Exploring Drug Re-Purposing for Treatment of Abdominal Aortic Aneurysms: a Systematic Review and Meta-analysis
Notice bibliographique
Résumé
WHAT THIS PAPER ADDSThis systematic review and meta-analysis found no supplement, medication, or drug class to effectively reduce the growth rate, risk of repair, or rupture rate of abdominal aortic aneurysms (AAAs).The potential benefits of metformin are under investigation in randomised controlled trials (RCTs), but publication bias may have influenced the positive finding in this study.Statins showed a significant reduction in growth rate, warranting consideration of a RCT.Recommended are improved measurements of exposure, doseeresponse curves, and utilisation of standard outcome measures (e.g., growth rate per group and mean difference) in observational studies related to the field of AAAs and medication.Objective: Large abdominal aortic aneurysms (AAAs) present a significant mortality risk.While numerous medical interventions have been proposed, no drugs have convincingly reduced AAA progression, rupture rates, or repair risk.This systematic review and meta-analysis aimed to assess the impact of re-purposed drugs or dietary supplements on slowing expansion rates, reducing the risk of rupture, or minimising the risk of repair for individuals with AAA.Methods: A systematic search was conducted in five databases.Both observational studies and randomised controlled trials were included.Unpublished data from two screening trials were incorporated.Risk of bias was assessed using the NewcastleeOttawa scale and revised Cochrane risk of bias tool.Meta-analyses were performed for each identified drug subclass and were stratified by overall risk of bias.Results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: Of 7 484 screened studies, 39 met the inclusion criteria.No studies on dietary supplements were included.A total of 84 cohorts were derived from the included studies, and twelve distinct drug groups underwent meta-analyses.Two drug groups, metformin and statins, were statistically significant in slowing AAA growth.No low risk of bias studies were included for these two drug groups, and the results had very high heterogeneity (I 2 > 80%).Both groups had a GRADE certainty of very low.Metformin, excluding high risk of bias studies, presented an estimated mean growth difference of AAA diameter between users and non-users of e0.73 mm/year, whilst statins had an overall estimated mean difference of e0.84 mm/year.Conclusion: This systematic review and meta-analysis suggests that metformin and statins may provide some effect in slowing AAA progression.However, no definitive evidence was found for any of the investigated drugs included in this study.Further research is needed to identify effective medical treatments for AAA progression with more robust methodology.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,033 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,020 | 0,046 |
| Bibliométrie | 0,007 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».