Objective To assess the efficacy and safety of glimepiride for type 2 diabetes mellitus (T2DM). Methods We searched the literature from PubMed, Ovid (All EBM Reviews), CNKI, Wanfang, VIP, CBM and other databases. Evaluating the quality of the study according to Cochrane systematic reviews, Meta-analysis was performed for the results of homogeneous studies by The Cochrane Collaboration’s software RevMan 5.0, and the heterogeneous data conducted a descriptive qualitative analysis. Results Six RCTs included in the analysis and Meta-analysis was not performed due to the insufficient data (for the median or standard deviation). Six RCTs are multi-center, randomized, double-blind, placebo-controlled trials. The results showed that glimepiride groups to reduce glycosylated hemoglobin, lower fasting and postprandial blood glucose, postprandial plasma insulin enhance the efficacy were statistically significant differences (Plt;0.05) compared to placebo groups. Four studies informed the impact of fasting plasma insulin (FI) and 3 studies showed that the glimepiride groups improving the fasting plasma insulin (FI) were statistically significant differences (Plt;0.05), but 1 study showed the two groups had no significant difference (Pgt;0.05). All studies showed minor adverse reactions of glimepiride. Conclusion Glimepiride can reduce the glycosylated hemoglobin, lower the fasting and postprandial blood glucose, improve fasting and postprandial plasma insulin for type 2 diabetes patients, and have minor adverse reactions. In a word, glimepiride is an effective and security sulfonylureas drug.
We reported one case of MTX-induced aplastic anemia and reviewed related literature to investigate the mechanism of action of MTX, and summarize the clinical feature, diagnostic criteria, risk factor, and interventions. These were hoped to arouse the attention of clinicians and clinical pharmacists, in order to effectively prevent, diagnose, and treat MTX-induced aplastic anemia.
Objective To evaluate the efficacy and safety of different doses of intravenous immunoglobulin (IVIG) in the treatment of relapsing-remitting multiple sclerosis (RRMS). Methods We searched for randomized controlled trials of different doses of IVIG in the treatment of RRMS. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses with The Cochrane Collaboration’s Revman 4.2.0 software. Results Three randomized controlled trials of different dose of IVIG in the treatment of RRMS were included. One was of high quality and the other two were of lower quality. Heterogeneity was identified in one study which reported IVIG in postpartum RRMS. Two studies reported the relapsefree rate and no significant difference was noted between IVIG and placebo. Two studies reported the annual relapse rate, and no significant difference was observed (OR -0.00, 95% CI -0.36 to 0.36, P=0.98). Two studies reported the MRI lesions, and no difference was identified, either. The incidence of adverse events was similar between IVIG and placebo. Conclusion There is insufficient evidence to support the dose-effect relationship of IVIG in the treatment of RRMS. Therefore, an individualized dosing regimen should be applied according to patients’ tolerance and economic status.