Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis
Objective The objective of this meta-analysis was to compare the efficacy and drug safety of tolvaptan with placebo for autosomal dominant polycystic kidney disease (ADPKD). Methods The PubMed, Embase, and Cochrane Library databases were searched from inception to September 10, 2021. Eligible studie...
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| Veröffentlicht in: | International urology and nephrology 2023-03, Vol.55 (3), p.631-640 |
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| creator | Lu, Jingkui Xu, Wei Gong, Lifeng Xu, Min Tang, Weigang Jiang, Wei Xie, Fengyan Ding, Liping Qian, Xiaoli |
| description | Objective
The objective of this meta-analysis was to compare the efficacy and drug safety of tolvaptan with placebo for autosomal dominant polycystic kidney disease (ADPKD).
Methods
The PubMed, Embase, and Cochrane Library databases were searched from inception to September 10, 2021. Eligible studies comparing tolvaptan and placebo in the treatment of patients with ADPKD were included. Data were analysed using Review Manager Version 5.3.
Results
Thirteen studies involving 3575 patients were included in the meta-analysis. Compared with placebo, tolvaptan had a better effect on delaying eGFR decline (MD 1.27, 95% CI 1.24–1.29,
P
|
| doi_str_mv | 10.1007/s11255-022-03353-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9958178</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2779702946</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-f523579f47be2f0eaaad6056281ee347c2823d12f91996d6eed1d8eda30d07063</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhSMEoqXwAiyQJTZsAv5J4oQFEqrKj1SJDaytufa41yWxg-1clKfglXG4pRQWrDzSfHN8jk5VPWX0JaNUvkqM8batKec1FaIVdX-vOmWtFDVv--b-nfmkepTSNaV06Cl9WJ2IjnbD0LHT6seFtU6DXgl4QxJYzCsJluQwHmDO4MkBY1oSmUfQuAvEeZL3SHJEyBP6vMEzZFfGRL67vCew5JDCBCMxYXIeCjOHcdVryk6Tr854XIlxCSHhawJkwgw1eBjX5NLj6oGFMeGTm_es-vLu4vP5h_ry0_uP528va93IJte25aKVg23kDrmlCACmo23He4YoGql5z4Vh3A6s5DQdomGmRwOCGippJ86qN0fdedlNaHSxH2FUc3QTxFUFcOrvjXd7dRUOahjansm-CLy4EYjh24Ipq8kljeMIHsOSFJeMCSqbZijo83_Q67DEEnij5CApH5rNET9SOoaUItpbM4yqrW917FuVvtWvvtXm4tndGLcnvwsugDgCqaz8FcY_f_9H9idftbnf</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2779702946</pqid></control><display><type>article</type><title>Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lu, Jingkui ; Xu, Wei ; Gong, Lifeng ; Xu, Min ; Tang, Weigang ; Jiang, Wei ; Xie, Fengyan ; Ding, Liping ; Qian, Xiaoli</creator><creatorcontrib>Lu, Jingkui ; Xu, Wei ; Gong, Lifeng ; Xu, Min ; Tang, Weigang ; Jiang, Wei ; Xie, Fengyan ; Ding, Liping ; Qian, Xiaoli</creatorcontrib><description><![CDATA[Objective
The objective of this meta-analysis was to compare the efficacy and drug safety of tolvaptan with placebo for autosomal dominant polycystic kidney disease (ADPKD).
Methods
The PubMed, Embase, and Cochrane Library databases were searched from inception to September 10, 2021. Eligible studies comparing tolvaptan and placebo in the treatment of patients with ADPKD were included. Data were analysed using Review Manager Version 5.3.
