Beigi 2014.
Methods | Study design: RCT parallel group | |
Participants | Country: Iran Nº patients: 30 (14 in folic acid group and 16 in placebo group) Setting: community Mean age: 39; 42 years in folic acid group and 36 years in placebo group Gender: all male Inclusion criteria: negative history of hypertension, diabetes mellitus, ischaemic heart disease, cerebrovascular disease, collagen vascular disease or vasculitis Exclusion criteria: quote "surgical sympathectomy or any sort of vascular bypass; using aspirin, calcium channel blocker, B6 or B12; stop smoking during the study and have not compliance of being treated. Also, patients with hypercoagulative state due to inherited thrombophilia (factor V Leiden, A202120G prothrombin variant, acquired activated protein C resistance, protein C and S deficiency, antithrombin deficiency" |
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Interventions | Treatment: Folic acid group: oral 5 mg folic acid tablet (by Jallinus Pharmacy, Tehran, Iran) Placebo group: oral placebo with the same colour, size, weight and box (by Amin Pharmacy, Isfahan, Iran) Duration of treatment: 1 day ‐ a single dose of folic acid or placebo Follow‐up: 6 months |
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Outcomes | Primary: Major and minor amputations | |
Notes | Conflict of Interest: none declared The study authors reported the following regarding a link between homocysteine levels and Buergers disease: quote "At the beginning of the study, homocysteine level was higher than normal in 19 patients (63%). There was a significant decrease in homocysteine level during 6 months in folic acid group (P < 0.001), but there was no change in the placebo group." |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computerised randomisation |
Allocation concealment (selection bias) | Low risk | There was a person responsible for allocation concealment; codified using computerised randomisation, only revealed at the end of the trial |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Double blind |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Doctor responsible for outcome assessment assessed the patients at the start and at the end of treatment, but was not responsible for drug administration |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Study without losses to follow‐up |
Selective reporting (reporting bias) | High risk | Did not describe the development of rest pain or ischaemic ulcers after the treatment |
Other bias | High risk | Participants without critical ischaemia were eligible, resulting in low chances to be amputated. Conflict of interest: none declared. |