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Messori A, Fadda V, Maratea D, Trippoli S, Gatto R, De Rosa M, Marinai C. Biological drugs for the treatment of rheumatoid arthritis by the subcutaneous route: interpreting efficacy data to assess statistical equivalence. Ther Adv Musculoskelet Dis 2014; 6:207-16. [PMID: 25435923 DOI: 10.1177/1759720x14554792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND No equivalence analysis has yet been conducted on the effectiveness of biologics in rheumatoid arthritis. Equivalence testing has a specific scientific interest, but can also be useful for deciding whether acquisition tenders are feasible for the pharmacological agents being compared. METHODS Our search covered the literature up to August 2014. Our methodology was a combination of standard pairwise meta-analysis, Bayesian network meta-analysis and equivalence testing. The agents examined for their potential equivalence were etanercept, adalimumab, golimumab, certolizumab, and tocilizumab, each in combination with methotrexate (MTX). The reference treatment was MTX monotherapy. The endpoint was ACR50 achievement at 12 months. Odds ratio was the outcome measure. The equivalence margins were established by analyzing the statistical power data of the trials. RESULTS Our search identified seven randomized controlled trials (2846 patients). No study was retrieved for tocilizumab, and so only four biologics were evaluable. The equivalence range was set at odds ratio from 0.56 to 1.78. There were 10 head-to-head comparisons (4 direct, 6 indirect). Bayesian network meta-analysis estimated the odds ratio (with 90% credible intervals) for each of these comparisons. Between-trial heterogeneity was marked. According to our results, all credible intervals of the 10 comparisons were wide and none of them satisfied the equivalence criterion. A superiority finding was confirmed for the treatment with MTX plus adalimumab or certolizumab in comparison with MTX monotherapy, but not for the other two biologics. CONCLUSION Our results indicate that these four biologics improved the rates of ACR50 achievement, but there was an evident between-study heterogeneity. The head-to-head indirect comparisons between individual biologics showed no significant difference, but failed to demonstrate the proof of no difference (i.e. equivalence). This body of evidence presently precludes any option of undertaking competitive tenderings for the procurement of these agents.
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Messori A, Fadda V, Maratea D, Trippoli S. Indirect meta-analytical comparison of azathioprine and of beta interferon effectiveness in all forms of multiple sclerosis pooled together. J Neurol Sci 2014; 347:408-10. [PMID: 25455308 DOI: 10.1016/j.jns.2014.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/25/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Comparing benefits expected in the design of randomized trials with the results of mature meta-analysis: an analysis on aspiration thrombectomy in acute myocardial infarction. Int J Cardiol 2014; 176:1417-9. [PMID: 25150494 DOI: 10.1016/j.ijcard.2014.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/02/2014] [Indexed: 11/19/2022]
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Messori A, Fadda V, Gatto R, Maratea D, Trippoli S. New oral anticoagulants in acute coronary syndrome: is there any advantage over existing treatments? Int Cardiovasc Res J 2014; 8:124-6. [PMID: 25177676 PMCID: PMC4109037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 03/01/2014] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND After an acute coronary syndrome, dual antiplatelet therapy with clopidogrel plus aspirin is still a standard of care, but several new approaches have been investigated. OBJECTIVES The present study re-examined the studies published thus far on this topic to evaluate the effectiveness of dual antiplatelet therapy in comparison to some of these new approaches (mainly, ticagrelor + aspirin and dual therapy plus a new oral anticoagulant [NOAC]; i.e., "triple therapy"). MATERIALS AND METHODS The clinical material was directly derived from that reported in recent meta-analyses. Our re-analysis relied on standard equivalence methods in which interpretation is based on Relative Risks (RRs) along with their 95% Confidence Intervals (CI). The equivalence margins employed in our statistical testing were directly derived from those reported in randomized studies. RESULTS The equivalence margins were initially set at RR ranging from 0.775 to 1.29. According to these margins, triple therapy based on any NOAC proved to be superior to dual therapy alone, but at the same time demonstrated its equivalence with dual therapy. The results for apixaban-based triple therapy were inconclusive (not superior, not not-inferior, not equivalent and, of course, not inferior to the controls). Those for rivaroxaban-based triple therapy showed that this combination treatment was superior to dual therapy alone and failed to meet the criterion of equivalence. In the comparison between rivaroxaban-based triple therapy and ticagrelor + aspirin, the RR was 1 and its 95% CI remained within a post-hoc margin of ± 15%. CONCLUSIONS Even if one considers the most effective NOAC in combination with clopidogrel + ticagrelor, this triple therapy is not more effective than ticagrelor + aspirin. On the other hand, the increased risk of bleeding with triple regimens is well demonstrated. We therefore conclude that these triple regimens did not play any important roles in the patients experiencing an acute coronary syndrome.
