tetano
Editor, Senior Moderator
Br J Clin Pharmacol
. 2022 Mar 31.
doi: 10.1111/bcp.15338. Online ahead of print.
Efficacy of pharmacological interventions in COVID-19: A network meta-analysis
Sandhiya Selvarajan[SUP] 1 [/SUP], Annuja Anandaradje[SUP] 1 [/SUP], Santhosh Shivabasappa[SUP] 1 [/SUP], Deepthy Melepurakkal Sadanandan[SUP] 2 [/SUP], N Sreekumaran Nair[SUP] 2 [/SUP], Melvin George[SUP] 3 [/SUP]
Affiliations
Abstract
Aim: To perform network meta-analysis for a head-to-head comparison of various interventions used in COVID - 19 on mortality, clinical recovery, time to clinical improvement and the occurrence of serious adverse events.
Methods: Systematic search was performed using online databases with suitable MeSH terms including coronavirus, COVID-19, Randomized Controlled Trial, hydroxychloroquine, lopinavir/ritonavir, tocilizumab, remdesivir, favipiravir, dexamethasone, and interferon-β. Data were independently extracted by two study investigators and analysed.
Results: Out of 1225 studies screened, 23 were included for qualitative and quantitative analysis. Among the drugs studied, dexamethasone reduces mortality by 10%, with a relative risk (RR) of 0.90 (95% CI [0.82-0.97]) and increases clinical recovery by 6% (RR 1.06, 95% CI [1.02-1.10]) compared to standard of care. Similarly, remdesivir administered for 10 days increased clinical recovery by 10%, reduced time to clinical improvement by 4 days and lowered the occurrence of serious adverse events by 27% as compared to standard of care.
Conclusion: In comparison to standard of care, dexamethasone was found to increase clinical recovery and lower mortality; remdesivir was significantly associated with a lower risk of mortality as compared to tocilizumab and higher clinical recovery and shorter time to clinical improvement as compared to HCQ and tocilizumab; remdesivir followed by tocilizumab were found to have lesser occurrence of serious adverse events in patients with moderate to severe COVID-19.
Keywords: Clinical recovery; dexamethasone; hydroxychloroquine; mortality; remdesivir.
. 2022 Mar 31.
doi: 10.1111/bcp.15338. Online ahead of print.
Efficacy of pharmacological interventions in COVID-19: A network meta-analysis
Sandhiya Selvarajan[SUP] 1 [/SUP], Annuja Anandaradje[SUP] 1 [/SUP], Santhosh Shivabasappa[SUP] 1 [/SUP], Deepthy Melepurakkal Sadanandan[SUP] 2 [/SUP], N Sreekumaran Nair[SUP] 2 [/SUP], Melvin George[SUP] 3 [/SUP]
Affiliations
- PMID: 35357033
- DOI: 10.1111/bcp.15338
Abstract
Aim: To perform network meta-analysis for a head-to-head comparison of various interventions used in COVID - 19 on mortality, clinical recovery, time to clinical improvement and the occurrence of serious adverse events.
Methods: Systematic search was performed using online databases with suitable MeSH terms including coronavirus, COVID-19, Randomized Controlled Trial, hydroxychloroquine, lopinavir/ritonavir, tocilizumab, remdesivir, favipiravir, dexamethasone, and interferon-β. Data were independently extracted by two study investigators and analysed.
Results: Out of 1225 studies screened, 23 were included for qualitative and quantitative analysis. Among the drugs studied, dexamethasone reduces mortality by 10%, with a relative risk (RR) of 0.90 (95% CI [0.82-0.97]) and increases clinical recovery by 6% (RR 1.06, 95% CI [1.02-1.10]) compared to standard of care. Similarly, remdesivir administered for 10 days increased clinical recovery by 10%, reduced time to clinical improvement by 4 days and lowered the occurrence of serious adverse events by 27% as compared to standard of care.
Conclusion: In comparison to standard of care, dexamethasone was found to increase clinical recovery and lower mortality; remdesivir was significantly associated with a lower risk of mortality as compared to tocilizumab and higher clinical recovery and shorter time to clinical improvement as compared to HCQ and tocilizumab; remdesivir followed by tocilizumab were found to have lesser occurrence of serious adverse events in patients with moderate to severe COVID-19.
Keywords: Clinical recovery; dexamethasone; hydroxychloroquine; mortality; remdesivir.