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أعرض في EDS

Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis

التفاصيل البيبلوغرافية
العنوان: Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis
المؤلفون: Judith M Vonk, Eelko Hak, Katrien Oude Rengerink, Hubert G M Niesters, Debbie van Baarle, Maarten J Bijlsma, Guiling Zhou, Stefan Verweij, Stijn de Vos, Anna Maria Gerdina Pasmooij, Peter Mol
المصدر: BMJ Open Respiratory Research, Vol 10, Iss 1 (2023)
بيانات النشر: BMJ Publishing Group, 2023.
سنة النشر: 2023
المجموعة: LCC:Medicine
LCC:Diseases of the respiratory system
مصطلحات موضوعية: Medicine, Diseases of the respiratory system, RC705-779
الوصف: Objective Current evidence on the effectiveness of SARS-CoV-2 prophylaxis is inconclusive. We aimed to systematically evaluate published studies on repurposed drugs for the prevention of laboratory-confirmed SARS-CoV-2 infection and/or COVID-19 among healthy adults.Design Systematic review.Eligibility Quantitative experimental and observational intervention studies that evaluated the effectiveness of repurposed drugs for the primary prevention of SARS-CoV-2 infection and/or COVID-19 disease.Data source PubMed and Embase (1 January 2020–28 September 2022).Risk of bias Cochrane Risk of Bias 2.0 and Risk of Bias in Non-Randomised Studies of Interventions tools were applied to assess the quality of studies.Data analysis Meta-analyses for each eligible drug were performed if ≥2 similar study designs were available.Results In all, 65 (25 trials, 40 observational) and 29 publications were eligible for review and meta-analyses, respectively. Most studies pertained to hydroxychloroquine (32), ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) (11), statin (8), and ivermectin (8). In trials, hydroxychloroquine prophylaxis reduced laboratory-confirmed SARS-CoV-2 infection (risk ratio: 0.82 (95% CI 0.74 to 0.90), I2=48%), a result largely driven by one clinical trial (weight: 60.5%). Such beneficial effects were not observed in observational studies, nor for prognostic clinical outcomes. Ivermectin did not significantly reduce the risk of SARS-CoV-2 infection (RR: 0.35 (95% CI 0.10 to 1.26), I2=96%) and findings for clinical outcomes were inconsistent. Neither ACEi or ARB were beneficial in reducing SARS-CoV-2 infection. Most of the evidence from clinical trials was of moderate quality and of lower quality in observational studies.Conclusions Results from our analysis are insufficient to support an evidence-based repurposed drug policy for SARS-CoV-2 prophylaxis because of inconsistency. In the view of scarce supportive evidence on repurposing drugs for COVID-19, alternative strategies such as immunisation of vulnerable people are warranted to prevent the future waves of infection.PROSPERO registration number CRD42021292797.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2052-4439
Relation: https://bmjopenrespres.bmj.com/content/10/1/e001674.full; https://doaj.org/toc/2052-4439
DOI: 10.1136/bmjresp-2023-001674
URL الوصول: https://doaj.org/article/21cd98ae02b5486ea9d64750c16b16f3
رقم الأكسشن: edsdoj.21cd98ae02b5486ea9d64750c16b16f3
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:20524439
DOI:10.1136/bmjresp-2023-001674