Cochrane Collaboration

About: Cochrane Collaboration is a nonprofit organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Systematic review & Randomized controlled trial. The organization has 1995 authors who have published 3928 publications receiving 382695 citations.

A systematic review of Cernilton for the treatment of benign prostatic hyperplasia

Abstract: Objective To systematically review the evidence for the clinical effects and safety of the rye-grass pollen extract (Cernilton) in men with symptomatic benign prostatic hyperplasia (BPH) Methods Trials were identified by searching Medline, specialized databases (EMBASE, Cochrane Library, Phytodok), bibliographies, and contacting relevant trialists and manufacturers Randomized or controlled clinical trials were included if: men with symptomatic BPH were treated with Cernilton; a control group received either placebo or pharmacological therapy; the treatment duration was 30 days; and clinical outcomes were reported Results In all, 444 men were enrolled in two placebo-controlled and two comparative trials lasting 12–24 weeks Three studies used a double-blind method although the concealment of treatment allocation was unclear in all Cernilton improved ‘self-rated urinary symptoms’ (the proportion reporting satisfactory or improving symptoms) vs placebo and another plant product, Tadenan The weighted mean (95% confidence interval) risk ratio (RR) for self-rated improvement vs placebo was 240 (121–475) and the weighted RR vs Tadenan was 142 (121–475) Cernilton reduced nocturia compared with placebo or Paraprost (a mixture of amino acids); against placebo, the weighted RR was 205 (141–300), and against Paraprost the weighted mean difference for nocturia was – 040 times per evening (– 073 to 007) Cernilton did not improve urinary flow rates, residual volume or prostate size compared with placebo or the comparative study agents Adverse events were rare and mild; the withdrawal rate for Cernilton was 48%, compared with 27% for placebo and 52% for Paraprost Conclusions The Cernilton trials analysed were limited by their short duration, limited number of enrolees, omissions in reported outcomes, and the unknown quality of the preparations used The comparative trials had no confirmed active control The available evidence suggests that Cernilton is well tolerated and modestly improves overall urological symptoms, including nocturia Additional randomized placebo and active-controlled trials are needed to evaluate the long-term clinical effectiveness and safety of Cernilton

Comparison of long versus short duration of anticoagulant therapy after a first episode of venous thromboembolism: a meta-analysis of randomized, controlled trials

Abstract: . Pinede L, Duhaut P, Cucherat M, Ninet J, Pasquier J, Boissel JP (Hopital Edouard Herriot and Unite de Pharmacologie Clinique, Lyon, France). J Intern Med 2000; 247: 553–562. Objective. To assess the length of oral anticoagulant therapy (short versus long duration) after a first episode of venous thromboembolism (VTE). Design. Meta-analysis of randomized controlled trials, comparing two durations of anticoagulation, identified in 1999 by a computerized search of the Cochrane Controlled Trial Register, Medline and Embase, completed by an extensive review of the references of pertinent articles. Setting and subjects. The meta-analysis was performed on literature data. Seven published controlled trials were included. Relative risks with 95% confidence intervals were computed using the relative risk logarithm method. Statistical significance was set up at 0.01 for the test of association. Main outcome measures. Outcomes are major haemorrhage and recurrence after a 12-month follow-up. Results. For the recurrence end-point (sample size of 2304 patients), a duration treatment of 12–24 weeks seems preferable to a 3–6 week regimen, with a relative risk (RR) of 0.60 (95% CI: 0.45–0.79, P < 0.001). For the major haemorrhage end-point (1823 patients), the RR is not significantly different from 1 (RR = 1.43, 95% CI: 0.51–4.01, P = 0.5). The results were similar for the subgroup ‘permanent risk factors’ or ‘idiopathic VTE’ (RR for recurrence = 0.48, 95% CI: 0.34–0.68, P < 0.001). The tendency was similar, although not reaching statistical significance, for the ‘temporary risk factors’ subgroup (RR for recurrence = 0.34, 95% CI: 0.13–0.93, P = 0.035). Conclusions. After a first episode of VTE, a long-term treatment regimen allows a significant reduction in the incidence of recurrences without increasing the incidence of bleeding events.

Designing and Reporting Clinical Trials on Treatments for Cutaneous Leishmaniasis

Abstract: Cutaneous leishmaniasis is considered to be one of the most neglected and serious parasitic infectious skin diseases in many developing countries. We have assessed the design and reporting of randomized, controlled trials evaluating treatments included in 2 Cochrane systematic reviews on cutaneous leishmaniasis. The analysis of the methodological quality identified some potential bias that can make it difficult to determine whether truly effective therapies exist for this disease. We found important weaknesses in the adequacy and transparency of randomization, loss of participants, causative Leishmania species, outcome measures, and follow-up times. Given these distorting effects on the evidence base, we propose guidelines for authors who wish to conduct clinical trials aimed at the development of effective therapies in cutaneous leishmaniasis. The recommendations in this report will hopefully deserve the attention of the World Health Organization and assist in the planning and prioritization of global strategies for improving the interpretation and replication of clinical research on cutaneous leishmaniasis.