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Treatments for alopecia areata, alopecia totalis and alopecia universalis

There is no good trial evidence that any treatments provide long‐term benefit to patients with alopecia areata, alopecia totalis and alopecia universalis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Treatments for female pattern hair loss

The most common type of hair loss in women is FPHL, also known as androgenic alopecia. Unlike men, women do not go bald, but have hair thinning predominantly over the top and front of the head. It can occur at any time, from puberty until later in life. However, it occurs more frequently in postmenopausal women.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Irinotecan chemotherapy combined with fluoropyrimidines versus irinotecan alone for overall survival and progression‐free survival in patients with advanced and/or metastatic colorectal cancer

Patients with inoperable colorectal cancer (CRC) are likely to receive chemotherapy drugs as their primary treatment. Irinotecan (IRI) and fluoropyrimidines are two such drugs widely used in this setting, either alone or as part of multi‐drug chemotherapy treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Cyclophosphamide for treating rheumatoid arthritis

This review included 31 patients taking cyclophosphamide and 39 patients taking placebo. Patients taking cyclophosphamide had improved tender and swollen joint scores. Patients receiving placebo were six times more likely to discontinue treatment because of lack of treatment effect than patients receiving cyclophosphamide. Withdrawals from adverse reactions were higher in the cyclophosphamide group. Side effects from cyclophosphamide included hemorrhagic cystitis, nausea, vomiting, leucopenia, thrombocytopenia, alopecia, amenorrhea and herpes zoster infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Treatment for people with lupus nephritis

Lupus nephritis is an inflammatory condition affecting the kidneys which is caused by systemic lupus erythematosus (SLE), an autoimmune disease that is more common among women. About half of all people with SLE develop lupus nephritis, and of these about 1/10 experience chronic kidney disease or kidney failure. Treatment aims to delay disease progression and achieve remission by stabilising and improving kidney function and minimising side effects. For about the past 30 years, standard treatment for lupus nephritis has focused on a combination of cyclophosphamide (an alkylating agent) and corticosteroids.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Chemotherapy alone versus endocrine therapy alone for metastatic breast cancer

Breast cancer is the most common cancer in women. If the cancer has spread beyond the breast (metastatic disease), treatments include chemotherapy (anti‐cancer drugs) and endocrine therapy (also known as hormonal treatment). Endocrine therapy is mainly given to women whose cancer is determined to be hormone‐responsive, that is, where hormone receptors (oestrogen or progesterone receptors) are expressed in the tumour cells. The aim of this review was to see if starting treatment with chemotherapy or starting treatment with endocrine therapy provides more benefit in terms of survival, response to treatment, toxicity from treatment and quality of life. Ten eligible studies were identified, eight of which provided information on response to treatment (in 817 patients) and six on overall survival (in 692 patients). Trials were generally old (published between 1963 and 1995) and small in size (median of 70 women, range 50 to 226 women in each trial) and were of modest quality. The types of chemotherapy used were reasonably conventional by today's standards; the endocrine therapies varied considerably.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

The use of the immunosuppressive drug mitoxantrone (MX) in people with multiple sclerosis (MS)

This is an update of the Cochrane review "Mitoxantrone for multiple sclerosis" (published on Cochrane Database of Systematic Reviews 2013, Issue 5).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

A modified formulation of doxorubicin for the treatment of newly diagnosed ovarian cancer

PLD is an improved formulation of an anticancer drug that has been around since the 1960s. When used with carboplatin (carbo), it has been shown to improve survival in women with epithelial ovarian cancer (EOC) that has come back (relapsed) six months or longer after the last platinum (carbo)‐based treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The effect of the immunosuppressive drug cyclophosphamide in people with multiple sclerosis

MS is a chronic disease of the nervous system affecting young and middle‐aged adults. MS is supposed to be related to the immune system. CFX is an immunosuppressive drug used for various autoimmune diseases. As its use for MS is controversial, the Authors of this review aimed to assess CFX efficacy for patients with progressive MS. Among the pertinent literature, only five studies met the inclusion criteria of minimum methodological quality , with a total of 90 MS patients treated with CFX.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Chemotherapy for men with prostate cancer who have not responded to hormone therapy

