title: Sodium selenite for treatment of Kashin-Beck disease in children: a systematic review of randomised controlled trials.
abstract: OBJECTIVE
  To assess the effectiveness and safety of sodium selenite in treatment of patients with Kashin-Beck disease (KBD).
  
  
  METHODS
  We searched for all publications between January 1966 and October 2011 using seven electronic databases. All randomized controlled trials (RCTs) assessing the effects of sodium selenite on KBD vs no treatment or placebo were included. For dichotomous data, odds ratios (OR) and 95% confidence intervals (CI) were estimated according to the intention-to-treat principles. For continuous data, mean difference (MD) was used for outcomes pooled on the same scale.
  
  
  RESULTS
  A total of 10 RCTs involving 2244 patients were included. The methodological quality of the included studies was low. When comparing the outcome of sodium selenite treatment group vs the control group, the OR of repairing rate of metaphyseal lesions was 5.63 (95% CI: 3.67-8.63) and repairing rate at the distal end of phalanges was 2.98 (95% CI: 1.32-6.70) based on X-ray assessment, which was statistically significant difference in favour of sodium selenite. In one RCT which reported data on clinical improvement, no statistically significant difference was observed in the treatment vs control group (OR 1.50, 95% CI: 0.43-5.30). Se content in hair was (MD 0.11, 95% CI: 0.09-0.13) which was statistically significant higher in selenium group.
  
  
  CONCLUSIONS
  Current evidence suggests that sodium selenite is more effective than placebo or no treatment in patients with KBD. However, the evidence was limited by potential biases; thus, further high quality large-scale RCTs are still needed to evaluate the short term and long term effects of selenium.
authors.affiliation: Department of Geriatrics, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, Sichuan province, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Jirong
authors.forename: P
authors.initials: P
authors.lastname: Huiyun
authors.forename: Y
authors.initials: Y
authors.lastname: Zhongzhe
authors.forename: D
authors.initials: D
authors.lastname: Birong
authors.forename: L
authors.initials: L
authors.lastname: Weimin
authors.forename: Y
authors.initials: Y
authors.lastname: Ming
authors.forename: S
authors.initials: S
authors.lastname: Yi
mesh_terms: D002648:Child; D019587:Dietary Supplements; D006801:Humans; D057767:Kashin-Beck Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D018038:Sodium Selenite / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018038:Sodium Selenite