دورية أكاديمية
أعرض في EDS

Disease-Modifying Antirheumatic Drugs in the Treatment of Autoimmune Inner Ear Disease: A Systematic Review and Meta-Analysis of Auditory and Vestibular Outcomes.

التفاصيل البيبلوغرافية
العنوان: Disease-Modifying Antirheumatic Drugs in the Treatment of Autoimmune Inner Ear Disease: A Systematic Review and Meta-Analysis of Auditory and Vestibular Outcomes.
المؤلفون: Gordis TM; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC., Shah SR, Ward C, Rizk HG
المصدر: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2023 Jan 01; Vol. 44 (1), pp. 2-9.
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100961504 Publication Model: Print Cited Medium: Internet ISSN: 1537-4505 (Electronic) Linking ISSN: 15317129 NLM ISO Abbreviation: Otol Neurotol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2001-
مواضيع طبية MeSH: Antirheumatic Agents*/therapeutic use , Autoimmune Diseases*/drug therapy , Labyrinth Diseases*/drug therapy, Humans ; Methotrexate/therapeutic use ; Etanercept ; Rituximab/therapeutic use
مستخلص: Objective: To answer the following question: In patients with primary autoimmune inner ear disease (AIED), (population) what impact do disease-modifying antirheumatic agents (DMARDs) (intervention) when compared with no treatment or corticosteroids (comparison) have on auditory and vestibular outcomes (outcome)?
Study Design: Systematic review and meta-analysis.
Data Sources: According to PRISMA guidelines, PubMed, Scopus, CINAHL, and Cochrane Library databases were searched from inception to March 10, 2022.
Study Selection: Studies of patients receiving DMARDs for the treatment of AIED were selected for review. Case reports, phase I/II trials, studies of patients with secondary AIED, and studies of AIED patients receiving solely corticosteroids were excluded.
Data Extraction: Primary outcomes were pure-tone audiometry and speech discrimination scores at baseline and after DMARD treatment. Secondary outcomes were rates of subjective audiovestibular complaints and rates of adverse reactions. No objective vestibular outcomes underwent meta-analysis.
Data Synthesis: Mean differences were calculated using RevMan 5.4. Heterogeneity was assessed with the Q test and I2 statistic. Pooled prevalence rates of audiovestibular symptoms were expressed as a percentage with 95% confidence intervals.
Results: Ten studies with a total of 187 patients were included. Treatments included methotrexate, etanercept, azathioprine, anakinra, cyclophosphamide, rituximab, and infliximab. Mean treatment duration was 10.8 ± 22.2 months and mean follow-up was 13.7 ± 8.1 months. The pure-tone audiometry and speech discrimination scores mean differences between baseline and post-DMARD were -2.1 [-4.1, -0.1] dB and 13.9 [8.5, 19.4] %, respectively. Seven studies reported 38 adverse events, four of which were classified as serious.
Conclusion: DMARDs showed statistically significant improvement in auditory outcomes, as well as subjective symptoms, with relatively low rates of adverse events. They warrant further exploration to better compare with corticosteroids.
Competing Interests: The authors disclose no conflicts of interest.
(Copyright © 2022, Otology & Neurotology, Inc.)
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المشرفين على المادة: 0 (Antirheumatic Agents)
YL5FZ2Y5U1 (Methotrexate)
OP401G7OJC (Etanercept)
4F4X42SYQ6 (Rituximab)
تواريخ الأحداث: Date Created: 20221212 Date Completed: 20221214 Latest Revision: 20230821
رمز التحديث: 20230822
DOI: 10.1097/MAO.0000000000003743
PMID: 36509432
قاعدة البيانات: MEDLINE
الوصف
تدمد:1537-4505
DOI:10.1097/MAO.0000000000003743