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Messori A, Fadda V, Maratea D, Trippoli S. Left atrial appendage occlusion devices versus pharmacological agents for stroke prevention in atrial fibrillation: testing the noninferiority margins. JACC Cardiovasc Interv 2014; 7:942-3. [PMID: 25147042 DOI: 10.1016/j.jcin.2014.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 04/03/2014] [Accepted: 04/10/2014] [Indexed: 10/24/2022]
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. Anti-reabsorptive agents in women with osteoporosis: determining statistical equivalence according to evidence-based methods. J Endocrinol Invest 2014; 37:769-773. [PMID: 25008458 DOI: 10.1007/s40618-014-0124-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/16/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND In the present study, we undertook an equivalence analysis on the effectiveness of the main anti-reabsorptive agents indicated for women with osteoporosis. METHODS Our methodology was a combination of meta-analysis (both pair-wise meta-analysis and network meta-analysis) and equivalence testing. The end-point was the incidence on new vertebral fractures. The anti-reabsorptive agents examined included alendronate, zoledronate, ibandronate, risedronate, and denosumab. RESULTS Our analysis involved nine randomized trials. Ten head-to-head indirect comparisons were examined through network meta-analysis and the respective values of RR were estimated. The 95 % confidence intervals for RR remained within the interval of a relative ±40 % variation for all comparisons that involved alendronate, risedronate, ibandronate, and denosumab. In contrast, the comparisons involving zoledronate satisfied a post hoc margin up to ±67 %. CONCLUSION Our results confirm that most of these anti-reabsorptive drugs (namely, alendronate, risedronate, ibandronate, and denosumab) are equivalent according to reasonable equivalence margins.
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Messori A, Maratea D, Fadda V, Trippoli S. Letter: estimating the cost-neutral price of sofosbuvir-based triple therapy for the treatment of naïve patients with genotype 1 HCV infection in Italy. Aliment Pharmacol Ther 2014; 40:217-8. [PMID: 24946068 DOI: 10.1111/apt.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 12/08/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Application of the gompertz method for evaluating survival gains in patients receiving cardiac resynchronization therapy. J Am Coll Cardiol 2014; 63:2879. [PMID: 24814490 DOI: 10.1016/j.jacc.2014.01.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 01/07/2014] [Indexed: 11/16/2022]
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. Testing the therapeutic equivalence of alogliptin, linagliptin, saxagliptin, sitagliptin or vildagliptin as monotherapy or in combination with metformin in patients with type 2 diabetes. Diabetes Ther 2014; 5:341-4. [PMID: 24793219 PMCID: PMC4065299 DOI: 10.1007/s13300-014-0066-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In studying the therapeutic evidence of innovative drug treatments, increasing attention is being devoted to differentiating between results that indicate no significant differences among the treatments under examination ("no proof of difference") and results that demonstrate the therapeutic equivalence among the treatments ("proof of no difference"). AIM Our analysis was aimed at evaluating the degree of therapeutic equivalence for dipeptidylpeptidase-4 (DPP-4) inhibitors given in type 2 diabetes as monotherapy or in combination with metformin. METHODS Equivalence was determined by developing a standard Forest plot that incorporated the information on margins previously reported in randomized trials on these agents. The end point was HbA1c change from baseline; the equivalence margin was set at ±0.25% change in HbA1c. The clinical material was obtained from a systematic review on this topic. RESULTS Given as monotherapy, linagliptin, sitagliptin, and vildagliptin (but not saxagliptin) met the equivalence criterion when compared with one another. Given in combination with metformin, linagliptin, saxagliptin, sitagliptin, and vildagliptin showed an equivalent effect whereas alogliptin did not satisfy the equivalence criterion. CONCLUSIONS Considering the most recent therapeutic guidelines, our results are of interest particularly as regards the information on DPP-4 inhibitors in combination with metformin. Four of the five DPP-4 inhibitors under examination clearly showed to have the same effectiveness; the fifth agent-alogliptin-failed to meet the equivalence criterion, but only because its superiority could not be excluded.
