Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis
ObjectiveTo compare the efficacy and safety of pharmaceutical interventions to prevent etomidate-induced myoclonus (EIM), providing the optimal intervention for clinical practice.MethodsPubMed, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1507616/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832590641921523712 |
|---|---|
| author | Lu Chen Lu Chen Pengxiang Zhou Pengxiang Zhou Zhengqian Li Ziyang Wu Suodi Zhai Suodi Zhai |
| author_facet | Lu Chen Lu Chen Pengxiang Zhou Pengxiang Zhou Zhengqian Li Ziyang Wu Suodi Zhai Suodi Zhai |
| author_sort | Lu Chen |
| collection | DOAJ |
| description | ObjectiveTo compare the efficacy and safety of pharmaceutical interventions to prevent etomidate-induced myoclonus (EIM), providing the optimal intervention for clinical practice.MethodsPubMed, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge Infrastructure, WanFang database, and SinoMed database were searched from the inception to sixth May 2024. We included randomized controlled trials (RCTs) comparing intravenous pharmaceutical interventions to prevent EIM with placebo, no intervention, or another pharmaceutical intervention.ResultsForty-eight RCTs involving 4,768 participants randomly assigned to 20 intravenous pharmaceutical interventions and normal saline were included. Granisetron (odds ratio [OR]: 0.01, 95% confidence interval [CI]: 0.00 to 0.06; one study, moderate certainty) and oxycodone (OR: 0.01, 95% CI: 0.00 to 0.05; three studies, low certainty) was found to be the most effective intervention in reducing the risk of EIM and ranked highest in terms of surface under the cumulative ranking values (94.4% and 89.7% probability), followed by sufentanil (76.5% probability) and remifentanil (74.8% probability). Further subgroup analysis of EIM at mild, moderate-to-severe levels highlighted granisetron and oxycodone as the favorable interventions for reducing EIM. For safety outcomes, the synthesized results indicated that opioids were associated with a higher risk of adverse events (AEs), while no severe AEs were observed.ConclusionModerate-to-low certainty evidence indicated that granisetron and oxycodone may represent the optimal intervention for reducing the risk of overall and moderate-to-severe EIM with a reasonable safety profile, providing the potential interventions for clinical practice.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=291275. |
| format | Article |
| id | doaj-art-ed18ca55ce8c4fd7b7e7e18d29418e64 |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-ed18ca55ce8c4fd7b7e7e18d29418e642025-01-23T09:42:15ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.15076161507616Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysisLu Chen0Lu Chen1Pengxiang Zhou2Pengxiang Zhou3Zhengqian Li4Ziyang Wu5Suodi Zhai6Suodi Zhai7Department of Pharmacy, Peking University Third Hospital, Beijing, ChinaDepartment of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong, ChinaDepartment of Pharmacy, Peking University Third Hospital, Beijing, ChinaInstitute for Drug Evaluation, Peking University Health Science Center, Beijing, ChinaDepartment of Anesthesiology, Peking University Third Hospital, Beijing, ChinaDepartment of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Pharmacy, Peking University Third Hospital, Beijing, ChinaInstitute for Drug Evaluation, Peking University Health Science Center, Beijing, ChinaObjectiveTo compare the efficacy and safety of pharmaceutical interventions to prevent etomidate-induced myoclonus (EIM), providing the optimal intervention for clinical practice.MethodsPubMed, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge Infrastructure, WanFang database, and SinoMed database were searched from the inception to sixth May 2024. We included randomized controlled trials (RCTs) comparing intravenous pharmaceutical interventions to prevent EIM with placebo, no intervention, or another pharmaceutical intervention.ResultsForty-eight RCTs involving 4,768 participants randomly assigned to 20 intravenous pharmaceutical interventions and normal saline were included. Granisetron (odds ratio [OR]: 0.01, 95% confidence interval [CI]: 0.00 to 0.06; one study, moderate certainty) and oxycodone (OR: 0.01, 95% CI: 0.00 to 0.05; three studies, low certainty) was found to be the most effective intervention in reducing the risk of EIM and ranked highest in terms of surface under the cumulative ranking values (94.4% and 89.7% probability), followed by sufentanil (76.5% probability) and remifentanil (74.8% probability). Further subgroup analysis of EIM at mild, moderate-to-severe levels highlighted granisetron and oxycodone as the favorable interventions for reducing EIM. For safety outcomes, the synthesized results indicated that opioids were associated with a higher risk of adverse events (AEs), while no severe AEs were observed.ConclusionModerate-to-low certainty evidence indicated that granisetron and oxycodone may represent the optimal intervention for reducing the risk of overall and moderate-to-severe EIM with a reasonable safety profile, providing the potential interventions for clinical practice.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=291275.https://www.frontiersin.org/articles/10.3389/fphar.2024.1507616/fullBayesian analysisetomidatemyoclonusrandomized controlled trialsnetwork meta-analysis |
| spellingShingle | Lu Chen Lu Chen Pengxiang Zhou Pengxiang Zhou Zhengqian Li Ziyang Wu Suodi Zhai Suodi Zhai Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis Frontiers in Pharmacology Bayesian analysis etomidate myoclonus randomized controlled trials network meta-analysis |
| title | Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis |
| title_full | Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis |
| title_fullStr | Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis |
| title_full_unstemmed | Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis |
| title_short | Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis |
| title_sort | comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate induced myoclonus a systematic review and bayesian network meta analysis |
| topic | Bayesian analysis etomidate myoclonus randomized controlled trials network meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1507616/full |
| work_keys_str_mv | AT luchen comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT luchen comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT pengxiangzhou comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT pengxiangzhou comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT zhengqianli comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT ziyangwu comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT suodizhai comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis AT suodizhai comparativeefficacyandsafetyof20intravenouspharmaceuticalinterventionforpreventionofetomidateinducedmyoclonusasystematicreviewandbayesiannetworkmetaanalysis |