抗感染药物对轻度至重度 COVID-19 患者的疗效和安全性比较:随机对照试验的系统回顾和网络荟萃分析。

Q3 Medicine
Ethiopian Medical Journal Pub Date : 2023-04-01
Dejene Tolossa Debela, Tsegahun Manyazewal, Merga Belina, Kassahun Habtamu, Abebaw Fekadu
{"title":"抗感染药物对轻度至重度 COVID-19 患者的疗效和安全性比较:随机对照试验的系统回顾和网络荟萃分析。","authors":"Dejene Tolossa Debela, Tsegahun Manyazewal, Merga Belina, Kassahun Habtamu, Abebaw Fekadu","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Different anti-infective drugs have been proposed for the treatment of patients with COVID-19. We carried out a network meta-analysis to assess their relative efficacy and safety.</p><p><strong>Methods: </strong>We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety of any anti-infective drugs published up to April 30, 2022 for different outcomes. We did both pairwise and network meta-analysis with 95% confidence intervals using a fixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading of Recommendations, Assessment, Development and Evaluation approach considering P<0.05 to be statistically significant.</p><p><strong>Results: </strong>We included 68 RCTs for 27,680 participants on 22 anti-infective drugs. For clinical recovery at 14 days Ivermectin (OR= 3.00, 95%CI: [1.82; 4.96]; p < 0.0001; moderate certainty evidence), Baricitinib plus Remdesivir (OR= 2.20, 95%CI: [1.35; 3.53]; p = 0.005; low certainty evidence), and Favipiravir (OR= 2.16, 95%CI: [1.27; 3.68]; p = 0.004; moderate certainty evidence) were statistically effective than standard of care. There was no statistically significant difference between treatments for the viral clearance at 14 days outcome and standard of care. In terms of death outcome, only combined therapy of Baricitinib and Remdesivir showed statistically significant risks of ratio (RR= 0.47, 95%CI: [0.23; 0.99]; p = 0.03). Arbidol (RR= 0.46, 95% CI: [0.23; 0.95]; p = 0.04) was statistically safe drug than standard of care.</p><p><strong>Conclusion: </strong>This Network Meta-analysis suggests that Baricitinib plus Remdesivir is more effective than the other anti-infective drugs in treating patients with COVID-19 in terms of clinical recovery at 14 days, mortality and adverse events outcomes.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836338/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: A systematic review and network meta-analysis of randomized controlled trials.\",\"authors\":\"Dejene Tolossa Debela, Tsegahun Manyazewal, Merga Belina, Kassahun Habtamu, Abebaw Fekadu\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Different anti-infective drugs have been proposed for the treatment of patients with COVID-19. We carried out a network meta-analysis to assess their relative efficacy and safety.</p><p><strong>Methods: </strong>We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety of any anti-infective drugs published up to April 30, 2022 for different outcomes. We did both pairwise and network meta-analysis with 95% confidence intervals using a fixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading of Recommendations, Assessment, Development and Evaluation approach considering P<0.05 to be statistically significant.</p><p><strong>Results: </strong>We included 68 RCTs for 27,680 participants on 22 anti-infective drugs. For clinical recovery at 14 days Ivermectin (OR= 3.00, 95%CI: [1.82; 4.96]; p < 0.0001; moderate certainty evidence), Baricitinib plus Remdesivir (OR= 2.20, 95%CI: [1.35; 3.53]; p = 0.005; low certainty evidence), and Favipiravir (OR= 2.16, 95%CI: [1.27; 3.68]; p = 0.004; moderate certainty evidence) were statistically effective than standard of care. There was no statistically significant difference between treatments for the viral clearance at 14 days outcome and standard of care. In terms of death outcome, only combined therapy of Baricitinib and Remdesivir showed statistically significant risks of ratio (RR= 0.47, 95%CI: [0.23; 0.99]; p = 0.03). Arbidol (RR= 0.46, 95% CI: [0.23; 0.95]; p = 0.04) was statistically safe drug than standard of care.</p><p><strong>Conclusion: </strong>This Network Meta-analysis suggests that Baricitinib plus Remdesivir is more effective than the other anti-infective drugs in treating patients with COVID-19 in terms of clinical recovery at 14 days, mortality and adverse events outcomes.</p>\",\"PeriodicalId\":11937,\"journal\":{\"name\":\"Ethiopian Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836338/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ethiopian Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ethiopian Medical Journal","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

