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The following is a summary of “Comparative efficacy of intratympanic gentamicin and intratympanic corticosteroid in the treatment of Meniere’s disease: a systematic review and meta-analysis,” published in the September 2024 issue of Neurology by Wu et al.
Researchers conducted a retrospective study to evaluate the efficacy of gentamicin compared to corticosteroids for treating Meniere’s disease (MD).
They extensively searched PubMed, Embase, and Web of Science until May 2024. For continuous outcomes, pooled effect estimates were determined by calculating the weighted mean difference (WMD). In contrast, for binary outcomes, the risk ratio (RR) was used, each accompanied by their respective 95% CIs. Heterogeneity among the studies was assessed using Cochran’s I2 and Q statistics.
The results showed 12 studies involving 694 patients. The analysis found that the gentamicin group demonstrated superior vertigo control rates compared to the corticosteroid group (RR: 1.36, 95% CI: 1.13 to 1.65, P<0.001). In subgroup analysis, the gentamicin group showed higher vertigo control rates at 6 months compared to the corticosteroid group (RR: 1.69, 95% CI: 1.28 to 2.24, P<0.001), no statistically significant difference between the 2 groups at 12 months (RR: 1.48, 95% CI: 0.88 to 2.49, P=0.14). Regarding changes in pure tone average, the corticosteroid group was superior to the gentamicin group (WMD: 4.41, 95% CI: 3.31 to 5.52, P<0.001).
They concluded that the intratympanic gentamicin group achieves higher vertigo control rates, whereas the corticosteroid group demonstrates better improvement in pure tone averages. However, the high heterogeneity in vertigo control rates warrants caution.
Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1471010/full
