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2018 ; 8
(3
): e017883
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Effects of five types of selenium supplementation for treatment of Kashin-Beck
disease in children: a systematic review and network meta-analysis
#MMPMID29511006
Xie D
; Liao Y
; Yue J
; Zhang C
; Wang Y
; Deng C
; Chen L
BMJ Open
2018[Mar]; 8
(3
): e017883
PMID29511006
show ga
OBJECTIVE: To compare the effectiveness of five kinds of selenium supplementation
for the treatment of patients with Kashin-Beck disease, and rank these selenium
supplementations based on their performance. DESIGN: We searched for all
publications between 1 January 1966 and 31 March 2017 using seven electronic
databases. GRADE system to network meta-analyses (NMAs) was applied to rate the
quality of the evidence. We conducted a random effects model NMA in STATA 12.1 to
determine comparative effectiveness of each intervention. Rankings were obtained
by using the surface under the cumulative ranking curve (SUCRA) values and mean
ranks. RESULTS: A total of 15 randomised controlled trials involving 2931
patients were included. After assessment of the overall quality of the evidence,
we downgraded our primary outcomes from high to low or very low quality. NMAs
showed that all five kinds of selenium supplementation had higher metaphysis
X-ray improvement which were superior to placebo. Ranking on efficacy indicated
that selenium salt was ranked the highest, followed by sodium selenite + vitamin
E, selenium enriched yeast, sodium selenite and then sodium selenite + vitamin C.
CONCLUSIONS: Based on the results of NMA, all five types of selenium supplements
are more effective than placebo and so that selenium supplementation is of help
in repairing metaphyseal lesions. Since the overall quality of the evidence was
low or very low, the SUCRA values may be misleading and should be considered
jointly with the The Grading of Recommendations Assessment, Development and
Evaluation (GRADE) confidence in the estimates for each comparison. The quality
of the evidence is insufficient to draw a conclusion about what method of
selenium supplementation is most effective. PROSPERO REGISTRATION NUMBER:
CRD42016051874.