Drug efficacy in treating stable angina pectoris: a protocol for network meta-analysis of randomised controlled trials

Abstract

IntroductionThere were 11 pairwise meta-analysis on the efficacy of β-blockers (including atenolol, propranolol, bisoprolol, metoprolol and nadolol), calcium channel blockers (including amlodipine, diltiazem, felodipine, nifedipine and verapamil), and nitrates (including isosorbide dinitrate, isosorbide mononitrate and nitroglycerin) in treating stable angina pectoris. No network meta-analytic study has been published to evaluate the efficacies of these antianginal drugs. Current clinical guidelines (eg, National Institute of Health and Care Excellence (NICE) clinical guideline 126) are only based on the findings of limited clinical trials and pairwise meta-analysis. This study aims to fill this gap of research by conducting a Bayesian network meta-analysis to compare all these antianginal drugs.Methods and analysesRandomised controlled trials (RCT) on the drug therapy of stable angina pectoris with multiple outcome measures, selected from symptomatic relief, ECG tests, exercise tests, heart rates and blood pressures, etc, will be included. Overall effect sizes will be represented as mean differences with 95% credible intervals (CrI) for continuous outcome data and as ORs with 95% CrI for dichotomous outcome data. Bayesian network meta-analysis by WinBUGS will be conducted to compare the efficacies of these drugs. Sensitivity analysis on the quality of RCTs and subgroup analysis on the category of included drugs will be performed.Ethics and disseminationEthical approval is not required because this study includes no confidential personal data and interventions on the patients. Network meta-analysis is based on the RCT reports of eligible drugs in treating stable angina pectoris. The results of this study will be disseminated by an open access and peer-reviewed publication.Trial registration numberPROSPERO CRD42014007113.

Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

“…The protocol of systematic reviews and meta-analyses that reported the designs and methodologies before conduct would enhance the study designs and transparency, hence the reliability and reproducibility of evidence [21]. Our study was impartial, valid and reliable in compliant with the pre-speci ed protocol [24,25]. Previous network meta-analyses [19,20] without protocols did not identify the limitations which included PRISMAdiscrepancy, inappropriate model selection based on heterogeneity test, inadequate statistical analysis, and lack of evidence assessment (Supplement 12).…”

“…Therefore, their results and conclusions [19,20] were biased and untrustworthy. Our study conducted a rigorous and comprehensive network meta-analysis in accordance with the PRISMA statements [21][22][23] and the pre-speci ed protocol [24,25]. We employed the random-effects model for data synthesis with an assumption of different populations among eligible RCTs [29].…”

Comparative efficacy of selective serotonin reuptake inhibitors (SSRI) in treating major depressive disorder: a protocol for network meta-analysis of randomised controlled trials

“…The overall effect sizes will be determined as mean difference for continuous outcomes and ORs for dichotomous outcomes with their 95% credible intervals. Network meta-analysis based on the Bayesian hierarchical model 31 32 of included RCTs will be conducted. The differences in clinical and methodological characteristics among RCTs will be explored by subgroup analysis and sensitivity analysis.…”

Towards Drug Repurposing in Cancer Cachexia: Potential Targets and Candidates

“…Nadolol Nadolol, a β 3 -adrenoceptor antagonist approved by the FDA, is also used in diverse treatments, such as those for angina pectoris, infantile hemangioma, and hypertension [112][113][114]. Cutaneous vascular lesion, bradycardia, hypotension, and hypoglycemia are the more common adverse events correlated with this drug [115].…”