Results
Thirteen studies involving 3575 patients were included in the meta-analysis. Compared with placebo, tolvaptan had a better effect on delaying eGFR decline (MD 1.27, 95% CI 1.24–1.29,
P
< 0.01) and TKV increase (MD − 3.01, 95% CI − 3.55 to − 2.47,
P
< 0.01) in ADPKD treatment. Additionally, tolvaptan reduced the incidence of complications such as renal pain (OR 0.71, 95% CI 0.58–0.87,
P
< 0.01), urinary tract infection (OR 0.69, 95% CI 0.54–0.89,
P
< 0.01), haematuria (OR 0.68, 95% CI 0.51–0.89,
P
< 0.01), and hypertension (OR 0.66, 95% CI 0.52–0.82,
P
< 0.01). However, tolvaptan was associated with a higher incidence rate of adverse events such as thirst (OR 8.48 95% CI 4.53–15.87,
P
< 0.01), polyuria (OR 4.71, 95% CI 2.17–10.24,
P
< 0.01), and hepatic injury (OR 4.56, 95% CI 2.51–8.29,
P
< 0.01).
Conclusion
Tolvaptan can delay eGFR decline and TKV increase and reduce complications such as renal pain, urinary tract infection, haematuria, and hypertension in the treatment of ADPKD. However, tolvaptan increases the adverse effects of thirst, polyuria and hepatic injury.]]></description><identifier>ISSN: 1573-2584</identifier><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-022-03353-8</identifier><identifier>PMID: 36069961</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Abdominal Pain ; Antidiuretic Hormone Receptor Antagonists - therapeutic use ; Benzazepines - adverse effects ; Epidermal growth factor receptors ; Hematuria ; Hematuria - drug therapy ; Humans ; Hypertension ; Hypertension - complications ; Kidney diseases ; Liver ; Medicine ; Medicine & Public Health ; Meta-analysis ; Nephrology ; Nephrology - Review ; Pain ; Pharmacovigilance ; Placebos ; Polycystic kidney ; Polycystic Kidney, Autosomal Dominant ; Polyuria ; Polyuria - complications ; Thirst ; Tolvaptan - therapeutic use ; Urinary tract ; Urinary tract diseases ; Urinary tract infections ; Urogenital system ; Urology</subject><ispartof>International urology and nephrology, 2023-03, Vol.55 (3), p.631-640</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-f523579f47be2f0eaaad6056281ee347c2823d12f91996d6eed1d8eda30d07063</citedby><cites>FETCH-LOGICAL-c474t-f523579f47be2f0eaaad6056281ee347c2823d12f91996d6eed1d8eda30d07063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11255-022-03353-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11255-022-03353-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36069961$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, Jingkui</creatorcontrib><creatorcontrib>Xu, Wei</creatorcontrib><creatorcontrib>Gong, Lifeng</creatorcontrib><creatorcontrib>Xu, Min</creatorcontrib><creatorcontrib>Tang, Weigang</creatorcontrib><creatorcontrib>Jiang, Wei</creatorcontrib><creatorcontrib>Xie, Fengyan</creatorcontrib><creatorcontrib>Ding, Liping</creatorcontrib><creatorcontrib>Qian, Xiaoli</creatorcontrib><title>Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><addtitle>Int Urol Nephrol</addtitle><description><![CDATA[Objective
The objective of this meta-analysis was to compare the efficacy and drug safety of tolvaptan with placebo for autosomal dominant polycystic kidney disease (ADPKD).
Methods
The PubMed, Embase, and Cochrane Library databases were searched from inception to September 10, 2021. Eligible studies comparing tolvaptan and placebo in the treatment of patients with ADPKD were included. Data were analysed using Review Manager Version 5.3.
Results
Thirteen studies involving 3575 patients were included in the meta-analysis. Compared with placebo, tolvaptan had a better effect on delaying eGFR decline (MD 1.27, 95% CI 1.24–1.29,
P
< 0.01) and TKV increase (MD − 3.01, 95% CI − 3.55 to − 2.47,
P
< 0.01) in ADPKD treatment. Additionally, tolvaptan reduced the incidence of complications such as renal pain (OR 0.71, 95% CI 0.58–0.87,
P
< 0.01), urinary tract infection (OR 0.69, 95% CI 0.54–0.89,
P
< 0.01), haematuria (OR 0.68, 95% CI 0.51–0.89,
P
< 0.01), and hypertension (OR 0.66, 95% CI 0.52–0.82,
P
< 0.01). However, tolvaptan was associated with a higher incidence rate of adverse events such as thirst (OR 8.48 95% CI 4.53–15.87,
P
< 0.01), polyuria (OR 4.71, 95% CI 2.17–10.24,
P
< 0.01), and hepatic injury (OR 4.56, 95% CI 2.51–8.29,
P
< 0.01).
