Efficacy of pharmacologic treatment in tinnitus patients without specific or treatable origin: A network meta-analysis of randomised controlled trials
| Autor: | Chih-Sung Liang, Jiann Jy Chen, Yi Cheng Wu, Hung Chang Kuo, Yu-Kang Tu, Brendon Stubbs, Bing Yan Zeng, Michael Roerecke, Tien Yu Chen, Yen-Wen Chen, Trevor Thompson, Pao-Yen Lin, Ping-Tao Tseng, Bing Syuan Zeng, Shih Pin Hsu, Lee Smith, Andre F. Carvalho, Chao Ming Hung, Kuan-Pin Su, Ming Kung Wu, Chih-Wei Hsu |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
VAS Visual analogue scale Gin ginkgo biloba Gab gabapentin VePar Vestipitant and paroxetine Bet Betahistine VES Vestipitant law.invention PLA placebo Randomized controlled trial law MIS Misoprostol NER Neramexane PaVitE papaverine hydrochloride plus vitamin E MeSul Melatonin and sulodexide RCT Randomised controlled trials CHL Chlorpheniramine PAR Paroxetine DeGin Intra-tympanic dexamethasone injection plus ginkgo biloba ACA Acamprosate Zinc Zinc supplementation GABA gamma-Aminobutyric acid General Medicine SUCRA Surface under the cumulative ranking curve NMA Network meta-analysis Acamprosate THI Tinnitus handicap inventory Meta-analysis DEX Intra-tympanic dexamethasone injection medicine.symptom RR Rate ratio ALVitC Alpha-lipoic acid plus vitamin C PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses Research Paper medicine.drug medicine.medical_specialty Gabapentin Visual analogue scale Placebo SER Sertraline ALP Alprazolam KRG Korean red ginseng R5-920 SMD Standardized mean difference 95%CIs 95% confidence intervals Internal medicine otorhinolaryngologic diseases medicine Mel Melatonin alone DeLid Intra-tympanic dexamethasone injection plus lidocaine ClD Clonazepam plus deanxit CLO Clonazepam NOR Nortriptyline Ozone Ozone exposure business.industry DeMel Intra-tympanic dexamethasone injection plus melatonin AMI Amitriptyline CLES Common language effect size Pen Pentoxifylline VAR Vardenafil TRI Postaurical subcutaneous triamcinolone injection Car Carbamazepine Strictly standardized mean difference TRA Trazodone OXC Oxcarbazepine PIR Piribedil RF Met Intra-tympanic methylprednisolone injection PRA Pramipexole RB business GaLid gabapentin plus intradermal lidocaine injection Tinnitus GRADE Grading of Recommendations Assessment Development and Evaluation |
| Zdroj: | EClinicalMedicine EClinicalMedicine, Vol 39, Iss, Pp 101080-(2021) |
| ISSN: | 2589-5370 |
| DOI: | 10.1016/j.eclinm.2021.101080 |
| Popis: | Background Although tinnitus has a prevalence between 20 and 42.8%, the currently recommended management for tinnitus, such as tinnitus support and psychologic therapies, are relatively time-consuming and expensive. Several new pharmacologic treatments designed for tinnitus patients without specific origin had been developed but their efficacy remains unclear. Methods The current Network Meta-Analysis (NMA) of randomised controlled trials (RCTs) was conducted to evaluate the efficacy of different pharmacologic treatments for tinnitus management in tinnitus patients without specific or treatable origin (i.e. primary tinnitus). Databases were searched from inception to April 5th, 2021. All network meta-analytic procedures were conducted under the frequentist model. We calculated the effect size of outcomes with different rating scales with standardized mean difference. PROSPERO registration: CRD42020177742. Findings Overall, 36 RCTs were included with 2,761 participants. The main results revealed that pharmacologic interventions with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) and those with anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) were associated with superior improvement in tinnitus severity and response rate compared to placebo/control. Oral amitriptyline were associated with the highest improvement in tinnitus severity and the fourth highest response rate. None of the investigated interventions was associated with different changes in quality of life compared to placebo/control. All the investigated treatments were associated with similar drop-out rate to placebo/control. Interpretation The current NMA suggests a potential role for treatments with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) or anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) as the preferable effective treatments for tinnitus without specific or treatable origin. Funding none. |
| Databáze: | OpenAIRE |
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