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Messori A, Conti M, Fadda V, Maratea D, Trippoli S. Meta-regression of treatments for metastatic colorectal cancer: Quantifying incremental benefit from 2000 to 2012. World J Clin Oncol 2014; 5:191-193. [PMID: 24829867 PMCID: PMC4014792 DOI: 10.5306/wjco.v5.i2.191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/03/2013] [Accepted: 01/20/2014] [Indexed: 02/06/2023] Open
Abstract
To evaluate the overall effectiveness of treatments for metastatic colorectal cancer, a meta-regression was undertaken in which randomized studies from 2000 to 2012 were evaluated and the temporal trend for both overall survival (OS) and progression-free survival (PFS) was determined. Our literature search was essentially based on PubMed but information sources were scanned. Trials were included if a fluoropyrimidine regimen was given to at least one arm and information on PFS and OS was available. Medians for OS and PFS were our end-points. Covariates included temporal trend, arm allocation and Kirsten rat sarcoma status. In analyzing 130 treatment arms identified through our literature search, meta-regression showed an improvement with time for both OS (P < 0.001) and PFS (P < 0.001). The increase in median OS was from 14.9 mo in 2000 to 18.8 mo in 2012. Likewise, the improvement in PFS was from 5.7 to 8.1 mo. Multivariate analysis confirmed these findings. A post-hoc multivariate analysis was focused on patient arms treated with bevacizumab (n = 17) or without bevacizumab (n = 113); the multivariate-adjusted improvement attributable to bevacizumab was 1.66 mo for OS (P = 0.071) and 1.59 mo for PFS (P = 0.002). Overall, our results indicate that OS and PFS have improved from 2000 to 2012 but the extent of this improvement is small and seems to have quite a questionable clinical relevance.
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Maratea D, Fadda V, Trippoli S, Gatto R, De Rosa M, Marinai C, Messori A. Letter: biological drugs for inducing remission in ulcerative colitis. Aliment Pharmacol Ther 2014; 39:1242-4. [PMID: 24735145 DOI: 10.1111/apt.12690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 02/15/2014] [Indexed: 12/19/2022]
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Fadda V, Maratea D, Trippoli S, Messori A. Dexmedetomidine vs propofol in intensive care unit patients. World J Anesthesiol 2014; 3:134-136. [DOI: 10.5313/wja.v3.i1.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/10/2013] [Accepted: 12/19/2013] [Indexed: 02/06/2023] Open
Abstract
Dexmedetomidine is indicated as a sedative agent in intensive care units (ICUs). While several clinical trials and two meta-analyses have compared this agent with propofol or midazolam, the results were variable depending on the specific end-point (e.g., duration of mechanical ventilation, ICU mortality, maintaining a target depth of sedation, incidence of delirium episodes, length of hospital stay). Hence, the effectiveness of this new agent vs the comparators seems to be controversial. Trial sequential analysis (TSA) is a statistical technique that can estimate the optimal, cumulative number of patients that would be needed to generate a conclusive result. We therefore applied a TSA model to the most recent meta-analysis evaluating dexmedetomidine. A total of 10 randomized controlled trials were included in our analysis. According to our results, the comparison of dexmedetomidine vs propofol showed no proof of incremental effectiveness for the end-points of length of ICUs stay and incidence of delirium episodes. In contrast, futility (i.e., proof of no incremental effectiveness) was demonstrated for the end-point of mechanical ventilation. Hence, the results for the comparison of dexmedetomidine vs propofol were inconclusive for the first two end-points; on the other hand, conclusiveness was reached for the third end-point. We conclude that the place of dexmedetomidine in therapy of critically ill patients is very uncertain and further controlled trials are still needed.
