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Non-Steroidal Anti-Inflammatory Drugs as Protective Factor in Alzheimer’s Diseases: A Systematic Review and Meta-Analysis Protocol

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Advances in Alzheimer's Disease 2023年第2期12卷 17-28页

作者： Akash Asthana rachna agarwal Shashank Tripathi Department of Statistics University of Lucknow Lucknow India Department of Neurochemistry Institute of Human Behavior and Allied Sciences New Delhi India

Introduction: NSAIDs inhibit COX-2, which is responsible for regulating neurons leading to neurodegeneration in Alzheimer’s disease. Alzheimer’s disease is a neurodegenerative disease affecting the geriatric population, as it affects more than two third cases of dementia in the sphere. Results obtained from experimental and observational studies were unclear regarding the protective role of NSAIDs in AD, therefore this justifies the need for meta-analysis. Methods: Database search was PubMed, Web of Science, and Embase. Experimental studies and Observational studies investigating the effect of NSAIDs on AD. For experimental studies indicators used were MMSE score, ADAS-cog score, CDR-sob score, NPI score, and Hazard ratio. Similarly for Observational studies, Odds Ratio and Relative Risk are used. Results: As this is the study protocol, therefore it is not possible to write the results of the study in the study protocol. There is a total of 06 (MMSE, ADAS-cog, CDR-sob, HR, RR, and OR) indicators used in the study, so 06 results will be obtained showing the pooled effect size which will indicate the use of NSAIDs as a protective factor for Alzheimer’s disease. Discussion: The present systematic review will improve the understanding of the relative efficacies of NSAIDs in AD and possibly guide clinical practices by providing the current best evidence on the efficacy of various regimens of NSAIDs in the management of AD subjects. Conclusion: Conclusion can be drawn only after the final meta-analysis using three study design (RCT, Cohort and Case-control study designs) and six indicators.

关键词： Alzheimer’s Disease NSAIDs Meta-Analysis RCT OR RR

A Systematic Review and Meta-Analysis of Randomized Control Trials to Check Role of Non-Steroidal Anti-inflammatory Drugs as Protective Factor in Alzheimer Disease Subjects

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Advances in Alzheimer's Disease 2023年第1期12卷 1-16页

作者： Akash Asthana Shashank Tripathi rachna agarwal Department of Statistics University of Lucknow Lucknow India Department of Neurochemistry Institute of Human Behavior and Allied Sciences New Delhi India

Background: Alzheimer’s disease is the major neurodegenerative disease, affecting more than two third cases of dementia in the world. NSAIDs are widely used anti-inflammatory analgesic agents representing 7.7% of worldwide prescriptions of which 90% are in patients over 65 years old. Based on mixed findings observed by different RCTs, a systematic review and meta-analysis were conducted to develop a better understanding of the protective role of Non-steroidal anti-inflammatory drugs (NSAIDs) in AD. Methods: Database search was Pubmed, WebScience, and Embase. RCTs investigating the effect of NSAIDs on AD or test scores assessing cognitive function in people without AD at baseline were included. Three indicators were MMSE Score, ADAS-cog score, and CDR-sob. 10 studies were included in the present Meta-analysis. Results: For the ADAS-cog score, the pooled effect size was -0.31 with 95% CI -0.06 to 0.02, which was statistically significant (p = 0.03). MMSE score difference, the pooled effect size was -0.06 with 95% CI -0.22 to 0.10, which was statistically insignificant (p-value = 0.47). For the MMSE average score, the pooled effect size was -0.002 with 95% CI -0.03 to 0.07, which was statistically insignificant (p-value = 0.87). For the CDR-sob score difference, the pooled effect size calculated using the random effect model was -0.06 with 95% CI -0.39 to 0.05 which was statistically insignificant (p = 0.14). For CDR-sob average score, the pooled effect size calculated using the random effect model was 0.21 with 95% CI -0.09 to 0.51, which was statistically insignificant (p-value = 0.17). Conclusion: Present Meta-analysis shows that NSAIDs in general are not effective in the treatment of AD. They also have no protective effect against the development of AD on their sustained use.