Conclusion
Tolvaptan can delay eGFR decline and TKV increase and reduce complications such as renal pain, urinary tract infection, haematuria, and hypertension in the treatment of ADPKD. However, tolvaptan increases the adverse effects of thirst, polyuria and hepatic injury.]]></description><subject>Abdominal Pain</subject><subject>Antidiuretic Hormone Receptor Antagonists - therapeutic use</subject><subject>Benzazepines - adverse effects</subject><subject>Epidermal growth factor receptors</subject><subject>Hematuria</subject><subject>Hematuria - drug therapy</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Kidney diseases</subject><subject>Liver</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Nephrology</subject><subject>Nephrology - Review</subject><subject>Pain</subject><subject>Pharmacovigilance</subject><subject>Placebos</subject><subject>Polycystic kidney</subject><subject>Polycystic Kidney, Autosomal Dominant</subject><subject>Polyuria</subject><subject>Polyuria - complications</subject><subject>Thirst</subject><subject>Tolvaptan - therapeutic use</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urogenital system</subject><subject>Urology</subject><issn>1573-2584</issn><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1TAQhSMEoqXwAiyQJTZsAv5J4oQFEqrKj1SJDaytufa41yWxg-1clKfglXG4pRQWrDzSfHN8jk5VPWX0JaNUvkqM8batKec1FaIVdX-vOmWtFDVv--b-nfmkepTSNaV06Cl9WJ2IjnbD0LHT6seFtU6DXgl4QxJYzCsJluQwHmDO4MkBY1oSmUfQuAvEeZL3SHJEyBP6vMEzZFfGRL67vCew5JDCBCMxYXIeCjOHcdVryk6Tr854XIlxCSHhawJkwgw1eBjX5NLj6oGFMeGTm_es-vLu4vP5h_ry0_uP528va93IJte25aKVg23kDrmlCACmo23He4YoGql5z4Vh3A6s5DQdomGmRwOCGippJ86qN0fdedlNaHSxH2FUc3QTxFUFcOrvjXd7dRUOahjansm-CLy4EYjh24Ipq8kljeMIHsOSFJeMCSqbZijo83_Q67DEEnij5CApH5rNET9SOoaUItpbM4yqrW917FuVvtWvvtXm4tndGLcnvwsugDgCqaz8FcY_f_9H9idftbnf</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Lu, Jingkui</creator><creator>Xu, Wei</creator><creator>Gong, Lifeng</creator><creator>Xu, Min</creator><creator>Tang, Weigang</creator><creator>Jiang, Wei</creator><creator>Xie, Fengyan</creator><creator>Ding, Liping</creator><creator>Qian, Xiaoli</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230301</creationdate><title>Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis</title><author>Lu, Jingkui ; Xu, Wei ; Gong, Lifeng ; Xu, Min ; Tang, Weigang ; Jiang, Wei ; Xie, Fengyan ; Ding, Liping ; Qian, Xiaoli</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-f523579f47be2f0eaaad6056281ee347c2823d12f91996d6eed1d8eda30d07063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Pain</topic><topic>Antidiuretic Hormone Receptor Antagonists - therapeutic use</topic><topic>Benzazepines - adverse effects</topic><topic>Epidermal growth factor receptors</topic><topic>Hematuria</topic><topic>Hematuria - drug therapy</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Kidney diseases</topic><topic>Liver</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Nephrology</topic><topic>Nephrology - Review</topic><topic>Pain</topic><topic>Pharmacovigilance</topic><topic>Placebos</topic><topic>Polycystic kidney</topic><topic>Polycystic Kidney, Autosomal Dominant</topic><topic>Polyuria</topic><topic>Polyuria - complications</topic><topic>Thirst</topic><topic>Tolvaptan - therapeutic use</topic><topic>Urinary tract</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urogenital