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Messori A, Fadda V, Maratea D, Trippoli S. Intramyocardial bone marrow-derived cells for ischemic heart disease: is the benefit clinically relevant? Atherosclerosis 2014; 234:152-3. [PMID: 24657384 DOI: 10.1016/j.atherosclerosis.2014.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 02/24/2014] [Accepted: 02/27/2014] [Indexed: 11/29/2022]
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Messori A, Fadda V, Gatto R, Maratea D, Trippoli S. Differentiating between "no proof of difference" and "proof of no difference" for new oral anticoagulants. BMJ 2014; 348:g1955. [PMID: 24604083 DOI: 10.1136/bmj.g1955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Maratea D, Fadda V, Trippoli S, Messori A. Glutamine in critically ill patients: trial-sequential analysis. Clin Nutr 2014; 33:735-6. [PMID: 24582923 DOI: 10.1016/j.clnu.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 02/10/2014] [Indexed: 11/26/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Risk of myocardial infarction with oral direct thrombin inhibitors: trial sequential analysis based on two published data sets. Am J Cardiol 2014; 113:746-8. [PMID: 24484867 DOI: 10.1016/j.amjcard.2013.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/20/2013] [Accepted: 11/23/2013] [Indexed: 10/25/2022]
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67
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Messori A, Fadda V, Maratea D, Trippoli S. Rates of Inhibitor development in previously untreated patients with severe hemophilia A treated with plasma-derived or recombinant factor VIII: no proof of difference or proof of no difference? Semin Thromb Hemost 2014; 40:269-70. [PMID: 24500575 DOI: 10.1055/s-0034-1367471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. Pegylated interferon-α2a versus pegylated interferon-α2b in hepatitis C: reappraisal of effectiveness on the basis of trial sequential analysis. Eur J Gastroenterol Hepatol 2014; 26:246-8. [PMID: 24366456 DOI: 10.1097/meg.0b013e3283657e20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Erythropoiesis-stimulating agents in heart failure: no proof of effectiveness or proof of no effectiveness? Eur J Heart Fail 2014; 15:944-5. [DOI: 10.1093/eurjhf/hft091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Messori A, Maratea D, Fadda V, Trippoli S. Risk of intracranial haemorrhage in patients with atrial fibrillation treated with novel oral anticoagulants: testing the equivalence margins between dabigratran, rivaroxaban and apixaban. Eur J Clin Pharmacol 2014; 70:505-6. [DOI: 10.1007/s00228-014-1644-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Intramuscular IFNß-1a in multiple sclerosis: 'no proof of effectiveness' or 'proof of no effectiveness'? Eur J Neurol 2014; 20:e131. [PMID: 24433477 DOI: 10.1111/ene.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 08/15/2013] [Indexed: 11/26/2022]
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72
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. Nephrotoxicity of Different Formulations of Amphotericin B: Summarizing Evidence by Network Meta-analysis. Clin Infect Dis 2013; 57:1783-4. [DOI: 10.1093/cid/cit588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. High-titre inhibitors in previously untreated patients with severe hemophilia A: an updated estimate of pooled incidence rates in patients treated with plasma-derived concentrates or recombinant Factor VIII. DRUGS AND CELL THERAPIES IN HEMATOLOGY 2013. [DOI: 10.4081/dcth.2013.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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74
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Messori A, Fadda V, Maratea D, Trippoli S, Marinai C. High-titre inhibitors in previously untreated patients with severe hemophilia A: an updated estimate of pooled incidence rates in patients treated with plasma-derived concentrates or recombinant Factor VIII. DRUGS AND CELL THERAPIES IN HEMATOLOGY 2013. [DOI: 10.4081/dcth.2013.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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75
