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A systematic review of effi cacy and tolerability of mebeverine in irritable bowel syndrome

World Journal of Gastroenterology 2010年第5期16卷 547-553页

作者： Mahnaz Darvish-Damavandi shekoufeh nikfar Mohammad Abdollahi Pharmaceutical Sciences Research Center Tehran University of Medical Sciences Tehran *** Iran Department of Pharmacoeconomics and Pharmaceutical Administration Faculty of Pharmacy Tehran University of Medical Sciences Tehran *** Iran Food & Drug Laboratory Research Center Deputy for Food & Drug Affairs Ministry of Health & Medical Education Tehran *** Iran Faculty of Pharmacy and Pharmaceutical Sciences Research Center and Endocrinology & Metabolism Research Center Tehran University of Medical Sciences Tehran *** Iran

We evaluated the eff icacy and tolerability of mebeverine, a musculotropic antispasmodic agent, in irritable bowel syndrome (IBS) and compared its usual dosages by meta-analysis. Medical databases and all relevant literature were searched from 1965 to June 2009 for any placebo-controlled clinical trials of mebeverine, using search terms such as mebeverine, clinical trials, and IBS. Eight randomized trials met our criteria, including six trials that compared mebeverine with placebo and two that compared mebeverine tablets with capsules. These eight trials included 555 patients randomized to receive either mebeverine or placebo with 352 (63%)women and 203 (37%) men in all subtypes of IBS. The pooled relative risk (RR) for clinical improvement of mebeverine was 1.13 (95% CI: 0.59-2.16, P = 0.7056) and 1.33 (95% CI: 0.92-1.93, P = 0.129) for relief of abdominal pain. The efficacy of mebeverine 200 mg compared to mebeverine 135 mg indicated RRs of 1.12 (95% CI: 0.96-1.3, P = 0.168) for clinical or global improvement and 1.08 (95% CI: 0.87-1.34, P = 0.463) for relief of abdominal pain. Thus, mebeverine is mostly well tolerated with no signif icant adverse effects; however, its eff icacy in global improvement of IBS is not statistically signif icant.

关键词： Clinical trial Metaanalysis Mebeverine Placebo Irritable bowel syndrome Systematic review

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Effi cacy of tricyclic antidepressants in irritable bowel syndrome:A meta-analysis

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World Journal of Gastroenterology 2009年第13期15卷 1548-1553页

作者： Roja Rahimi shekoufeh nikfar Ali Rezaie Mohammad Abdollahi Pharmaceutical Sciences Research Center Tehran University of Medical Sciences Food & Drug Affairs and Food & Drug Laboratory Research CenterMinistry of Health & Medical Education Faculty of Medicine University of Alberta Faculty of Pharmacy and Pharmaceutical Sciences Research CenterTehran University of Medical Sciences

We aimed to evaluate the efficacy of tricyclic antidepressants(TCAs) as a therapeutic option for irritable bowel syndrome(IBS) through meta-analysis of randomized controlled *** the years 1966 until September 2008,PubMed,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials were searched for double-blind,placebo-controlled trials investigating the effi cacy of TCAs in the management of *** randomized,placebo-controlled clinical trials met our criteria and were included in the *** used in the treatment arm of these trials included amitriptyline,imipramine,desipramine,doxepin and *** pooled relative risk for clinical improvement with TCA therapy was 1.93(95% CI:1.44 to 2.6,P<0.0001).Effect size of TCAs versus placebo for mean change in abdominal pain score among the two studies was -44.15(95% CI:-53.27 to -35.04,P<0.0001).It is concluded that low dose TCAs exhibit clinically and statistically signifi cant control of IBS symptoms.

关键词： Meta分析三环抗抑郁药肠易激综合征疗效临床反应腹痛

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Antioxidant therapy in the management of acute,chronic and post-ERCP pancreatitis:A systematic review

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World Journal of Gastroenterology 2009年第36期15卷 4481-4490页

作者： Seyed Sajad Mohseni Salehi Monfared Hamed Vahidi Amir Hossein Abdolghaffari shekoufeh nikfar Mohammad Abdollahi Endocrinology and Metabolism Research Centre Tehran University of Medical Sciences Student Scientific Research Center Tehran University of Medical Science Pharmaceutical Sciences Research Center Tehran University of Medical Sciences Food&Drug Affairs and Food&Drug Laboratory Research Center Ministry of Health&Medical Education Faculty of Pharmacy and Pharmaceutical Sciences Research Center and Endocrinology&Metabolism Research CentreTehran University of Medical Sciences

