Adjuvant steroid treatment following Kasai portoenterostomy and clinical outcomes of biliary atresia patients: an updated meta-analysis

Zhang, Minzhong; Xun, Pengcheng; He, Ka; Cai, Wei

doi:10.1007/s12519-016-0052-8

Cited by 22 publications

(19 citation statements)

References 36 publications

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“…Actual evidence for adjuvant therapy post‐KPE to try and improve results appears limited . Nevertheless, corticosteroids and ursodeoxycholic acid have been shown to improve some measures of outcome and are widely used. Still, BA remains the commonest indication for pediatric liver transplantation .…”

Section: Introductionmentioning

confidence: 99%

Biliary atresia: a scientometric analysis of the global research architecture and scientific developments

Friedmacher

Ford

Davenport

2019

J Hepato Biliary Pancreat

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Biliary atresia (BA) is a rare cholangiopathy of largely unknown etiology and unpredictable outcome. There has been an increasing number of BA-related publications, which may challenge researchers to determine their actual scientific value. This study aimed to evaluate the global research activity and developments relating to BA using a combination of scientometric methodologies and visualization tools. A comprehensive search strategy for the Web of Science TM database was designed to obtain bibliographic data on scientific BA publications for the timespan 1900-2018. Research output of countries, institutions, individual authors and collaborative networks was analyzed. Semi-qualitative research measures including citation rate and h-index were assessed. Choropleth mapping and network diagrams were used to visualize results. In total, 4,459 publications on BA were identified (88.5% in English), originating from 63 countries. The largest number was published by the USA (n = 991; 22.2%), Japan (n = 667; 15.0%) and the UK (n = 294; 6.6%). The USA combined the highest number of cooperation articles (n = 140). The most productive collaborative network was established between the USA and Canada (n = 17). Scientific papers from the UK received the highest average citation rate (16.7), whereas the USA had the highest country-specific h-index (59). Eighty-eight (2.0%) items were published under the auspices of multicenter consortiums and registries. The most productive institutions and authors were based in the USA, the UK, Japan, France, Canada and Taiwan. BArelated research has constantly been progressing, becoming more multidisciplinary but with main research endeavors concentrated in a few high-income countries. Studies into pathogenesis of BA remain uncommon, but are sorely needed to foster true scientific progress with this rare disease. Hence, international collaborative and translational research should be strengthened to allow further evolution in this field.

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Section: Introductionmentioning

confidence: 99%

Biliary atresia: a scientometric analysis of the global research architecture and scientific developments

Friedmacher

Ford

Davenport

2019

J Hepato Biliary Pancreat

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“…A recent meta-analysis weakly supports this conclusion. 13 Researchers in retrospective cohort studies using a comparison with historical controls are subject to selection bias and changes in clinical care that undermine the reliability of drawing a causal inference about the role of methylprednisolone. 14 On the basis of available data, it is fair to say that we just do not know whether the postoperative use of corticosteroids provides any meaningful clinical benefit or whether the suggestion of short-term improvement in jaundice-free survival is offset by the potential for serious risks (some of which are difficult to assess in a short-term study, such as impact on neurodevelopmental outcome).…”

Section: Robert "Skip" Nelson MD Phd Commentsmentioning

confidence: 99%

“…However, it is reasonable to ask whether placebo exposure can be minimized by using a different control group or study design. There are different adjuvant treatments that might impact postoperative inflammation and thus jaundicefree survival with the native liver 13 but none of these have been studied adequately to serve as an active control arm. Unless a study is designed to demonstrate the superiority of the new intervention over an existing treatment, an active controlled design requires an analysis in which a noninferiority margin is used, which can only be established by conducting previous placebo-controlled trials.…”

Section: Robert "Skip" Nelson MD Phd Commentsmentioning

confidence: 99%

The Potential Benefits of Research May Justify Certain Research Risks

2019

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US regulations allow institutional review boards to approve pediatric clinical trials only when the risks are minimal or (in some cases) a minor increase over minimal, or when the risks are justified by a potential for direct benefit to the participants. But how should an institutional review board determine if the risks of pediatric clinical trials are justified by a potential for participant benefit? In this Ethics Rounds article, we consider which potential benefits can justify which research risks with a focus on randomized clinical trials.

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“…Manifestasi pada atresia bilier terjadi akibat inflamasi dan kolangiopati yang menyebabkan obstruksi lumen duktus bilier ekstrahepatik dan menyebabkan ikterus kolestasis pada minggu awal kehidupan. 14 8 Zhang MZ (2017) 10 Chen Y (2015) 9…”

Section: Efektivitas Pemberian Steroid Pada Pasien Atresia Bilier Pasunclassified

Pemberian Steroid untuk Meningkatkan Bilirubin Clearance pada Pasien dengan Atresia Bilier Pasca Prosedur Kasai

Oswari¹,

Lidvihurin

2019

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Latar belakang. Insidensi atresia bilier di dunia berkisar antara 5-37 kasus/100.000 kelahiran hidup. Setelah prosedur Kasai, bilirubin clearance hanya tercapai 50%. Pemberian steroid diharapkan dapat mengurangi inflamasi, tetapi keuntungan penggunaan steroid belum dapat dibuktikan. Oleh karena itu, dilakukan laporan kasus berbasis bukti untuk menilai bilirubin clearance setelah pemberian steroid pada pasien dengan atresia bilier pasca prosedur Kasai.Tujuan. Mengetahui efektivitas pemberian steroid untuk meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosesur Kasai.Metode. Pencarian studi dilakukan melalui penelusuran tiga pangkalan data ilmiah, yaitu PubMed, Scopus, dan Cochrane. Setelah dilakukan penapisan judul dan abstrak, didapatkan 3 studi yang akan ditelaah secara kritis meliputi validitas, kepentingan, dan kemamputerapan menggunakan Oxford Center of Evidenced-Based Medicine 2011.Hasil. Telaah kritis dilakukan pada 3 studi dan didapatkan hasil yang valid, penting, dan mampu diterapkan. Ketiga studi tersebut menjukkan pemberian steroid dosis sedang-tinggi efektif dalam meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosedur Kasai dibandingkan dengan plasebo atau terapi nonsteroid, terutama pada anak yang berusia kurang dari 70 hari saat prosedur Kasai dilakukan. Pemberian steroid dapat meningkatkan bilirubin clearance setelah follow up jangka pendek (≤1 tahun).Kesimpulan. Pemberian steroid dosis sedang-tinggi efektif dalam meningkatkan bilirubin clearance pada pasien atresia bilier pasca prosedur Kasai yang berusia kurang dari 70 hari saat prosedur dilakukan.

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Adjuvant steroid treatment following Kasai portoenterostomy and clinical outcomes of biliary atresia patients: an updated meta-analysis

Cited by 22 publications

References 36 publications

Biliary atresia: a scientometric analysis of the global research architecture and scientific developments

Biliary atresia: a scientometric analysis of the global research architecture and scientific developments

The Potential Benefits of Research May Justify Certain Research Risks

Pemberian Steroid untuk Meningkatkan Bilirubin Clearance pada Pasien dengan Atresia Bilier Pasca Prosedur Kasai

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