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Messori A, Fadda V, Maratea D, Trippoli S. Same-day discharge after percutaneous coronary intervention: trial sequential analysis of outcomes. J Am Coll Cardiol 2013; 63:376-7. [PMID: 24161332 DOI: 10.1016/j.jacc.2013.05.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/21/2013] [Indexed: 02/07/2023]
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Messori A, Fadda V, Maratea D, Trippoli S. Sequential analysis shows that β blockade in non-cardiac surgery is ineffective and may even be harmful. BMJ 2013; 347:f6296. [PMID: 24150673 DOI: 10.1136/bmj.f6296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Omega-3 polyunsaturated fatty acids for patients at risk of sudden cardiac death and ventricular arrhythmias: Trial sequential analysis. Heart Lung 2013; 42:391-2. [DOI: 10.1016/j.hrtlng.2013.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
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Maratea D, Fadda V, Trippoli S, Messori A. Off-pump versus on-pump coronary artery bypass grafting: quantifying information size by trial sequential analysis. Eur J Intern Med 2013; 24:e65-6. [PMID: 23702027 DOI: 10.1016/j.ejim.2013.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 04/18/2013] [Accepted: 04/23/2013] [Indexed: 11/27/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Intracoronary Infusion of Bone-marrow Derived Mononuclear Cells in Acute Myocardial Infarction: Are Outcomes Influenced by the Number of Infused Cells? Heart Lung Circ 2013; 22:786-7. [DOI: 10.1016/j.hlc.2012.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 10/24/2012] [Indexed: 11/29/2022]
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Maratea D, Fadda V, Trippoli S, Messori A. Effectiveness of drug-eluting balloons: quantifying the information size from clinical trials. Int J Cardiol 2013; 168:4435-7. [PMID: 23972366 DOI: 10.1016/j.ijcard.2013.06.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 06/30/2013] [Indexed: 02/07/2023]
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Messori A, Fadda V, Maratea D, Trippoli S. ω-3 fatty acid supplements for secondary prevention of cardiovascular disease: from "no proof of effectiveness" to "proof of no effectiveness". JAMA Intern Med 2013; 173:1466-8. [PMID: 23779264 DOI: 10.1001/jamainternmed.2013.6638] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Messori A, Fadda V, Maratea D, Trippoli S. Erythropoietin in patients with acute myocardial infarction: no proof of effectiveness or proof of no effectiveness? Clin Cardiol 2013; 36:E39-40. [PMID: 23929820 DOI: 10.1002/clc.22187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 06/11/2013] [Indexed: 11/11/2022] Open
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84
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Messori A, Fadda V, Maratea D, Trippoli S. Intra-aortic balloon pump in high-risk percutaneous coronary interventions without cardiogenic shock: trial sequential analysis of outcomes. Int J Cardiol 2013; 168:4534-6. [PMID: 23890904 DOI: 10.1016/j.ijcard.2013.06.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/30/2013] [Indexed: 02/06/2023]
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Fadda V, Maratea D, Trippoli S, Messori A. Temporal trend of short-term mortality in severely ill patients receiving parenteral glutamine supplementation. Clin Nutr 2013; 32:492-3. [DOI: 10.1016/j.clnu.2013.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/24/2013] [Indexed: 11/17/2022]
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86
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Messori A, Maratea D, Fadda V, Trippoli S. Comparing new anticoagulants in atrial fibrillation using the number needed to treat. Eur J Intern Med 2013; 24:382-3. [PMID: 22959884 DOI: 10.1016/j.ejim.2012.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 08/05/2012] [Accepted: 08/08/2012] [Indexed: 11/21/2022]
