Alprazolam para el temblor esencial
Información
- DOI:
- https://doi.org/10.1002/14651858.CD009681.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 06 diciembre 2015see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Trastornos del movimiento
- Copyright:
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- Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
EB: protocol and review editing, literature searching, study selection, quality assessment, data extraction.
AN: protocol and review editing.
GQ: literature searching, quality assessment, data extraction.
CC: protocol editing, quality assessment, study selection.
GF: protocol editing, editing and revising of the review.
MZ: protocol editing, revising of the review.
Sources of support
Internal sources
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None, Other
External sources
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None, Other
Declarations of interest
The original review was not compliant with Cochrane Commercial Sponsorship policy for the following reasons:
CC received financial support from Merz (manufacturer of Botulinum toxin), Teva (manufacturer of propranolol) and other pharma companies.
AN received financial support from Lundbeck (manufacturer of benzodiazepine clobazam) and UCB (manufacturer of levetiracetam).
MZ received financial support from Novartis (manufacturer of propranolol [Sandoz]), UCB, Lundbeck and other pharma companies.
Conversely, the current update have a majority of authors and lead author free of conflicts as the lead author and all the other authors have not received payments from manufacturers or marketers of the interventions of interest or potential comparators within the 3 years of the decision to update and none of the authors are/were employed by a company who has a real or potential financial interest in the findings of the review and/or have a relevant patent.
Acknowledgements
The review authors would like to express their gratitude to Cristina Sampaio and to Ricardo M. Fernandes for precious comments and guidance provided during development of the final version of this review.
Version history
| Published | Title | Stage | Authors | Version |
| 2015 Dec 06 | Alprazolam for essential tremor | Review | Elisa Bruno, Alessandra Nicoletti, Graziella Quattrocchi, Graziella Filippini, Mario Zappia, Carlo Colosimo | |
| 2012 Mar 14 | Alprazolam for essential tremor | Protocol | Elisa Bruno, Alessandra Nicoletti, Graziella Quattrocchi, Carlo Colosimo, Graziella Filippini, Mario Zappia | |
Differences between protocol and review
In an attempt to provide a standardised and reliable assessment of the quality of the evidence on study outcomes, we decided to use the GRADE evidence profile, a systematic and explicit system for grading the evidence according to four quality categories. We reported results obtained through this approach in summary of findings Table 1.
Methods for future updates
We did not perform two preplanned analysis because data were insufficient. These analyses will be eventually implemented, if possible, in future updates of the review.
Methods for analysing continuous data: Scales used to assess tremor in most studies are continuous. We will transform ordinal scales with enough categories to continuous scales by assigning a score to each grade, so that we can express the intervention effect as a difference in means, or as a standardised mean difference (SMD). In the case of an ordinal scale with few categories, we will combine data from adjacent categories into two categories, and will use methods for binary data such as odds ratios (ORs) or risk differences (RDs) to evaluate intervention effects.
Sensitivity analysis: We will undertake sensitivity analyses to assess the robustness of results to fixed‐effect versus random‐effects assumptions, and inclusion or exclusion of studies at high risk of bias (i.e. inadequate allocation concealment and lack of a blinded outcome assessor). We will use best‐ and worst‐case scenarios when taking missing data into account.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Aged; Humans; Middle Aged;
PICO
Flowchart of the literature search on alprazolam and essential tremor.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1: Comparison for efficacy, Outcome 1: Clinical rating scale
| Alprazolam for essential tremor | ||||||
| Patient or population: patients with essential tremor | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | Number of participants | Quality of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Assumed risk | Corresponding risk | |||||
| Control | Alprazolam | |||||
| Tremor severity | Mean tremor severity in control groups was | Mean tremor severity in intervention group was | 24 | ⊕⊝⊝⊝ | ||
| Withdrawals due to adverse events Follow‐up: 2 weeks | None | None | 24 (1 study) | ⊕⊝⊝⊝ | ||
| Quality of life Investigator global assessment Scale from 1 to 7 Follow‐up: 2 weeks | Mean score in the control group was 3.83 points | Mean score in the intervention group was 1.16 lower (0.17 to 2.15 lower) | 24 (1 study) | ⊕⊝⊝⊝ | ||
| Quality of life Investigator global assessment Scale from 1 to 7 Follow‐up: 2 weeks | Mean score in the control group was 3.5points | Mean score in the intervention group was 0.67 lower (0.27 to 1.61 lower) | 24 (1 study) | ⊕⊝⊝⊝ | ||
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) | ||||||
| GRADE Working Group grades of evidence | ||||||
| aDowngraded by 2 levels for very serious risk of bias: allocation and blinding methods not described (selection bias); number of adverse events in the placebo group not reported (reporting bias); essential tremor diagnostic criteria applied to participants not reported; patient exclusion and inclusion criteria not specified. An arbitrary, not validated, clinical rating scale for tremor severity was used for assessment of tremor. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Clinical rating scale Show forest plot | 1 | 24 | Mean Difference (IV, Fixed, 95% CI) | ‐0.75 [‐0.83, ‐0.67] |
