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Clinical Lymphoma, Myeloma & Leukemia Jan 2021To investigate the effects of mitoxantrone and daunorubicin in induced chemotherapy on complete remission (CR), death during induction therapy, overall survival (OS),... (Meta-Analysis)
Meta-Analysis
PURPOSE
To investigate the effects of mitoxantrone and daunorubicin in induced chemotherapy on complete remission (CR), death during induction therapy, overall survival (OS), disease-free survival (DFS), and relapse in patients of all ages with acute myeloid leukemia (AML).
METHODS
We searched published reports at the Medline, Embase, and Cochrane Databases as well as other databases from inception through July 2019. There was no restriction on date of publication or language (PROSPERO registration CRD42018095843).
RESULTS
We enrolled 12 randomized controlled trials that included data of 4583 AML patients whose disease was untreated or relapsed/refractory, and compared the CR, death during induction therapy, DFS, and OS between mitoxantrone and daunorubicin. Mitoxantrone significantly increased the CR rate (relative risk = 1.07; 95% confidence interval [CI], 1.01, 1.14; P = .03) and DFS (hazard ratio = 0.87; 95% CI, 0.79, 0.96; P = .005) compared to daunorubicin. However, there was no significant difference in death during induction therapy (relative risk = 1.00; 95% CI, 0.81, 1.24; P = .99) and OS (hazard ratio = 0.94; 95% CI, 0.87, 1.01; P = .077) between the two drugs.
CONCLUSION
Although more studies are needed to compare mitoxantrone with higher-dose daunorubicin, the results showed that compared to daunorubicin, mitoxantrone can significantly improve CR and DFS in patients of all ages. These findings suggest that mitoxantrone may be a better choice than daunorubicin as an induction chemotherapy agent for AML patients, especially in developing countries.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Daunorubicin; Female; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Mitoxantrone; Randomized Controlled Trials as Topic
PubMed: 32863193
DOI: 10.1016/j.clml.2020.08.001 -
Current Medicinal Chemistry 2021A systematic review and meta-analysis of clinical trials were undertaken to evaluate the effect of diacerein intake on cardiometabolic profiles in patients with type 2... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A systematic review and meta-analysis of clinical trials were undertaken to evaluate the effect of diacerein intake on cardiometabolic profiles in patients with type 2 diabetes mellitus (T2DM).
METHODS
Electronic databases such as PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials were searched from inception to 31 July 2019. Statistical heterogeneity was evaluated using Cochran's Q test and I-square (I) statistic. Data were pooled using random-effects models and weighted mean difference (WMD).
RESULTS
From 1,733 citations, seven clinical trials were eligible for inclusion and meta-analysis. A significant reduction in hemoglobin A1c (HbA1c) (WMD -0.73; 95%CI -1.25 to -0.21; P= 0.006; I2= 72.2%) and body mass index (BMI) (WMD -0.55; 95%CI -1.03 to -0.07; P= 0.026; I= 9.5%) was identified. However, no significant effect of diacerein intake was identified on fasting blood sugar (FBS) (WMD -9.00; 95%CI -22.57 to 4.57; P= 0.194; I2= 60.5%), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD 0.39; 95%CI -0.95 to 1.73; P= 0.569; I= 2.2%), body weight (WMD - 0.54; 95%CI -1.10 to 0.02; P= 0.059), triglycerides (WMD -0.56; 95%CI -24.16 to 23.03; P= 0.963; I= 0.0%), total-cholesterol (WMD -0.21; 95%CI -12.19 to 11.78; P= 0.973; I= 0.0%), HDL-cholesterol (WMD -0.96; 95%CI -2.85 to 0.93; P= 0.321; I= 0.0%), and LDL-cholesterol levels (WMD -0.09; 95%CI -8.43 to 8.25; P= 0.983; I= 37.8%).
CONCLUSION
Diacerein intake may reduce HbA1c and BMI; however, no evidence of the effect was observed for FBS, HOMA-IR, body weight, triglycerides, total cholesterol, HDL-cholesterol or LDLcholesterol.
Topics: Anthraquinones; Blood Glucose; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Humans; Triglycerides
PubMed: 32723228
DOI: 10.2174/0929867327666200728134755 -
International Journal of Molecular... Jul 2020The risk of liver injury associated with the use of herbal medicinal products (HMPs) is well known among physicians caring for patients under a HMP therapy, as...
The risk of liver injury associated with the use of herbal medicinal products (HMPs) is well known among physicians caring for patients under a HMP therapy, as documented in case reports or case series and evidenced by using the Roussel Uclaf Causality Assessment Method (RUCAM) to verify a causal relationship. In many cases, however, the quality of HMPs has rarely been considered regarding potential culprits such as contaminants and toxins possibly incriminated as causes for the liver injury. This review aims to comprehensively assemble details of tentative hepatotoxic contaminants and toxins found in HMPs. Based on the origin, harmful agents may be divided according two main sources, namely the phyto-hepatotoxin and the nonphyto-hepatotoxin groups. More specifically, phyto-hepatotoxins are phytochemicals or their metabolites naturally produced by plants or internally in response to plant stress conditions. In contrast, nonphyto-hepatotoxic elements may include contaminants or adulterants occurring during collection, processing and production, are the result of accumulation of toxic heavy metals by the plant itself due to soil pollutions, or represent mycotoxins, herbicidal and pesticidal residues. The phyto-hepatotoxins detected in HMPs are classified into eight major groups consisting of volatile compounds, phytotoxic proteins, glycosides, terpenoid lactones, terpenoids, alkaloids, anthraquinones, and phenolic acids. Nonphyto-hepatotoxins including metals, mycotoxins, and pesticidal and herbicidal residues and tentative mechanisms of toxicity are discussed. In conclusion, although a variety of potential toxic substances may enter the human body through HMP use, the ability of these toxins to trigger human liver injury remains largely unclear.