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Conti M, Trippoli S, Messori A. Warfarin and aspirin for primary prevention in patients with heart failure in sinus rhythm. Cardiovasc Diagn Ther 2013; 3:111-2. [PMID: 24282754 PMCID: PMC3839199 DOI: 10.3978/j.issn.2223-3652.2013.05.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/03/2013] [Indexed: 01/20/2023]
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88
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Maratea D, Fadda V, Trippoli S, Messori A. Viscosupplementation in patients with knee osteoarthritis: temporal trend of benefits assessed by meta-regression. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2013; 24:829-30. [PMID: 23715908 DOI: 10.1007/s00590-013-1249-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 05/20/2013] [Indexed: 11/29/2022]
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89
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Fadda V, Maratea D, Trippoli S, Messori A. Mechanical endovascular therapy in ischaemic stroke: temporal trend of outcomes. Int J Stroke 2013; 8:E12-3. [PMID: 23692487 DOI: 10.1111/j.1747-4949.2012.00964.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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90
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Messori A, Fadda V, Maratea D, Trippoli S. Acute lymphoblastic leukemia in first complete remission: temporal trend of outcomes in studies comparing allogeneic transplant with autologous transplant or chemotherapy. Ann Hematol 2013; 92:1221-8. [PMID: 23677128 DOI: 10.1007/s00277-013-1766-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 04/17/2013] [Indexed: 12/25/2022]
Abstract
In patients with acute lymphoblastic leukemia in first complete remission, several studies have compared allogeneic transplant with autologous transplant or chemotherapy. This material can be the basis for analyzing the temporal trend of outcomes. Our study was designed as a meta-regression focused on temporal trends and based on the endpoint of 5-year leukemia-free survival (5yLFS). Studies in which 5yLFS was determined in a patient group subjected to allogeneic transplant and in a control group (treated with autologous transplant and/or chemotherapy) were eligible for our meta-analysis. A standard literature search was carried out to identify pertinent studies. The results of included studies were submitted to an observational meta-analysis and to a meta-regression focused on two covariates (calendar year in which the study was conducted; percentage of high-risk patients). The endpoint of 5yLFS was separately assessed between allogeneic transplant and autologous transplant or chemotherapy. Our analysis included 14 studies that covered a period (1983 to 1999) in which patients were conditioned only with myeloablative conditioning and not with non-myeloablative ones. In the risk ratio (RR) analysis, the pooled outcome showed a significantly better profile for allogeneic transplantation (RR = 1.42; 95 % confidence interval (CI), 1.22 to 1.65). Separate analysis of the two treatment options found a pooled 5yLFS of 45 % (95 % CI, 38 to 51 %) for allogeneic transplant vs 30 % (95 % CI, 23 to 37 %) for the controls. In meta-regression, the temporal trend analysis revealed that, in patients subjected to allogeneic transplant, the values of 5yLFS showed no significant change over the 16-year interval (p = 0.720); the same stability over time was found in the control group (p = 0.489). On the other hand, the percentage of high-risk patients influenced outcomes in both patient groups at levels of statistical significance (p = 0.014 and p = 0.045 in the allotransplant group and in the controls, respectively). Our results can represent a reference point for future analyses focused on patients treated in more recent years.
