Peri-abortion contraceptive counseling: A systematic review of randomized controlled trials

Objective To assess the effects of peri-abortion contraceptive counseling interventions. Methods We performed a systematic review of randomized controlled trials (RCTs) that compared the effect of different types of peri-abortion contraceptive counseling interventions and were published as original papers in scientific journals. The literature search was performed in June 2021 in PubMed, Central Cochrane Library (CENTRAL), Scopus, and Google Scholar; without restrictions in language or publication date. Two independent authors identified studies that met the inclusion and exclusion criteria and extracted the data. The risk of bias was assessed using the Cochrane tool, and evidence certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Whenever possible, meta-analyses were performed. The protocol was registered at PROSPERO (CRD42020187354). Results Eleven RCTs were eligible for inclusion (published from 2004 to 2017), from which nine compared enhanced versus standard counseling. Pooled estimates showed that, compared to standard counseling, enhanced counseling was associated with a higher incidence of effective contraceptive use (>3 months) (relative risk [RR], 1.12; 95% confidence interval [CI], 1.09–1.16), although no significant difference was found in the incidence of long-acting reversible contraceptive use (RR, 1.25; 95% CI, 0.68–2.29), contraceptive uptake (RR, 1.06; 95% CI, 0.98–1.15), and obstetric event occurrence (RR, 0.91; 95% CI, 0.57–1.47). Certainty of evidence was very low for all outcomes. In addition, two studies compared contraceptive counseling provided by physicians versus that provided by non-physicians, which did not show significant differences. Conclusions Enhanced contraceptive counseling may favor effective contraceptive use but may not affect the rate of obstetric event occurrence. Also, the studies did not find a difference in the effects of counseling interventions given by different providers. Since evidence certainty was very low, future well-designed RCTs are needed to make informed decisions. Registration The study protocol was registered at PROSPERO (CRD42020187354).

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Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽

10.3390/cancers13122984 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2984

Author(s):

Stepan M. Esagian ◽

Christos D. Kakos ◽

Emmanouil Giorgakis ◽

Lyle Burdine ◽

J. Camilo Barreto ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Randomized Controlled Trials ◽

Transarterial Chemoembolization ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Controlled Trials ◽

Curative Intent ◽

Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

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Zinc Supplementation and Body Weight: A Systematic Review and Dose–Response Meta-analysis of Randomized Controlled Trials

Advances in Nutrition ◽

10.1093/advances/nmz084 ◽

2019 ◽

Cited By ~ 2

Author(s):

Shima Abdollahi ◽

Omid Toupchian ◽

Ahmad Jayedi ◽

David Meyre ◽

Vivian Tam ◽

...

Keyword(s):

Systematic Review ◽

Body Weight ◽

Randomized Controlled Trials ◽

Dose Response ◽

Zinc Supplementation ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Anthropometric Measures ◽

Randomized Controlled

ABSTRACT The aim of this study was to determine the effect of zinc supplementation on anthropometric measures. In this systematic review and dose–response meta-analysis, we searched PubMed, Scopus, ISI Web of Science, and the Cochrane Library from database inception to August 2018 for relevant randomized controlled trials. Mean differences and SDs for each outcome were pooled using a random-effects model. Furthermore, a dose–response analysis for zinc dosage was performed using a fractional polynomial model. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-seven trials (n = 1438 participants) were included in the meta-analysis. There were no significant changes in anthropometric measures after zinc supplementation in the overall analysis. However, subgroup analyses revealed that zinc supplementation increased body weight in individuals undergoing hemodialysis (HD) [3 trials, n = 154 participants; weighted mean difference (WMD) = 1.02 kg; 95% CI: 0.38, 1.65 kg; P = 0.002; I2 = 11.4%] and decreased body weight in subjects who are overweight/obese but otherwise healthy (5 trials, n = 245 participants; WMD = −0.55 kg; 95% CI: −1.06, −0.04 kg; P = 0.03; I2 = 31.5%). Dose–response analyses revealed a significant nonlinear effect of supplementation dosage on BMI (P = 0.001). Our data suggest that zinc supplementation increases body weight in patients undergoing HD and decreases body weight in individuals who are overweight/obese but otherwise healthy, although after normalization for study duration, the association observed in subjects who are overweight/obese disappeared. Although more high-quality studies are needed to reach a definitive conclusion, our study supports the view that zinc may be associated with body weight.

