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Inocêncio GSG, Meneses-Santos D, Costa MDMDA, Vieira WA, de Almeida VL, Rodrigues RPCB, Rode SDM, Paranhos LR. Efficacy, safety, and potential industry bias in using deoxycholic acid for submental fat reduction ‒ A systematic review and meta-analysis of randomized clinical trials. Clinics (Sao Paulo) 2023; 78:100220. [PMID: 37806137 PMCID: PMC10570630 DOI: 10.1016/j.clinsp.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/30/2023] [Accepted: 05/12/2023] [Indexed: 10/10/2023] Open
Abstract
Lipolytic substance injections to reduce localized fat have been extensively used because it is a low-invasive method. This review aimed to evaluate the efficacy and safety of deoxycholic acid in submental fat reduction compared to a placebo and investigate the potential industry sponsorship bias in the results of randomized clinical trials on this topic. Ten electronic databases were extensively searched for randomized clinical trials without restriction on language and year of publication. Two reviewers extracted the data and assessed the individual risk of bias in the studies with the RoB 2.0 tool. The industry sponsorship bias was evaluated according to citations in the articles regarding industry funding/sponsorship throughout the texts. Fixed and random effects meta-analyses were performed, and the results were reported in Risk Ratio (RR) at a 95% Confidence Interval (95% CI). The initial search provided 5756 results, of which only five were included. Only two studies had a low risk of bias. All studies showed a potential industry bias. The meta-analysis showed that patients treated with deoxycholic acid had significant positive results for all efficacy outcomes and a higher risk of fibrosis, pain, erythema, numbness, swelling, edema, pruritus, nodules, headache, and paresthesia. The low to moderate certainty of evidence found allows concluding that deoxycholic acid is effective in submental fat reduction, causing well-tolerated adverse effects. However, all eligible studies showed a potential industry bias.
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Affiliation(s)
| | - Daniela Meneses-Santos
- Division of Morphology, Centro de Ciências da Saúde e Biológicas, Universidade Federal de Sergipe, SE, Brazil
| | | | - Walbert A Vieira
- Department of Restorative Dentistry, Endodontics Division, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Vinicius Lima de Almeida
- Postgraduate Program in Dentistry, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Sigmar de Mello Rode
- Department of Dental Materials and Prothesis, Instituto de Ciência e Tecnologia, Universidade Estadual Paulista Júlio de Mesquita Filho, São José dos Campos, SP, Brazil
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
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IRIE MS, DIETRICH L, SOUZA GLD, SOARES PBF, MOURA CCG, SILVA GRD, PARANHOS LR. Ozone disinfection for viruses with applications in healthcare environments: a scoping review. Braz Oral Res 2022; 36:e006. [DOI: 10.1590/1807-3107bor-2022.vol36.0006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 07/13/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
| | - Lia DIETRICH
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil
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REIS NTDA, João Lucas Carvalho PAZ, PARANHOS LR, BERNARDINO ÍDM, MOURA CCG, IRIE MS, SOARES PBF. Use of platelet-rich fibrin for bone repair: a systematic review and meta-analysis of preclinical studies. Braz Oral Res 2022; 36:e129. [DOI: 10.1590/1807-3107bor-2022.vol36.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
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dos Santos MBF, Agostini BA, Moraes RR, Schwendicke F, Sarkis‐Onofre R. Industry sponsorship bias in clinical trials in implant dentistry: Systematic review and meta‐regression. J Clin Periodontol 2019; 46:510-519. [DOI: 10.1111/jcpe.13100] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/15/2019] [Accepted: 02/27/2019] [Indexed: 01/28/2023]
Affiliation(s)
| | | | | | - Falk Schwendicke
- Department of Operative and Preventive Dentistry Charité–Universitätsmedizin Berlin Berlin Germany
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Pratts M, Citrome L, Grant W, Leso L, Opler LA. A single-dose, randomized, double-blind, placebo-controlled trial of sublingual asenapine for acute agitation. Acta Psychiatr Scand 2014; 130:61-8. [PMID: 24606117 DOI: 10.1111/acps.12262] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess sublingual asenapine for acute agitation. METHOD Agitated adults 18-65 years (any diagnosis) presenting for treatment in an emergency department and found to have a score of ≥14 on the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) were randomized to receive either a single dose of a sublingual 10 mg tablet of asenapine or placebo. Primary outcome measure was change in the PANSS-EC score from baseline to 2 h after medication or placebo administration. Secondary outcomes included the percentage of responders with a ≥ 40% reduction from baseline on the PANSS-EC score at 2 h. RESULTS A total of 120 subjects were randomized, 60 each to sublingual asenapine or placebo. Mean (SE) baseline PANSS-EC scores for the asenapine-treated and placebo-treated subjects were 19.4 ± 0.66 and 20.1 ± 0.61, respectively. Mean PANSS-EC scores at endpoint (LOCF) was 7.4 ± 0.65 for the asenapine-treated subjects and 14.7 ± 0.98 for the placebo-treated subjects. Change in PANSS-EC score at 2 h was statistically significantly greater for the asenapine-treated subjects compared with the placebo-treated subjects. NNT for response vs. placebo was 3 (95% CI 2-4). CONCLUSION Sublingual asenapine was efficacious in the treatment of agitation with an effect size comparable to that observed in prior studies of intramuscular antipsychotics.
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Affiliation(s)
- M Pratts
- St. Joseph's Hospital Health Center, Syracuse, NY, USA
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Barton D, Stossel T, Stell L. After 20 years, industry critics bury skeptics, despite empirical vacuum. Int J Clin Pract 2014; 68:666-73. [PMID: 24837089 DOI: 10.1111/ijcp.12438] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
After more than 20 years, the conflict of interest (COI) movement has failed to substantiate its central claim that interactions between physicians, researchers and the medical products industry cause physicians to make clinical decisions that are adverse to the best interests of their patients. The COI movement's instigators have produced no solid evidence of harm commensurate with their extravagant allegations. At the same time, they have diverted resources away from more worthwhile pursuits, such as basic and applied medical research, clinical care and medical education towards onerous compliance exercises and obtrusive laws. Perhaps worst of all, they have made it respectable to ignore the epistemological foundations of medical science, diverting attention away from the scientific merit of the information presented and focusing it instead on the identity and motives of those who present the information.
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Affiliation(s)
- D Barton
- Center for Medical Innovation, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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