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Messori A, Fadda V, Maratea D, Trippoli S. Treatments for non-Hodgkin lymphoma in HIV-positive patients: quantifying incremental benefit from 1993 to 2004 by metaregression. Am J Hematol 2013; 88:435. [PMID: 23420571 DOI: 10.1002/ajh.23420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 02/09/2013] [Accepted: 02/13/2013] [Indexed: 11/10/2022]
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92
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Maratea D, Fadda V, Trippoli S, Messori A. Between-study variability of short-term mortality in patients with pararenal aortic pathologies treated with chimney or fenestrated endografts. J Endovasc Ther 2013; 20:253-5. [PMID: 23581775 DOI: 10.1583/1545-1550-20.2.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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93
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Messori A, Fadda V, Maratea D, Trippoli S. Meta-analysis of observational studies to evaluate immediate outcomes after endarterectomy or stenting for carotid artery stenosis. Ann Vasc Surg 2013; 26:1166-7. [PMID: 23068428 DOI: 10.1016/j.avsg.2012.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 05/17/2012] [Indexed: 11/27/2022]
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94
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Messori A, Maratea D, Fadda V, Trippoli S. All-cause mortality in patients with unprotected left main coronary disease: comparison between stenting and coronary artery bypass grafting. Am J Cardiol 2013; 111:919-21. [PMID: 23453180 DOI: 10.1016/j.amjcard.2012.11.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 11/29/2012] [Indexed: 11/17/2022]
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95
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Messori A, Maratea D, Fadda V, Trippoli S. Outcomes in patients with unprotected left main coronary disease: comparison between drug-eluting stents and coronary artery by-pass grafting. Am J Cardiol 2013; 111:779-80. [PMID: 23414652 DOI: 10.1016/j.amjcard.2012.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 11/08/2012] [Indexed: 10/27/2022]
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96
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Maratea D, Fadda V, Trippoli S, Messori A. Letter: First-line monotherapies for chronic hepatitis B - indirect comparison between entecavir and tenofovir. Aliment Pharmacol Ther 2013; 37:584-5. [PMID: 23369168 DOI: 10.1111/apt.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 12/22/2012] [Indexed: 12/08/2022]
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Messori A, Santarlasci B, Trippoli S. Guadagno di sopravvivenza dei nuovi farmaci. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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98
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Messori A, Trippoli S, Biancari F. Early and intermediate survival after transcatheter aortic valve implantation: systematic review and meta-analysis of 14 studies. BMJ Open 2013; 3:bmjopen-2012-001770. [PMID: 23315515 PMCID: PMC3549234 DOI: 10.1136/bmjopen-2012-001770] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Transcatheter aortic valve implants (TAVIs) is indicated as an alternative to surgical valve replacement for patients unfit for surgery. No systematic review has studied survival after 2 years and limited information is available on between-study heterogeneity. OBJECTIVES A systematic review and meta-analysis on intermediate survival after TAVI. DATA SOURCES PubMed, EMBASE, Scopus and references of selected articles. STUDY ELIGIBILITY CRITERIA Clinical studies evaluating TAVI, published between 2010 and 2012, reporting survival at 2 or more years. PARTICIPANTS About 3500 patients from 14 studies. STUDY APPRAISAL AND SYNTHESIS METHODS Proportion meta-analysis with 95% CI and heterogeneity assessment (I(2) and Cochran's Q). Meta-regression analysis was performed as well. RESULTS Pooled immediate postoperative death rate was 7.8% (95% CI 6.2% to 9.8%, I(2)=40.8%; Cochran's Q=97.7 with 92.9 df, p<0.0001) and stroke rate was 3.8% (95% CI 2.8% to 5.0%, I(2)=34.3%; Cochran's Q=96.5 with 92.9 df, p<0.0001). Pooled death rates at 1, 2 and 3 years were 23.2%, 31.0% and 38.6%, respectively. Among studies reporting on concomitant percutaneous coronary intervention, pooled death rates at 30 days, 1 year and 2 years were 6.3%, 17.8% and 25.8%, respectively. LIMITATIONS Although our analysis examined a total of about 3500 patients, only a minority of these were actually followed up after 2 years. CONCLUSIONS Pooled survival rates after TAVI (at 2 years: 69.0%; at 3 years: 61.4%) can be considered excellent, particularly in the light of the high-risk profile of this patient population. IMPLICATIONS OF KEY FINDINGS: The favourable intermediate outcome in patients subjected to TAVI seems to justify its use in patients unfit for surgery. Such pooled results indicate that TAVI is a valid alternative to surgical valve replacement, but lack of data on late durability after TAVI prevents its use in low-risk patients with long expectancy of life.
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Messori A, Fadda V, Maratea D, Trippoli S. Maintenance Chemotherapy in Ovarian Cancer: A Trial-Sequential Analysis. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jct.2013.47145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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100
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Messori A, Fadda V, Maratea D, Trippoli S. Does network meta-analysis generate any new knowledge? Thromb Haemost 2012; 109:360. [PMID: 23238169 DOI: 10.1160/th12-10-0749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 11/07/2012] [Indexed: 11/05/2022]
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