PDF(Pubmed)
Abstract：
The purpose of this systematic review is to collect, appraise, and synthesize existing evidence from systematic reviews and meta-analyses (SRs/MAs) on the effectiveness of tolvaptan for water retention in heart failure.
A comprehensive literature search was performed on PubMed, EMBASE, web of science, Cochrane reviews for SRs/Mas published between the databases\' establishment to November 17, 2021. All the records were managed with Endnote 20. Standardized forms were used to extract data. Revman 5.3 was used to make forest plots to show the characteristics of outcomes. The methodological and evidence quality were respectively evaluated by AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews 2) and GRADE (Grading of Recommendation of Assessment, Development, and Evaluation) system.
A total of 9 SRs/Mas between 2015 to 2020 met inclusion criteria. Serum sodium concentration and urine output were considered as primary outcomes and body weight change and all-cause mortality as second outcomes. Through conducting forest plots, it appeared that tolvaptan brought more positive effect than conventional therapies. It was pessimistic when it comes to the quality of the 9 studies. all the 9 articles were rated as low-quality because AMSTAR 2 evaluation showed that they each had at least one critical item (items 2, 4, 7, 9, 11, 13 and 15) defect. Besides, every article had a few non-critical item defects too. The result of GRADE assessment was not optimistic, so the overall quality of the evidences was low as well.
Tolvaptan can be recommended for water retention in HF patients, but more evidence is needed.
A comprehensive literature search was performed on PubMed, EMBASE, web of science, Cochrane reviews for SRs/Mas published between the databases\' establishment to November 17, 2021. All the records were managed with Endnote 20. Standardized forms were used to extract data. Revman 5.3 was used to make forest plots to show the characteristics of outcomes. The methodological and evidence quality were respectively evaluated by AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews 2) and GRADE (Grading of Recommendation of Assessment, Development, and Evaluation) system.
A total of 9 SRs/Mas between 2015 to 2020 met inclusion criteria. Serum sodium concentration and urine output were considered as primary outcomes and body weight change and all-cause mortality as second outcomes. Through conducting forest plots, it appeared that tolvaptan brought more positive effect than conventional therapies. It was pessimistic when it comes to the quality of the 9 studies. all the 9 articles were rated as low-quality because AMSTAR 2 evaluation showed that they each had at least one critical item (items 2, 4, 7, 9, 11, 13 and 15) defect. Besides, every article had a few non-critical item defects too. The result of GRADE assessment was not optimistic, so the overall quality of the evidences was low as well.
Tolvaptan can be recommended for water retention in HF patients, but more evidence is needed.
摘要：
目的：本系统综述的目的是收集，评价,并综合来自系统评价和荟萃分析（SRs/MAs）的现有证据，证明托伐普坦对心力衰竭水潴留的有效性。
方法：在PubMed上进行了全面的文献检索，EMBASE,科学网,Cochrane评论在数据库建立至2021年11月17日之间发布的SRs/Mas。所有记录均使用Endnote20进行管理。使用标准化表格来提取数据。Revman5.3用于制作森林地块，以显示结果的特征。方法和证据质量分别通过AMSTAR-2（评估系统评论的计量工具2）和GRADE（评估建议的分级，发展,和评估)系统。
结果：2015年至2020年期间共有9个SRs/Mas符合纳入标准。血清钠浓度和尿量被认为是主要结果，体重变化和全因死亡率被认为是第二结果。通过进行森林地块，看来托伐普坦比传统疗法带来了更积极的效果。当涉及到9项研究的质量时，它是悲观的。所有9篇文章都被评为低质量,因为AMSTAR2评估显示,每篇文章都有至少一个关键项目(项目2,4,7,9,11,13和15)缺陷.此外,每篇文章都有一些非关键项目缺陷。等级评定结果不容乐观,所以证据的整体质量也很低。
结论：托伐普坦可用于心力衰竭患者的水潴留，但需要更多的证据.
方法：在PubMed上进行了全面的文献检索，EMBASE,科学网,Cochrane评论在数据库建立至2021年11月17日之间发布的SRs/Mas。所有记录均使用Endnote20进行管理。使用标准化表格来提取数据。Revman5.3用于制作森林地块，以显示结果的特征。方法和证据质量分别通过AMSTAR-2（评估系统评论的计量工具2）和GRADE（评估建议的分级，发展,和评估)系统。
结果：2015年至2020年期间共有9个SRs/Mas符合纳入标准。血清钠浓度和尿量被认为是主要结果，体重变化和全因死亡率被认为是第二结果。通过进行森林地块，看来托伐普坦比传统疗法带来了更积极的效果。当涉及到9项研究的质量时，它是悲观的。所有9篇文章都被评为低质量,因为AMSTAR2评估显示,每篇文章都有至少一个关键项目(项目2,4,7,9,11,13和15)缺陷.此外,每篇文章都有一些非关键项目缺陷。等级评定结果不容乐观,所以证据的整体质量也很低。
结论：托伐普坦可用于心力衰竭患者的水潴留，但需要更多的证据.