We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with *** bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis(AP)or chronic pancreatitis(CP)and in the prevention of post-endoscopic retrograde cholangio-pancreatography(post-ERCP)pancreatitis(PEP)up to February ***-two randomized,placebo-controlled,clinical trials met our criteria and were included in the *** for a cocktail of antioxidants which showed improvement in outcomes in three different clinical trials,the results of the administration of other antioxidants in both AP and CP clinical trials were incongruent and ***,antioxidant therapy including allopurinol and N-acetylcysteine failed to prevent the onset of PEP in almost all *** conclusion,the present data do not support a benefit of antioxidant therapy alone or in combination with conventional therapy in the management of AP,CP or *** double blind,randomized,placebo-controlled clinical trials with large sample size need to be conducted.

关键词：急性胰腺炎抗氧化剂产后管理系统评价治疗慢性临床试验书目数据库

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Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines:A meta-analysis

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World Journal of Gastroenterology 2013年第34期19卷 5738-5749页

作者： Roja Rahimi shekoufeh nikfar Mohammad Abdollahi Department of Traditional Pharmacy Faculty ofTraditional MedicineTehran University of Medical Sciences Pharmaceutical Sciences Research Center Tehran University of Medical Sciences Department of Pharmacoeconomics and Pharmaceutical Administration Faculty of PharmacyTehran University of Medical Sciences Food and Drug Organisation Ministry of Health and Medical Education Department of Toxicology and Pharma-cology Faculty of PharmacyTehran University of Medical Sciences

AIM:To evaluate the efficacy and tolerability of herbal medicines in inflammatory bowel disease(IBD)by conducting a ***:Electronic databases were searched for studies investigating efficacy and/or tolerability of herbal medicines in the management of different types of *** search terms were:"herb"or"plant"or"herbal"and"inflammatory bowel disease".Data were collected from 1966 to 2013(up to Feb).The"clinical response","clinical remission","endoscopic response","endoscopic remission","histological response","histological remission","relapse","any adverse events",and"seriousadverse events"were the key outcomes of *** used the Mantel-Haenszel,Rothman-Boice method for fixed effects and DerSimonian-Laird method for *** subgroup analyses,we separated the studies by type of IBD and type of herbal medicine to determine confounding factors and ***:Seven placebo controlled clinical trials met our criteria and were included(474 patients).Comparison of herbal medicine with placebo yielded a significant RR of 2.07(95%CI:1.41-3.03,P=0.0002)for clinical remission;a significant RR of 2.59(95%CI:1.24-5.42,P=0.01)for clinical response;a non-significant RR of 1.33(95%CI:0.93-1.9,P=0.12)for endoscopic remission;a non-significant RR of 1.69(95%CI:0.69-5.04)for endoscopic response;a non-significant RR of 0.64(95%CI:0.25-1.81)for histological remission;a non-significant RR of 0.86(95%CI:0.55-1.55)for histological response;a non-significant RR of 0.95(95%CI:0.52-1.73)for relapse;a non-significant RR of 0.89(95%CI:0.75-1.06,P=0.2)for any adverse events;and a non-significant RR of 0.97(95%CI:0.37-2.56,P=0.96)for serious adverse ***:The results showed that herbal medicines may safely induce clinical response and remission in patients with IBD without significant effects on endoscopic and histological outcomes,but the number of studies is limited to make a strong conclusion.

关键词： Herbal medicine Inflammatory bowel disease Efficacy Relapse Adverse events Meta-analysis

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Effectiveness of probiotics in irritable bowel syndrome:Updated systematic review with meta-analysis

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World Journal of Gastroenterology 2015年第10期21卷 3072-3084页

作者： Tina Didari Shilan Mozaffari shekoufeh nikfar Mohammad Abdollahi Department of Toxicology and Pharmacology Faculty of Pharmacy and Pharmaceutical Sciences Research CenterTehran University of Medical Sciences Department of Pharmacoeconomics and Pharmaceutical Administration Faculty of Pharmacy and Pharmaceutical Policy Research CenterTehran University of Medical Sciences

