Efetividade da pentoxifilina no tratamento da surdez súbita: revisão sistemática e metanálise proporcional
Arquivos
Data
2019-08-01
Autores
Vanette, Cintia
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: a surdez súbita, também denominada perda auditiva neurossensorial súbita idiopática (PANSI), é definida como perda neurossensorial de no mínimo 30 dB, em pelo menos três frequências audiométricas contíguas, instalada em até 72 horas. A etiologia da doença não está claramente definida e não há consenso na literatura sobre o melhor tratamento. Objetivo: avaliar a efetividade da pentoxifilina no tratamento da surdez súbita. Métodos: foram realizadas revisão sistemática e metanálise proporcional de estudos que avaliaram o tratamento de surdez súbita, os quais foram encontrados nas seguintes bases de dados eletrônicos: Pubmed, Embase, Lilacs, Cochrane, Scopus, Web of Science. Os critérios de elegibilidade foram: estudos experimentais ou observacionais (com no mínimo 5 pacientes cada estudo) que tenham avaliado tratamentos para surdez súbita. Os desfechos foram recuperação total e parcial da audição e presença de efeitos adversos. Para análise dos dados, utilizou-se o progama Stats Direct, versão 3.0.121. Resultados: dos 160 artigos encontrados, 128 foram selecionados para leitura de título e resumo, dos quais 104 foram excluídos. Foram eleitos para leitura na íntegra 24 artigos, sendo que 9 foram incluídos na revisão, totalizando 787 pacientes. Os tratamentos usados foram pentoxifilina, corticoide sistêmico e intratimpânico, betaistina, metilcolabamina, Ginkgo biloba. Os pacientes foram divididos em grupos: grupo 1 usou pentoxifilina isolada ou associada a outras drogas e grupo 2 não usou pentoxifilina. Para o desfecho recuperação total da audição, o grupo 1 apresentou proporção de 37%, com intervalo de confiança (IC) variando de 25 a 51% e o grupo 2 apresentou proporção de 25%, com IC entre 18 e 34%. Para o desfecho recuperação parcial da audição, o grupo 1 apresentou proporção de 33%, com IC variando de 22 a 45% e o grupo 2 apresentou proporção de 23%, com IC entre 16 e 30%. Na interpretação da metanálise, não houve diferença estatisticamente significativa entre os grupos, uma vez que houve sobreposição dos IC. Conclusão: Não houve diferença na recuperação da audição, tanto total quanto parcial, nem na presença de efeitos adversos, entre o subgrupo que utilizou pentoxifilina no tratamento de surdez súbita e o subgrupo que não utilizou.
Introduction: Sudden deafness, also called idiopathic sudden sensorineural hearing loss, is defined as sensorineural loss of at least 30 dB in at least three contiguous audiometric frequencies, installed within 72 hours. The etiology of the disease is not clearly defined and there is no consensus in the literature on the best treatment. Objective: to evaluate the effectiveness of pentoxifylline in the treatment of sudden deafness. Methods: a systematic review and proportional meta-analysis of studies evaluating the treatment of sudden deafness were performed, which were found in the following electronic databases: Pubmed, Embase, Lilacs, Cochrane, Scopus, Web of Science. Eligibility criteria were: experimental or observational studies (with at least 5 patients per study) who evaluated treatments for sudden deafness. The outcomes were total and partial recovery of hearing and presence of adverse effects. Stats Direct, version 3.0.121 was used to analyze the data. Results: of the 160 articles found, 128 were selected for title and abstract reading, of which 104 were excluded. Twenty-four articles were selected for reading, of which 9 were included in the review, totaling 787 patients. The treatments used were pentoxifylline, systemic and intratympanic corticoid, betaystine, methylcolabamine, Ginkgo biloba. Patients were divided into groups: group 1 used pentoxifylline alone or associated to other drugs and group 2 did not use pentoxifylline. For the outcome of total hearing recovery, group 1 presented a 37% proportion, with a confidence interval (CI) ranging from 25 to 51% and group 2 presented a proportion of 25%, with CI between 18 and 34%. For the outcome partial recovery of hearing, group 1 presented a proportion of 33%, with CI ranging from 22 to 45% and group 2 presented a proportion of 23%, with CI between 16 and 30%. In the interpretation of the meta-analysis, there was no statistically significant difference between the groups. Conclusion: There was no difference in hearing recovery, either total or partial, or in the presence of adverse effects, between the subgroup that used pentoxifylline in the treatment of sudden deafness and the subgroup that did not use.
Introduction: Sudden deafness, also called idiopathic sudden sensorineural hearing loss, is defined as sensorineural loss of at least 30 dB in at least three contiguous audiometric frequencies, installed within 72 hours. The etiology of the disease is not clearly defined and there is no consensus in the literature on the best treatment. Objective: to evaluate the effectiveness of pentoxifylline in the treatment of sudden deafness. Methods: a systematic review and proportional meta-analysis of studies evaluating the treatment of sudden deafness were performed, which were found in the following electronic databases: Pubmed, Embase, Lilacs, Cochrane, Scopus, Web of Science. Eligibility criteria were: experimental or observational studies (with at least 5 patients per study) who evaluated treatments for sudden deafness. The outcomes were total and partial recovery of hearing and presence of adverse effects. Stats Direct, version 3.0.121 was used to analyze the data. Results: of the 160 articles found, 128 were selected for title and abstract reading, of which 104 were excluded. Twenty-four articles were selected for reading, of which 9 were included in the review, totaling 787 patients. The treatments used were pentoxifylline, systemic and intratympanic corticoid, betaystine, methylcolabamine, Ginkgo biloba. Patients were divided into groups: group 1 used pentoxifylline alone or associated to other drugs and group 2 did not use pentoxifylline. For the outcome of total hearing recovery, group 1 presented a 37% proportion, with a confidence interval (CI) ranging from 25 to 51% and group 2 presented a proportion of 25%, with CI between 18 and 34%. For the outcome partial recovery of hearing, group 1 presented a proportion of 33%, with CI ranging from 22 to 45% and group 2 presented a proportion of 23%, with CI between 16 and 30%. In the interpretation of the meta-analysis, there was no statistically significant difference between the groups. Conclusion: There was no difference in hearing recovery, either total or partial, or in the presence of adverse effects, between the subgroup that used pentoxifylline in the treatment of sudden deafness and the subgroup that did not use.
Descrição
Palavras-chave
surdez súbita, perda auditiva neurossensorial súbita idiopática, pentoxifilina, sudden deafness, sudden idiopathic sensorineural hearing loss, pentoxifylline