Men with advanced prostate cancer and painful bone metastases are a difficult group of patients to treat. Data from recent randomised trials of chemotherapy suggest an improvement in overall survival, pain relief, and quality of life with this form of therapy. Side effects are common and can be severe. Chemotherapy offers a treatment option for men with hormone‐refractory prostate cancer (HRPC), but the decision to treat should be carefully considered by the patient and clinician. More studies are needed to find new and better agents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Methotrexate for treatment of chronic active ulcerative colitis

Ulcerative colitis is a long‐term (chronic) inflammatory bowel disease characterized by pains (abdominal cramping), a need to rush to the toilet to pass feces (fecal urgency) and bloody diarrhea.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Addition of drugs to a chemotherapy regimen for metastatic breast cancer

Advanced breast cancer is treatable but not curable. Women with advanced breast cancer have an average survival of about 2 years, although some women may live for many years beyond this. Therefore, it is important to investigate different chemotherapy treatment options. Chemotherapy can improve survival for women with metastatic breast cancer, but it can also cause toxic side effects. Of interest is whether there is any benefit by adding additional chemotherapy drugs, particularly given the potential harm caused by more dose‐intensive treatment. This review investigated the value of adding one or more chemotherapy drugs to a chemotherapy regimen. We found that the addition of chemotherapy drug/s to a regimen caused greater shrinkage of the tumour seen with imaging but increased toxicity. There is insufficient evidence to determine if there is an impact on time to disease progression and overall survival.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

The use of hormonal treatment in relapsed epithelial ovarian cancer

Epithelial ovarian cancer (EOC) arises from the cells covering the surface of the ovary. The majority of women with this type of cancer present with advanced stage disease at diagnosis. The initial treatment involves surgery (removal of as much disease as possible) followed by chemotherapy. In some cases chemotherapy is given to shrink the cancer before surgery is undertaken. Irrespective of the type of treatment received, cancer will return at some point in some women. Treatment following relapse, usually involves chemotherapy. The choice of chemotherapy depends on the cancer‐free period from the initial chemotherapy (platinum drugs). If relapse occurs after six months from finishing initial treatment with chemotherapy, women are treated with platinum drugs. However if the cancer recurs within six months, women are treated with non‐platinum drugs, since platinum drugs would be unlikely to work again. Eventually, the majority of women develop resistance to any chemotherapeutic drug. Some women also suffer from drug‐related side effects and poor quality of life (QoL) as a result of treatment. Therefore, there is a need for newer drug treatments with fewer side effects. In this context, hormone therapy have been tried. Luteinising hormone releasing hormone (LHRH) agonist are hormones that work by telling the pituitary gland located in the brain to stop producing this hormone and as a result the tumour cells in the ovary, which may be dependent on this hormone, cannot be stimulated. LHRH agonists have been used in relapsed EOC and some studies have shown low toxicity with these hormones.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Gemcitabine for unresectable, advanced or metastatic bladder cancer

When bladder cancer has spread beyond the bladder and is unresectable or metastatic, the possibility of cure is severely diminished. Treatment at this stage of the disease aims to reduce the disease‐related symptoms and to improve quality of life. Chemotherapy is the main treatment offered to patients with this condition and one drug that has recently shown activity is gemcitabine. This review aimed to determine the effectiveness and toxicity of gemcitabine by looking at the evidence published from randomised clinical trials. Patients receiving gemcitabine combined with cisplatin had a similar overall survival but less toxicity when compared to the well‐established chemotherapeutic treatment of MVAC (methotrexate, vinblastine, doxorubicin, cisplatin). This suggests that gemcitabine plus cisplatin may be considered an alternative chemotherapy schedule to MVAC for advanced bladder cancer but the evidence is limited to one trial only. For patients who have poor kidney function or poor performance status the combination of gemcitabine plus carboplatin may be considered.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Leflunomide for the treatment of rheumatoid arthritis

‐ Leflunomide probably improves pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Preoperative chemotherapy for women with operable breast cancer

Chemotherapy for patients with early stage breast cancer has been shown to improve survival. Traditionally, this therapy is given once the patient has undergone surgery. Since the early 1980's, interest has risen in administrating chemotherapy before surgery (known as preoperative or neoadjuvant chemotherapy) based on good results achieved in patients with locally advanced disease (cancer which is larger than 5cm and/or has spread to surrounding tissue or lymph nodes, or both). The rationale for preoperative chemotherapy is that an early introduction of systemic treatment (treatment that affects the whole body) will result in a decrease in the size of the tumour, hence making it possible to do more breast‐conserving surgery. For this review, we investigated the effect of the difference in timing of chemotherapy treatment for patients with early stage or operable disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Methotrexate for keeping ulcerative colitis inactive   