system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, Jingkui</creatorcontrib><creatorcontrib>Xu, Wei</creatorcontrib><creatorcontrib>Gong, Lifeng</creatorcontrib><creatorcontrib>Xu, Min</creatorcontrib><creatorcontrib>Tang, Weigang</creatorcontrib><creatorcontrib>Jiang, Wei</creatorcontrib><creatorcontrib>Xie, Fengyan</creatorcontrib><creatorcontrib>Ding, Liping</creatorcontrib><creatorcontrib>Qian, Xiaoli</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Jingkui</au><au>Xu, Wei</au><au>Gong, Lifeng</au><au>Xu, Min</au><au>Tang, Weigang</au><au>Jiang, Wei</au><au>Xie, Fengyan</au><au>Ding, Liping</au><au>Qian, Xiaoli</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><addtitle>Int Urol Nephrol</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>55</volume><issue>3</issue><spage>631</spage><epage>640</epage><pages>631-640</pages><issn>1573-2584</issn><issn>0301-1623</issn><eissn>1573-2584</eissn><abstract><![CDATA[Objective
The objective of this meta-analysis was to compare the efficacy and drug safety of tolvaptan with placebo for autosomal dominant polycystic kidney disease (ADPKD).
Methods
The PubMed, Embase, and Cochrane Library databases were searched from inception to September 10, 2021. Eligible studies comparing tolvaptan and placebo in the treatment of patients with ADPKD were included. Data were analysed using Review Manager Version 5.3.
Results
Thirteen studies involving 3575 patients were included in the meta-analysis. Compared with placebo, tolvaptan had a better effect on delaying eGFR decline (MD 1.27, 95% CI 1.24–1.29,
P
< 0.01) and TKV increase (MD − 3.01, 95% CI − 3.55 to − 2.47,
P
< 0.01) in ADPKD treatment. Additionally, tolvaptan reduced the incidence of complications such as renal pain (OR 0.71, 95% CI 0.58–0.87,
P
< 0.01), urinary tract infection (OR 0.69, 95% CI 0.54–0.89,
P
< 0.01), haematuria (OR 0.68, 95% CI 0.51–0.89,
P
< 0.01), and hypertension (OR 0.66, 95% CI 0.52–0.82,
P
< 0.01). However, tolvaptan was associated with a higher incidence rate of adverse events such as thirst (OR 8.48 95% CI 4.53–15.87,
P
< 0.01), polyuria (OR 4.71, 95% CI 2.17–10.24,
P
< 0.01), and hepatic injury (OR 4.56, 95% CI 2.51–8.29,
P
< 0.01).
Conclusion
Tolvaptan can delay eGFR decline and TKV increase and reduce complications such as renal pain, urinary tract infection, haematuria, and hypertension in the treatment of ADPKD. However, tolvaptan increases the adverse effects of thirst, polyuria and hepatic injury.]]></abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>36069961</pmid><doi>10.1007/s11255-022-03353-8</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1573-2584 |
| ispartof | International urology and nephrology, 2023-03, Vol.55 (3), p.631-640 |
| issn | 1573-2584 0301-1623 1573-2584 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9958178 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Pain Antidiuretic Hormone Receptor Antagonists - therapeutic use Benzazepines - adverse effects Epidermal growth factor receptors Hematuria Hematuria - drug therapy Humans Hypertension Hypertension - complications Kidney diseases Liver Medicine Medicine & Public Health Meta-analysis Nephrology Nephrology - Review Pain Pharmacovigilance Placebos Polycystic kidney Polycystic Kidney, Autosomal Dominant Polyuria Polyuria - complications Thirst Tolvaptan - therapeutic use Urinary tract Urinary tract diseases Urinary tract infections Urogenital system Urology |
| title | Efficacy and safety of tolvaptan versus placebo in the treatment of patients with autosomal dominant polycystic kidney disease: a meta-analysis |
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