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Introduction: Recent studies have demonstrated an association between hypoglycemic medications and neuroprotective action in neurodegenerative diseases, such as Parkinson's disease (PD). Therefore, in this meta-analysis, our objective was to evaluate the efficacy of these medications, compared to placebo, as disease-modifying therapy in patients with PD., Methods: We systematically searched PubMed, Embase, and Cochrane for studies comparing the use of hypoglycemic drugs and placebo in patients with PD. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) with 95 % confidence intervals (CI) were pooled across trials. Outcomes of interest were change in Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I, II, III, IV, and Parkinson's Disease Questionnaire 39 (PDQ-39)., Results: This meta-analysis included six randomized controlled trials (RCT) reporting data on 787 patients. Among them, 480 (61 %) received hypoglycemic drugs. Follow-up ranged from 36 to 61 weeks. At the end of follow-up, improvement in MDS-UPDRS part III score during OFF state occurred when subjects received any hypoglycemic agents at their lowest dose (MD -1.36; 95 % IC -2.78 to -0.47; I2 = 38 %), as well as highest doses (MD -1.58; 95 % IC -3.07 to -0.09; I2 = 50 %). Changes in MDS-UPDRS part III score in patients examined in the ON state who received any dose of any hypoglycemic agents (MD -3.32; 95 % IC -5.28 to -1.36; I2 = 0 %) were significant. There was no significant difference between groups MDS-UPDRS parts I, II, IV, and PDQ-39., Conclusion: In patients with PD, the use of hypoglycemic agents showed efficacy on symptomatic PD treatment with an improvement in MDS-UPDRS part III., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Hypertensive disorders during pregnancy elevate the likelihood of unfavorable outcomes for both mother and fetus. In cases of acute hypertension, several pharmacological interventions are available to lower blood pressure, such as hydralazine, a direct arteriolar vasodilator, and labetalol, a combined alpha and beta-blocker., Objectives: This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to compare the efficacy and safety of intravenous labetalol and intravenous hydralazine for acute hypertensive disorders during pregnancy., Methods: We systematically searched PubMed, Embase and Cochrane for studies comparing labetalol versus hydralazine in pregnant patients. The primary outcomes were median arterial blood pressure (MABP), diastolic blood pressure (DBP) and systolic blood pressure (SBP). We performed statistical analyses using R 4.1.1. Heterogeneity was examined with the Cochran Q test and I 2 statistics. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI), were computed with a random-effects model., Results: Nineteen RCTs were included in this meta-analysis, comprising 2,261 patients. Among them, 1,131 (50 %) received treatment with labetalol. There was no statistically significant difference between groups in terms of SBP (MD -1.74; 95 % CI -6.72 to 3.23; p = 0.49; I 2  = 93 %), MABP (MD -0.72; 95 % CI -2.34 to 0.90; p = 0.39; I 2  = 0 %), DBP (MD 0.25; 95 % CI -4.72 to 5.21; p = 0.92; I 2  = 96 %), tachycardia (RR 0.42; 95 % CI 0.15 to 1.18; p = 0.099; I 2  = 41 %), and placenta abruption (RR 0.42; 95 % CI 0.15 to 1.16; p = 0.093; I 2  = 0 %). However, labetalol significantly reduced maternal hypotension (RR 0.26; 95 % CI 0.21 to 0.33; p < 0.001; I 2  = 41 %) compared with hydralazine., Conclusion: This systematic review and meta-analysis of RCTs found that labetalol and hydralazine were efficient for hypertension disorders in pregnancy. However, labetalol reduced the incidence of maternal hypotension., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Competing Interests: The authors have no conflicts of interest to declare.