We reviewed the evidence about the effects and safety of methotrexate for maintaining remission in patients with ulcerative colitis, with the medical literature up to June 26, 2014.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Chinese medicinal herbs for the treatment of side‐effects from chemotherapy in breast cancer patients

Chinese medicinal herbs (CMH) include any mixture of herbal compounds and decoction (the process by which herbs are boiled and remaining liquid used for health purposes), including the development of herbal formulae and injections, and capsules. Although CMH are used to counteract the side effects of chemotherapy (cancer treatment with chemical agents that are selectively destructive to malignant cells and tissues) in patients being treated for cancer, the evidence for their use for women with breast cancer has not been ascertained. The purpose of this systematic review was to evaluate the effectiveness and safety of CMH in alleviating chemotherapy‐induced short term side effects for women either undergoing chemotherapy or having recently undergone chemotherapy. Short term side effects are those that occur during the course of the treatment and generally resolve within months of the completion of the therapy and affect up to 60% of patients.They include nausea and vomiting, mucositis (inflammation of the mucous membranes lining the digestive tract from the mouth down to the anus caused by chemotherapy); neutropenia (a decrease in white blood cells caused by chemotherapy); myelosuppression (a condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets), and fatigue (loss of energy and tirdness). This review found seven randomised studies involving 542 breast cancer patients addressing this question. These studies used six different herbal remedies to treat the side effects of chemotherapy, all used CMH plus chemotherapy as the intervention compared with chemotherapy alone. The results suggest that using Chinese herbs in conjunction with chemotherapy or CHM alone may be beneficial in terms of improvement in marrow suppression and Immune sytstem, and may improve overall state of quality of life. However, further trials are needed before the effects of TCM for people with breast cancer can be evaluated with any real confidence.There was no evidence of any harms of CMH.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Selenium supplements for the prevention of cardiovascular disease

Use of selenium enriched foods, supplements and fertilizers has increased in recent years in many countries because of the perception that selenium may reduce the risk of cardiovascular disease and other chronic conditions. Therefore, it is important to understand the effects of a nutrient that is frequently supplemented on common conditions such as cardiovascular disease or diabetes. This review assessed the effects of providing selenium supplements to healthy adults in order to prevent the occurrence of cardiovascular disease. Whether selenium supplements would reduce the risk factors associated with heart disease was also examined. We found 12 trials in which 19,715 healthy adults were randomly assigned to receive selenium supplements or placebo. The vast majority of participants involved in these trials were male individuals from the US, where people are already well nourished and take large amounts of selenium from natural foods. Overall, the included studies were regarded as at low risk of bias. In our review, providing selenium supplements to healthy adults did not prevent the occurrence of major cardiovascular disease. The increased risk of developing type 2 diabetes when taking selenium supplements, as suggested in some previous studies, could not definitely be ruled out in our review. In summary, this review of the available evidence to date suggests that taking selenium supplements is neither beneficial nor harmful for cardiovascular disease, but it is probably unnecessary for those who are already well nourished and who take large amounts of selenium from natural foods.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Five‐alpha‐reductase inhibitor drugs, such as finasteride or dutasteride, reduce the risk prostate cancer in men who have routine prostate cancer screening

Five‐alpha‐reductase inhibitor drugs have potential as chemopreventive agents. Reduction of prostate cancer was similar between racial groups, age groups (aged 65 years or older compared to younger age groups) and those with or without a family history of prostate cancer. Reduction of prostate cancer was limited to men who had a baseline prostate specific antigen (PSA) values less than 4.0 ng/mL. However, use of five‐alpha‐reductase inhibitors may also increase the risk of high‐grade prostate cancer in men undergoing prostate cancer screening. Future research is needed to determine if the use of five‐alpha‐reductase inhibitors can reduce prostate cancer in men who are not being regularly screened for prostate cancer. Future studies should also determine whether five‐alpha‐reductase inhibitors can reduce death and prostate cancer death and further evaluate the risk of developing high‐grade prostate cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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