Show simple item record

dc.contributor.authorCao, Zuwei
dc.contributor.authorYue, Fengjuan
dc.contributor.authorHuang, Wei
dc.contributor.authorRajenderkumar, Deepak
dc.contributor.authorZhao, Fei
dc.date.accessioned2019-05-21T09:06:46Z
dc.date.available2019-05-21T09:06:46Z
dc.date.issued2019-04-26
dc.identifier.citationCao, Z., Yue, F., Huang, W., Rajenderkumar, D. and Zhao, F., (2019) 'Different medications for the treatment of Ménière's disease by intratympanic injection: a systematic review and network meta‐analysis', Clinical Otolaryngology. https://doi.org/10.1111/coa.13350
dc.identifier.issn1749-4486
dc.identifier.urihttp://hdl.handle.net/10369/10513
dc.descriptionArticle published in Clinical Otolaryngology. available at https://doi.org/10.1111/coa.13350en_US
dc.description.abstractBackground: It is generally accepted that intratympanic injection provides an effective approach to manage severe vertigo in Ménière’s disease. Although there are several medications available, that which is the most effective is still subject to debate. Objective: To assess the effectiveness and safety of the different medications used in treatment of Ménière’s disease by intratympanic injection using a network meta-analysis. Methods: PubMed, EMBASE, CINAHL and CENTRAL were searched. Only randomized controlled trials that compared the effectiveness of medications used for intratympanic injection to treat Ménière’s disease with each other or a placebo were included. The primary outcome assessed was the effectiveness of medication in the management of vertigo symptoms. The effectiveness was expressed in terms of risk ratio (RR) with a 95% credible interval (CrI) for individual studies analyzed. Network meta-analyses was performed by Stata version 15.0 using the network package. Results: Nine studies involving 314 patients treated with 5 different medications were included in the present analysis. Number of injections given varied from 1 to 10 and follow-up time from 3 to 28 months. When compared to each other or to a placebo, Gentamicin was found to be the most efficacious medication, followed by Methylprednisolone, Latanoprost, Dexamethasone and Ganciclovir in order of effectiveness. However, no significant difference in efficacy was found between Gentamicin and Methylprednisolone when outcomes from studies with a follow-up time equal to or more than 24 months were analyzed. It was not possible to conduct subgroup and sensitivity analysis because of the limited number of studies that were included. Conclusion: All medications are more effective than a placebo in the treatment of Ménière’s disease by intratympanic injection. According to the SUCRA, Gentamicin ranked the most effective, with Gentamicin and Methylprednisolone equally effective in the long-term. When the potential risk of hearing loss induced by Gentamicin is taken into consideration, Methylprednisolone may be the best choice for treatment of Ménière’s disease by intratympanic injection.en_US
dc.description.sponsorshipThis work was supported by National Natural Science Foundation of China (Grant Number:81860871) and Guizhou Provincial Science and Technology Department (Grant Number: QKHJC [2017]1113 and QKHPTRC [2018]5764-14).en_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofseriesClinical Otolaryngology;
dc.titleDifferent medications for the treatment of Ménière’s disease by intratympanic injection: a systematic review and network meta-analysisen_US
dc.typeArticleen_US
dc.identifier.doihttps://doi.org/10.1111/coa.13350
dcterms.dateAccepted2019-04-18
rioxxterms.funderCardiff Metropolitan Universityen_US
rioxxterms.identifier.projectCardiff Metropolian (Internal)en_US
rioxxterms.versionAMen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/under-embargo-all-rights-reserveden_US
rioxxterms.licenseref.startdate2019-05-21
rioxxterms.freetoread.startdate2020-04-26
rioxxterms.funder.project37baf166-7129-4cd4-b6a1-507454d1372een_US


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record