Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide ...Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.展开更多
AIM: To systematically assess the efficacy and safety of β-adrenergic blocker plus 5-isosorbide mononitrate (BB + ISMN) and endoscopic band ligation (EBL) on prophylaxis of esophageal variceal rebleeding. METHODS: Ra...AIM: To systematically assess the efficacy and safety of β-adrenergic blocker plus 5-isosorbide mononitrate (BB + ISMN) and endoscopic band ligation (EBL) on prophylaxis of esophageal variceal rebleeding. METHODS: Randomized controlled trials (RCTs) comparing the efficacy and safety of BB + ISMN and EBL on prophylaxis of esophageal variceal rebleeding were gathered from Medline, Embase, Cochrane Controlled Trial Registry and China Biological Medicine database between January 1980 and August 2007. Data from five trials were extracted and pooled. The analyses of the available data using the Revman 4.2 software were based on the intention-to-treat principle. RESULTS: Four RCTs met the inclusion criteria. In comparison with BB + ISMN with EBL in prophylaxis of esophageal variceal rebleeding, there was no significant difference in the rate of rebleeding [relative risk (RR), 0.79; 95% CI: 0.62-1.00; P = 0.05], bleeding-related mortality (RR, 0.76; 95% CI: 0.31-1.42; P = 0.40), overall mortality (RR, 0.81; 95% CI: 0.61-1.08; P = 0.15) and complications (RR, 1.26; 95% CI: 0.93-1.70; P = 0.13). CONCLUSION:In the prevention of esophageal variceal rebleeding, BB + ISMN are as effective as EBL. There are few complications with the two treatment modalities. Both BB + ISMN and EBL would be considered as the first-line therapy in the prevention of esophageal variceal rebleeding.展开更多
Introduction Efective labour induction is marked by the onset of uterine contractions,progressive cervical dilation,and efacement,culminating in a vaginal birth without matemal or fetal complications.The success of in...Introduction Efective labour induction is marked by the onset of uterine contractions,progressive cervical dilation,and efacement,culminating in a vaginal birth without matemal or fetal complications.The success of induction largely depends on cenvical ripening.Isosorbide mononitrate(ISMN),a nitric axide donor,has shown potential for cervical ripening.faciitating labour induction by promoting cervical softening,efacement and dilation.This study evaluates the eficacy and safety of ISMN for cervical ripening before labour induction at term or post-term.Methods In this double-binded randomised controlled trial,160 primigravidas with an unripe cenix(Bishop score<6)undergoing labour induction at term or post-term were enolled.The ISMN group received 40mg of intravaginal ISMN in the posterior formix every 4hours,up to four doses.The placebo group received intravaginal pridoxine placebos on the same schedule.The primary outcome measured was the duration from labour induction to placental dllvery.Secondary outcomes included caesarean section rates.Results The ISMN group had a ststically significant shorter induction-to-delivery time compared with the placebo group(20.5714.64hours VS 23.15+5.13hours,p=0.01).Addionally,the time from the first dose to dellvery was reduced in the ISMN group.The caesarean section rate was lower in the ISMN group(29%VS 41%,p=0.17),though this dfferenrce was not stitially significant.Conclusion ISMN is an efctive and safe option for cerical ripening,poentally shortening the labour duration.展开更多
Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, ...Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials(RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography(ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.Results: Our study included 7 245 patients with angina(59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio(OR) = 4.824, 95% confidence interval(CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom(OR = 4.347, 95% CI = 3.635–5.198,P = 0.000), the efficacy of ECG(OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride(TG) [mean difference(MD) =-35.176, 95% CI =-37.439 to-32.912, P = 0.000], total cholesterol(TC)(MD =-24.296, 95% CI =-26.429 to-22.163, P = 0.000), the duration of angina attack(MD =-1.991, 95% CI =-2.349 to-1.633, P = 0.000), and the frequency of angina attack [standardized MD(SMD) =-2.840, 95% CI =-3.416 to-2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone(OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore,this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.展开更多
<strong>Objective</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> To compare the effective...<strong>Objective</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> To compare the effectiveness, safety and client acceptability of concurrent application of transcervical Foley catheter with vaginal ISMN-sustained release (SR) 60 mg tablet versus transcervical Foley catheter alone for pre-induction cervical ripening in women who are undergoing Vaginal birth after C-section (VBAC). </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A prospective single blind randomized control study w</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">as carried out including 110 pregnant women who had unfavorable cervix (MBS less than 6) at 40 weeks and 3 days of gestation. The two groups received either the trans-cervical foley catheter with a vaginal ISMN 60 mg sustained release (SR) tablet on 40 weeks and 3 days (Treatment arm 1, n = 57), or trans-cervical Foley alone on 40 weeks and 3 days (Treatment arm 2, n = 53). </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: At 40 weeks + 3 days gestation</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the mean age, mean parity and the mean modified Bishop Score (MBS) were comparable among the two treatment groups. Majority (n = 98, 89.1%) remained without spontaneously establishing labour at 24 hours of intervention. The difference in mean MBS at 40 weeks + 4 days (24-hours following the intervention) in the two groups was statistically not significant (P > 0.05). The group who received concurrent ISMN vaginal tablets achieved a higher number of successful VBACs (n = 33, 62.3%) over the group who received the Foley catheter only method (n = 29, 50.9%)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">however, not statistically significant (P > 0.05). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">The concurrent use of vaginal ISMN tablets (60</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mg SR) with a transcervical Foley catheter failed to show higher effectiveness compared to a transcervical Foley catheter alone as an induction method.</span></span></span>展开更多
基金The 2022 Ministry of Education General Project for Humanities and Social Sciences Research(Grant No.22YJAZH147)the General Subject of Guangzhou Philosophy and Social Science Development“14th Five-Year Plan”in 2023(Grant No.2023GZYB68)+2 种基金China University Industry-Academia-Research Innovation Fund-Huatong Guokang Medical Research Special Project(Grant No.2023HT017)2024 Guangdong Province General Project for the Planning of Philosophy and Social Sciences(Grant No.GD24CGL29)the Innovation Team Project of Colleges and Universities in Guangdong Province(Grant No.2022WCXTD011).