AIM:To investigate the efficacy of probiotics in irritable bowel syndrome(IBS) ***:Pub Med,Cochrane library,Scopus,Google Scholar,and *** databases were searched for literature published between September 2007 and December *** applied Mesh terms were "probiotics," "irritable bowel syndrome," and "irritable bowel syndrome treatment." The collected data contained24 clinical trials,of which 15 were eligible for meta-analysis and nine were reviewed *** studies were randomized placebo-controlled trials in patients with IBS that investigated the efficacy of probiotics in IBS *** Jadad score was used to assess the methodological quality of *** quality scale ranges from 0 to 5 points,with a score ≤ 2 indicating a low quality report,and a score of ≥3 indicating a high quality *** risk(RR),standardized effect size,and 95%CI were calculated using the Der Simonian-Laird *** Cochran Q test was used to test heterogeneity with P < *** plots were constructed and Egger's and BeggMazumdar tests were performed to assess publication ***:A total of 1793 patients were included in the *** RR of responders to therapies based on abdominal pain score in IBS patients for two included trials comparing probiotics to placebo was 1.96(95%CI:1.14-3.36;P = 0.01).RR of responders to therapies based on a global symptom score in IBS patients for two included trials comparing probiotics with placebo was 2.43(95%CI:1.13-5.21;P = 0.02).For adequate improvement of general symptoms in IBS patients,the RR of seven included trials(six studies) comparing probiotics with placebo was 2.14(95%CI:1.08-4.26;P = 0.03).Distension,bloating,and flatulence were evaluated using an IBS severity scoring system in three trials(two studies) to compare the effect of probiotic therapy in IBS patients with placebo,the standardized effect size of mean differences for probiotics therapy was-2.57(95%CI:-13.05--7.92)

关键词： Evidence-based medicine Irritable bowel syndrome M

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Antioxidant therapy in acute,chronic and post-endoscopic retrograde cholangiopancreatography pancreatitis:An updated systematic review and meta-analysis

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World Journal of Gastroenterology 2015年第30期21卷 9189-9208页

作者： Maziar Gooshe Amir Hossein Abdolghaffari shekoufeh nikfar Parvin Mahdaviani Mohammad Abdollahi Department of Toxicology and Pharmacology Faculty of Pharmacyand Pharmaceutical Sciences Research Centerand Endocrinology and Metabolism Research CenterEndocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical Sciences Pharmacology and Applied Medicine Department of Medicinal Plants Research CenterInstitute of Medicinal PlantsACECRKaraj 31375369Iran International Campus ICTUMSTehran University of Medical Sciences Department of Pharmacoeconomics and Pharmaceutical Administration Faculty of PharmacyTehran University of Medical Sciences Department of Pharmaceutics Faculty of PharmacyTehran University of Medical Sciences

AIM:To investigate the efficacy and adverse effects of antioxidant therapy in acute pancreatitis(AP),chronic pancreatitis(CP) and post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP).METHODS:Pub Med,Scopus,Google Scholar,Cochrane library database,and Evidence-based medicine/clinical trials published before August 2014 were searched. Clinical and laboratory outcomes of randomized trials of antioxidant therapy in patients with AP,CP and PEP were included. The methodological quality of the trials was assessed by the Jadad score based on the description of randomization,blinding,and dropouts(withdrawals). The results of the studies were pooled and meta-analyzed to provide estimates of the efficacy of antioxidant ***:Thirty four trials out of 1069 potentially relevant studies with data for 4898 patients wereeligible for inclusion. Antioxidant therapy significantly reduced the length of hospital stay in AP patients {mean difference-2.59 d(95%CI:-4.25-(-0.93)],P = 0.002}. Although,antioxidant therapy had no significant effect on serum C reactive protein(CRP) after 5-7 d in AP patients [mean difference-9.57(95%CI:-40.61-21.48,P = 0.55],it significantly reduced serum CRP after 10 d {mean difference-45.16 [95%CI:-89.99-(-0.33)],P = 0.048}. In addition,antioxidant therapy had no significant effect on CP-induced pain [mean difference-2.13(95%CI:-5.87-1.6),P = 0.26]. Antioxidant therapy had no significant effects on the incidence of all types of PEP [mean difference 1.05(95%CI:0.74-1.5),P = 0.78],severe PEP [mean difference 0.92(95%CI:0.43-1.97),P = 0.83],moderate PEP [mean difference 0.82(95%CI:0.54-1.23),P = 0.33],and mild PEP [mean difference 1.33(95%CI:0.99-1.78),P = 0.06]. Furthermore,while antioxidant therapy had no significant effect on serum amylase after less than 8 h sampling [mean difference-20.61(95%CI:-143.61-102.39),P = 0.74],it significantly reduced serum amylase close to 24-h sampling {mean difference-16.13 [95%CI:-22.98-(-9.28)],P <

关键词： Acute pancreatitis Chronic pancreatitis Post-endoscopic retrograde cholangiopancreatographypancreatitis Antioxidants Meta-analysis

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