Topics: Animals; Chemical and Drug Induced Liver Injury; Humans; Liver; Phytochemicals; Plant Preparations; Plants, Medicinal
PubMed: 32708570
DOI: 10.3390/ijms21145011 -
Journal of Diabetes Research 2020To figure out the effect of diacerein supplementation on type 2 diabetes mellitus (T2DM). (Meta-Analysis)
Meta-Analysis
AIMS
To figure out the effect of diacerein supplementation on type 2 diabetes mellitus (T2DM).
METHODS
An electronic search was processed on Pubmed, Embase, and Cochrane library for randomized controlled trials (RCTs) comparing the efficacy of diacerein with placebo on T2DM. The primary outcome was fasting blood glucose (FBG). Trial sequential analysis (TSA) was used to test the reliability of this pooled outcome. Secondary outcomes were glycosylated hemoglobin A1c (HbA1c), body mass index (BMI), lipid profiles, hematological indexes including hematocrit and platelet count, and systematic inflammatory level expressed as a C-reactive protein (CRP) level. Safety outcome was the rate of complications. The difference in continuous data was measured by mean difference (MD) and 95% confidence interval (CI), while the difference of dichotomous data was calculated by relative risk (RR) and 95% CI. A two-tailed < 0.05 was regarded as statistically significant.
RESULTS
Five RCTs with 278 participants were included. Compared with control, diacerein provided significant improvement on FBG (MD -0.52; 95% CI (-0.89~-0.14); < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant. < 0.05 was regarded as statistically significant.
CONCLUSION
Based on the current analysis, diacerein as an add-on treatment provided better glycemic control for T2DM but this benefit requires more verification. Compared with control, additional diacerein also lowered body weight and CRP level in T2DM, but increased the rate of gastrointestinal syndromes.
Topics: Anthraquinones; Blood Glucose; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Randomized Controlled Trials as Topic; Reproducibility of Results; Treatment Outcome
PubMed: 32104712
DOI: 10.1155/2020/2593792 -
Chemico-biological Interactions Sep 2019Anthraquinones constitute an important class of natural and synthetic compounds with a broad scope of pharmacological including anti-bacterial, antioxidant, laxative,... (Review)
Review
Anthraquinones constitute an important class of natural and synthetic compounds with a broad scope of pharmacological including anti-bacterial, antioxidant, laxative, anti-tumor and other activities. Physcion and physcion 8-O-β-glucopyranoside (PG) are common anthraquinones existed in various plants. Emerging studies suggested that physcion and PG not only exert anti-tumor, anti-microbial, anti-inflammatory, anti-oxidant, optical-related, enzyme inhibitory, lipid regulation and neuroprotective activities, but also lead to hepatotoxicity, renal toxicity and genetic damage. Besides, a growing number of pharmacokinetics researches of physcion and PG also have been conducted. However, no review of physcion or PG have been published by now, so the aim of present review is to give a comprehensive summary and analysis of the pharmacology, toxicity and pharmacokinetics of physcion and PG by consulting all the currently available literatures published in PubMed then give a future prospects about it.
Topics: Anthraquinones; Emodin; Glucosides; Phytochemicals
PubMed: 31226286
DOI: 10.1016/j.cbi.2019.06.035 -
Journal of Neuroimmunology Jul 2019The review assessed the efficacy and tolerability of mitoxantrone in patients with neuromyelitis optica spectrum disorder (NMOSD). Eight articles were reviewed with a...
The review assessed the efficacy and tolerability of mitoxantrone in patients with neuromyelitis optica spectrum disorder (NMOSD). Eight articles were reviewed with a total of 117 patients. Annualized relapse rate and progression of disability dramatically decreased post-treatment in most studies. Mitoxantrone was generally tolerated. Only one patient developed acute myeloid leukemia, which lead to septicemia and death. No serious cardiotoxicity was reported. Mitoxantrone may be effective in reducing the frequency of relapse and slowing down the progression of disability in patients with NMOSD. The risk of cardiotoxicity and leukemia detains it as a second-line agent for NMOSD.
Topics: Cardiomyopathies; Disease Progression; Epidemiologic Studies; Humans; Immunosuppressive Agents; Infections; Intercalating Agents; Leukemia, Myeloid, Acute; Leukopenia; Mitoxantrone; Neuromyelitis Optica; Randomized Controlled Trials as Topic; Recurrence; Topoisomerase II Inhibitors; Treatment Outcome
PubMed: 31005713
DOI: 10.1016/j.jneuroim.2019.04.007