文摘Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.
文摘AIM: To systematically assess the efficacy and safety of β-adrenergic blocker plus 5-isosorbide mononitrate (BB + ISMN) and endoscopic band ligation (EBL) on prophylaxis of esophageal variceal rebleeding. METHODS: Randomized controlled trials (RCTs) comparing the efficacy and safety of BB + ISMN and EBL on prophylaxis of esophageal variceal rebleeding were gathered from Medline, Embase, Cochrane Controlled Trial Registry and China Biological Medicine database between January 1980 and August 2007. Data from five trials were extracted and pooled. The analyses of the available data using the Revman 4.2 software were based on the intention-to-treat principle. RESULTS: Four RCTs met the inclusion criteria. In comparison with BB + ISMN with EBL in prophylaxis of esophageal variceal rebleeding, there was no significant difference in the rate of rebleeding [relative risk (RR), 0.79; 95% CI: 0.62-1.00; P = 0.05], bleeding-related mortality (RR, 0.76; 95% CI: 0.31-1.42; P = 0.40), overall mortality (RR, 0.81; 95% CI: 0.61-1.08; P = 0.15) and complications (RR, 1.26; 95% CI: 0.93-1.70; P = 0.13). CONCLUSION:In the prevention of esophageal variceal rebleeding, BB + ISMN are as effective as EBL. There are few complications with the two treatment modalities. Both BB + ISMN and EBL would be considered as the first-line therapy in the prevention of esophageal variceal rebleeding.
文摘Introduction Efective labour induction is marked by the onset of uterine contractions,progressive cervical dilation,and efacement,culminating in a vaginal birth without matemal or fetal complications.The success of induction largely depends on cenvical ripening.Isosorbide mononitrate(ISMN),a nitric axide donor,has shown potential for cervical ripening.faciitating labour induction by promoting cervical softening,efacement and dilation.This study evaluates the eficacy and safety of ISMN for cervical ripening before labour induction at term or post-term.Methods In this double-binded randomised controlled trial,160 primigravidas with an unripe cenix(Bishop score<6)undergoing labour induction at term or post-term were enolled.The ISMN group received 40mg of intravaginal ISMN in the posterior formix every 4hours,up to four doses.The placebo group received intravaginal pridoxine placebos on the same schedule.The primary outcome measured was the duration from labour induction to placental dllvery.Secondary outcomes included caesarean section rates.Results The ISMN group had a ststically significant shorter induction-to-delivery time compared with the placebo group(20.5714.64hours VS 23.15+5.13hours,p=0.01).Addionally,the time from the first dose to dellvery was reduced in the ISMN group.The caesarean section rate was lower in the ISMN group(29%VS 41%,p=0.17),though this dfferenrce was not stitially significant.Conclusion ISMN is an efctive and safe option for cerical ripening,poentally shortening the labour duration.
文摘Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials(RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography(ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.Results: Our study included 7 245 patients with angina(59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio(OR) = 4.824, 95% confidence interval(CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom(OR = 4.347, 95% CI = 3.635–5.198,P = 0.000), the efficacy of ECG(OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride(TG) [mean difference(MD) =-35.176, 95% CI =-37.439 to-32.912, P = 0.000], total cholesterol(TC)(MD =-24.296, 95% CI =-26.429 to-22.163, P = 0.000), the duration of angina attack(MD =-1.991, 95% CI =-2.349 to-1.633, P = 0.000), and the frequency of angina attack [standardized MD(SMD) =-2.840, 95% CI =-3.416 to-2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone(OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore,this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.
文摘<strong>Objective</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> To compare the effectiveness, safety and client acceptability of concurrent application of transcervical Foley catheter with vaginal ISMN-sustained release (SR) 60 mg tablet versus transcervical Foley catheter alone for pre-induction cervical ripening in women who are undergoing Vaginal birth after C-section (VBAC). </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A prospective single blind randomized control study w</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">as carried out including 110 pregnant women who had unfavorable cervix (MBS less than 6) at 40 weeks and 3 days of gestation. The two groups received either the trans-cervical foley catheter with a vaginal ISMN 60 mg sustained release (SR) tablet on 40 weeks and 3 days (Treatment arm 1, n = 57), or trans-cervical Foley alone on 40 weeks and 3 days (Treatment arm 2, n = 53). </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: At 40 weeks + 3 days gestation</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the mean age, mean parity and the mean modified Bishop Score (MBS) were comparable among the two treatment groups. Majority (n = 98, 89.1%) remained without spontaneously establishing labour at 24 hours of intervention. The difference in mean MBS at 40 weeks + 4 days (24-hours following the intervention) in the two groups was statistically not significant (P > 0.05). The group who received concurrent ISMN vaginal tablets achieved a higher number of successful VBACs (n = 33, 62.3%) over the group who received the Foley catheter only method (n = 29, 50.9%)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">, </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">however, not statistically significant (P > 0.05). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">The concurrent use of vaginal ISMN tablets (60</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mg SR) with a transcervical Foley catheter failed to show higher effectiveness compared to a transcervical Foley catheter alone as an induction method.</span></span></span>
