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SOYSAL, PINAR

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Author: Veronese, Nicola × Subject: systematic review ×

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    PublicationOpen Access
    An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of hydroxychloroquine and chloroquine therapy.
    (2020-12-11T00:00:00Z) Celotto, Stefano; Veronese, Nicola; Barbagallo, Mario; Ometto, Francesca; Smith, Lee; Pardhan, Shahina; Barnett, Yvonne; Ilie, Petre Cristian; Soysal, PINAR; Lagolio, Erik; Kurotschka, Peter Konstantin; Tonelli, Roberto; Demurtas, Jacopo; SOYSAL, PINAR
    Background & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. Results: From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases. Conclusions: There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy. Keywords: COVID-19; Chloroquine; Hydroxychloroquine; umbrella review.
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    PublicationOpen Access
    Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies
    (2019-10-01) Veronese, Nicola; Pizzol, Damiano; Demurtas, Jacopo; Smith, Lee; Sieber, Cornel; Strandberg, Timo; Bourdel-Marchasson, Isabelle; Sinclair, Alan; Petrovic, Mirko; Maggi, Stefania; SOYSAL, PINAR
    Abstract Purpose Sarcopenia and diabetes are two common conditions in older people. Some recent literature has proposed that these two conditions can be associated. However, to date, no attempt has been made to collate this literature. Therefore, we aimed to summarize the prevalence of sarcopenia in diabetes (and vice versa) and the prevalence of sarcopenia in people with diabetes complications, through a systematic review and meta-analysis. Methods Two authors searched major electronic databases from inception until March 2019 for case control/cross-sectional/longitudinal studies investigating sarcopenia and diabetes. The strength of the reciprocal associations between sarcopenia and diabetes was assessed through odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders, where possible. Results From 953 potential eligible articles, 20 were included in the systematic review, with 17 providing data for meta-analysis. Overall, 54,676 participants were included (mean age = 65.4 years). Diabetic participants had an increased prevalence of sarcopenia compared to controls (n = 10; OR = 1.635; 95% CI 1.204-2.220; p = 0.002; I-2 = 67%), whilst, after adjusting for potential confounders, sarcopenia was associated with an increased odds of having diabetes (OR = 2.067; 95% CI 1.396-3.624; p < 0.0001; I-2 = 0%). In 1868 diabetic participants with a complication, there was an increased prevalence of sarcopenia (OR = 2.446; 95% CI 1.839-3.254; p < 0.0001; I-2 = 0%), as compared with those with no complication. Very limited data existed regarding studies with a longitudinal design. Conclusions Our study suggests a bidirectional association between diabetes and sarcopenia, particularly when diabetic complications are present.