals.lww.com/ijebh a Collaborating Centre of JBI, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand ABSTRACT by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3gy8G8VagVy1noQVV3wH2du7UHDCprP5m8mBdFQ69S0Y= Aims: With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different
    [Show full text]
  • An Umbrella Review and Narrative Synthesis of the Effectiveness Of
    International Journal of Environmental Research and Public Health Review An Umbrella Review and Narrative Synthesis of the Effectiveness of Interventions Aimed at Decreasing Food Prices to Increase Food Quality Chiara Milani 1, Chiara Lorini 2,* , Alberto Baldasseroni 3, Claudia Dellisanti 3 and Guglielmo Bonaccorsi 2 1 School of Specialization in Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy 2 Department of Health Sciences, University of Florence, 50134 Florence, Italy 3 Department of Prevention, Local Health Unit Toscana Centro, 50135 Florence, Italy * Correspondence: chiara.lorini@unifi.it; Tel.: +39-0552751065 Received: 12 June 2019; Accepted: 1 July 2019; Published: 2 July 2019 Abstract: Background: sustainability of population diet is a public health concern: the high price of healthy food is one of the main causes of diet-related health problems. The aim of this study is to synthesize the evidence produced by systematic reviews that evaluated the effectiveness of decreasing healthy food prices to improve accessibility in order to positively modify the dietary pattern. Methods: We carried out a review of systematic reviews that examined the effects of the interventions, by exploring the online databases PubMed, Embase, Web of Science, Cochrane Library and hand-searching the reference lists. Results: after screening by titles and abstracts, we selected 11 systematic reviews that met the inclusion criteria, plus one that was hand-searched. The review generally presented a good quality. Studies concluded that measures aimed at modifying the prices of targeted healthy food were effective in improving population diet by modifying what people buy. Conclusions: the complexity of the outcome—population diet—as well as the poor transferability of data across populations and geographical areas makes it obligatory to provide clear and universal conclusions.
    [Show full text]