背景:目前已有不同的抗感染药物用于治疗COVID-19患者。我们进行了一项网络荟萃分析,以评估这些药物的相对疗效和安全性:我们在相关数据库中检索了截至 2022 年 4 月 30 日发表的所有随机对照试验,这些试验针对不同结果报告了任何抗感染药物的疗效和安全性。我们采用固定效应模型进行了配对分析和网络荟萃分析,并得出了95%的置信区间。我们采用标准的 "建议、评估、发展和评价分级 "方法的延伸,对研究的证据质量进行了评估:我们纳入了关于 22 种抗感染药物的 68 项研究,参与人数达 27,680 人。对于 14 天后的临床康复,Ivermectin(OR= 3.00,95%CI:[1.82; 4.96];p < 0.0001;中度确定性证据)、Baricitinib 加 Remdesivir(OR= 2.20,95%CI:[1.35; 3.53];p = 0.005;低度确定性证据)和法维拉韦(OR= 2.16,95%CI:[1.27; 3.68];p = 0.004;中度确定性证据)在统计学上比标准治疗有效。在 14 天病毒清除率方面,不同治疗方法与标准治疗方法之间没有统计学意义上的显著差异。在死亡结果方面,只有巴利昔尼和雷米地韦的联合疗法显示出统计学上显著的风险比(RR= 0.47,95%CI:[0.23; 0.99];P = 0.03)。阿比多(RR= 0.46,95%CI:[0.23; 0.95];P = 0.04)在统计学上是比标准护理安全的药物:该网络 Meta 分析表明,在治疗 COVID-19 患者方面,巴利昔尼联合雷米替韦在 14 天临床恢复、死亡率和不良事件方面比其他抗感染药物更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: A systematic review and network meta-analysis of randomized controlled trials.

Background: Different anti-infective drugs have been proposed for the treatment of patients with COVID-19. We carried out a network meta-analysis to assess their relative efficacy and safety.

Methods: We searched relevant databases for all randomized controlled trials that reported the efficacy and or safety of any anti-infective drugs published up to April 30, 2022 for different outcomes. We did both pairwise and network meta-analysis with 95% confidence intervals using a fixed-effect model. We assessed studies for quality of evidence using an extension of the standard Grading of Recommendations, Assessment, Development and Evaluation approach considering P<0.05 to be statistically significant.

Results: We included 68 RCTs for 27,680 participants on 22 anti-infective drugs. For clinical recovery at 14 days Ivermectin (OR= 3.00, 95%CI: [1.82; 4.96]; p < 0.0001; moderate certainty evidence), Baricitinib plus Remdesivir (OR= 2.20, 95%CI: [1.35; 3.53]; p = 0.005; low certainty evidence), and Favipiravir (OR= 2.16, 95%CI: [1.27; 3.68]; p = 0.004; moderate certainty evidence) were statistically effective than standard of care. There was no statistically significant difference between treatments for the viral clearance at 14 days outcome and standard of care. In terms of death outcome, only combined therapy of Baricitinib and Remdesivir showed statistically significant risks of ratio (RR= 0.47, 95%CI: [0.23; 0.99]; p = 0.03). Arbidol (RR= 0.46, 95% CI: [0.23; 0.95]; p = 0.04) was statistically safe drug than standard of care.

Conclusion: This Network Meta-analysis suggests that Baricitinib plus Remdesivir is more effective than the other anti-infective drugs in treating patients with COVID-19 in terms of clinical recovery at 14 days, mortality and adverse events outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Ethiopian Medical Journal
Ethiopian Medical Journal Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
0
期刊介绍: The Ethiopian Medical Journal (EMJ) is the official Journal of the Ethiopian Medical Association (EMA) and devoted to the advancement and dissemination of knowledge pertaining to the broad field of medicine in Ethiopia and other developing countries. Prospective contributors to the Journal should take note of the instructions of Manuscript preparation and submission to EMJ as outlined below.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信