关键词： NSAIDs Alzheimer’s Disease Meta-Analysis Hazard Ratio

CSF tau and amyloid β<sub>42</sub>levels in Alzheimer’s disease—A meta-analysis

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Advances in Alzheimer's Disease 2012年第3期1卷 30-44页

作者： rachna agarwal Neelam Chhillar Vijay Nath Mishra Chandra Bhushan Tripathi Department of Biostatistics Institute of Human Behaviour & Allied Sciences Delhi India Department of Neurochemistry Institute of Human Behaviour & Allied Sciences Delhi India Department of Neurology Institute of Medical Sciences Banaras Hindu University Varanasi India

Alzheimer’s disease International (ADI) estimates that there are currently 30 million people with dementia in the world. The main objective was to perform meta-analysis of studies of CSF tau and Amyloid β42 (Aβ42) levels in Alzheimer’s disease (AD) patients and controls. In the present study MEDLINE was reviewed from 1995 to 2009, supplemented by citation analysis from retrieved articles to select case control studies. Descriptive statistics showed that median effect size (raw mean difference) of CSF tau and Aβ42 levels were 301 pg/ml (Range: 22 to 614 pg/ml) and –352 pg/ml (Range: –969 to 203 pg/ml) respectively. The pooled effect size CSF tau and Aβ42 was 289.14 pg/ml (95% CI 253.278 to 325.013 pg/ml) and –329.02 pg/ml (95% CI –387.740 to –270.445 pg/ml) respectively. Heterogeneity in effect size of selected studies was present for both parameters (CSF tau: Q statistics = 1816.596, DF = 40, P = 0.000 and CSF Aβ42: Q-statistics = 1259.358, DF = 24, p 42 levels in AD and controls may be considered as potential biomarker along with the clinical phenotype to perform them during high quality diagnostic testing in dementia.

关键词： Alzheimer’s Disease Dementia CSF Amyloid β42 CSF Tau Meta-Analysis

Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study

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World Journal of Gastrointestinal Endoscopy 2017年第4期9卷 162-170页

作者： Harshit Garg Pratyusha Priyadarshini Sandeep Aggarwal Samagra agarwal rachna Chaudhary Department of Surgical Disciplines All India Institute of Medical Sciences Department of Medicine All India Institute of Medical Sciences

To compare the impact of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) on weight loss and obesity related comorbidities over two year follow-up via case control study design. METHODSForty patients undergoing LRYGB, who completed their two year follow-up were matched with 40 patients undergoing LSG for age, gender, body mass index and presence of type 2 diabetes mellitus (T2DM). Data of these patients was retrospectively reviewed to compare the outcome in terms of weight loss and improvement in comorbidities, i.e., T2DM, hypertension (HTN), obstructive sleep apnea syndrome (OSAS), hypothyroidism and gastroesophageal reflux disease (GERD). RESULTSPercentage excess weight loss (EWL%) was similar in LRYGB and LSG groups at one year follow-up (70.5% vs 66.5%, P = 0.36) while it was significantly greater for LRYGB group after two years as compared to LSG group (76.5% vs 67.9%, P = 0.04). The complication rate after LRYGB and LSG was similar (10% vs 7.5%, P = 0.99). The median duration of T2DM and mean number of oral hypoglycemic agents were higher in LRYGB group than LSG group (7 years vs 5 years and 2.2 vs 1.8 respectively, P < 0.05). Both LRYGB and LSG had significant but similar improvement in T2DM, HTN, OSAS and hypothyroidism. However, GERD resolved in all patients undergoing LRYGB while it resolved in only 50% cases with LSG. Eight point three percent patients developed new-onset GERD after LSG. CONCLUSIONLRYGB has better outcomes in terms of weight loss two years after surgery as compared to LSG. The impact of LRYGB and LSG on T2DM, HTN, OSAS and hypothyroidism is similar. However, LRYGB has significant resolution of GERD as compared to LSG.

关键词： Bariatric surgery Laparoscopic sleeve gastrectomy Laparoscopic Roux-en-Y gastric bypass Weight loss Comorbidities