Purpose: Recent evidence supports linaclotide (Lin) for colonoscopy preparation. This network meta-analysis evaluates the combination of different pill numbers of Lin with polyethylene glycol (PEG) (high and low volumes in liters (L)) for bowel cleansing. Methods: This systematic review and frequentist network meta-analysis, conducted in October 2024, assessed randomized controlled trials (RCTs) from Scopus, PubMed, Cochrane, WOS, and Embase. Risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated for categorical and continuous outcomes. PROSPERO ID: CRD42024618272. Results: Fourteen RCTs with 4,764 participants showed that total Boston Bowel Preparation Scale improved significantly with 2L PEG + 2Lin (MD = 2.03, 95%CI: [0.30:3.76], P = 0.0217), 3L-PEG + 3Lin (MD = 1.30, 95%CI: [0.42:2.18], P = 0.0038), and 4L-PEG (MD = 1.11, 95%CI: 0.23–1.98, P = 0.0129). Adenoma detection was highest with 3L-PEG + 3Lin (RR = 1.60, 95%CI: [1.05:2.43], P = 0.0280), while polyp detection improved with 2L PEG + 3Lin (RR = 1.72, 95%CI: [1.13:2.62], P = 0.0114) and 3L-PEG + 3Lin (RR = 1.33, 95%CI: [1.00:1.77], P = 0.0505). Procedure times were significantly reduced with 3L-PEG + 3Lin (MD = -4.6, 95%CI: [-6.24:-3.24], P < 0.0001), 3L-PEG + 1Lin (P = 0.035), and 4L-PEG (P < 0.01). Abdominal pain and abdominal bloating decreased with 2L PEG + 1Lin (P < 0.01) and 2L PEG + 2Lin (P = 0.021) but increased with 4L-PEG (P = 0.0178). Conclusions: Combining PEG with Lin improves bowel cleanliness compared to 3L-PEG, with 2L PEG + 2Lin being the most effective and well-tolerated. Despite some heterogeneity, the findings suggest that adding Lin may enhance bowel preparation with comparable safety, warranting consideration of individual patient factors.

Background and Purpose: Non-acute subdural hematoma (NASDH) is a prevalent neurological condition, encompassing chronic and subacute types. Despite standard-care, including surgical evacuation and medical management, recurrence rates remain high. Emerging evidence suggests that middle meningeal artery embolization (MMAE) as an adjunctive procedure may reduce recurrence. This study evaluates the efficacy and safety of MMAE in NASDH. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, EMBASE, WOS, Scopus, and Cochrane until November 2024. The analysis presented risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI) using R software. The GRADE system assessed evidence certainty, alongside trial sequential analysis for result reliability. PROSPERO ID: CRD42024625504. Results: Six RCTs and 1,544 patients were included, with an average of 4.7 months follow-up. Adjunctive MMAE, compared to standard-care, significantly reduced hematoma recurrence (8% vs 15.6%; RR: 0.52; 95% CI: [0.37:0.73]; P < 0.01) and surgical rescue (4.5% vs. 12.7%; RR: 0.36; 95% CI: [0.25:0.53]; P < 0.01). However, no significant effect was found for recurrence without surgery (P = 0.94), hematoma volume (P = 0.18), thickness (P = 0.34), or hospital stay (P = 0.37). Infection rates were higher with MMAE (8.4% vs. 4.8%; RR: 1.81; 95% CI: [1.23:2.66]; P < 0.01), but adverse events (AEs), serious AEs, intracranial hemorrhage, stroke, and mortality showed no significant differences. Conclusion: Adjunctive MMAE reduced hematoma recurrence and surgical rescue rates in NASDH with an acceptable safety profile despite increased infection rates. However, further large-scale trials with extended follow-ups are needed.

Knee osteoarthritis (KOA) is a degenerative joint disease associated with chronic pain and functional decline. Genicular artery embolization (GAE) is a minimally invasive intervention that targets abnormal synovial neovascularization. This systematic review evaluates the efficacy and safety of GAE compared with sham procedures in patients with symptomatic KOA. A systematic search of PubMed, EMBASE, Scopus, and Web of Science was conducted through March 2025. Only sham-controlled randomized controlled trials (RCTs) enrolling adults with symptomatic KOA were included. Data were extracted on study design, patient characteristics, interventions, outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Three sham-controlled RCTs with a total of 138 patients were included. GAE demonstrated short-term pain reduction, particularly in VAS scores, with one trial showing a significant improvement at 1 month (-50.8 vs -0.5). KOOS pain scores improved modestly across studies but lacked statistical significance. Functional outcomes were mixed; one trial reported significant improvement in WOMAC function, and another found enhanced quality of life in patients undergoing complete embolization. No serious adverse events occurred; minor complications such as catheter-site bruising were infrequent and self-limited. GAE appears to be a safe and minimally invasive treatment that may provide short-term symptomatic relief in select KOA patients. However, limited sample sizes, methodological variability, and short follow-up periods constrain definitive conclusions. Larger, standardized trials with longer follow-up are necessary to confirm efficacy and optimize patient selection.