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Bendamustine Is Not Associated With An Increase In Infections – Systematic Review and Meta-Analysis Of Randomized Controlled Trials

Blood ◽

10.1182/blood.v122.21.5125.5125 ◽

2013 ◽

Vol 122 (21) ◽

pp. 5125-5125 ◽

Cited By ~ 1

Author(s):

Anat Gafter-Gvili ◽

Ronit Gurion ◽

Pia Raanani ◽

Ofer Shpilberg ◽

Liat Vidal

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Alkylating Agent ◽

Meta Analysis ◽

Alkylating Agents ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled ◽

Solid Malignancies ◽

Grade 3

Abstract Background Bendamustine is a chemotherapeutic drug with structural similarities to both alkylating agents (nitrogen mustard derivative) and purine analogues (benzimidazole ring). Theoretically, due to its nucleoside-like properties it might be associated with more infections. Data in the literature is lacking regarding the infection-related adverse events of bendamustine-containing regimens. Thus, we aimed to assess this risk. Methods Systematic review and meta-analysis of all randomized controlled trials comparing bendamustine containing regimens (alone or combined with other chemotherapeutic agents and/or rituximab) to any other regimens. Trials evaluating bendamustine for any indication (hematological as well as solid malignancies) were included. A comprehensive search of The Cochrane Library, MEDLINE, conference proceedings and references was conducted until July 2013. Two reviewers appraised the quality of trials and extracted data. Outcomes assessed were: any infections, grade 3-4 infections, fatal infections, grade 3-4 neutropenia and grade 3-4 lymphopenia. For dichotomous data, relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. We used fixed effect model to pool data, unless there was significant heterogeneity, in which case we used the random effects model. Results Ten trials conducted between the years 1998 and 2013 and randomizing 2360 patients were included. We included 4 trials of patients with non-Hodgkin lymphoma (Rummel 2013, Rummel 2010, Herold 2006 and the Bright study 2013), 3 trials of CLL (Knauf 2009, Niederle 2013, LeBlond 2013), 1 trial of patients with multiple myeloma (Ponish 2006) and 2 trials of breast carcinoma patients. The bendamustine arm included: bendamustine alone (2 trials), bendamustine-rituximab (BR) (4 trials), bendamustine, vincristine, prednisone (BOP) (1 trial), bendamustine, MTX. 5FU (BMF) (2 trials) and bendamustine, prednisone (BP) (1 trial). The comparator arms in 8 of the trials included other alkylating agents: chlorambucil, R -CHOP, cyclophosphamide, MTX, 5-FU (CMF) and melphalan-prednisone (MP) – each regimen used in 2 trials and COP used in 1 trial. In 2 trials the comparator arm included fludarabine based regimens (alone or with rituximab). There was no statistically significant effect for bendamustine on the rate of any type of infection (RR 1.06 [95% CI 0.83, 1.34], 6 trials, figure). This analysis included only trials of hematological malignancies. There was no increase in the rate of grade 3-4 infections (RR 1.45 [95% CI 0.86, 2.45], 7 trials) or fatal infection (RR 0.69 [95% CI 0.30, 1.58], 3 trials). Data were too scarce to analyze by specific types of infections separately. There was no increase in the rate of grade 3-4 neutropenia in the bendamustine arm (RR 0.9 [95% CI 0.58, 1.42], 6 trials). This was true both when the comparator was alkylating agent containing regimens (RR 0.87 [95% CI 0.52, 1.48], 4 trials) or fludarabine containing regimens (RR 1.02 [95% CI 0.54, 1.91], 2 trials). There was a significant increase in grade 3-4 lymphopenia in the bendamustine arm compared to alkylating agent containing regimens (RR 1.95[95% CI 1.54, 2.47). Conclusions Our systematic review demonstrates no effect of bendamustine on the rate of infections when compared to either alkylating agents or fludarabine, in hematological as well as in solid malignancies, despite an increase in lymphopenia. Thus, bendamustine remains a safe therapeutic option. The main drawback of this meta-analysis is the heterogeneity between malignancies and treatments. Disclosures: No relevant conflicts of interest to declare.

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Can musical intervention improve memory in Alzheimer’s patients? Evidence from a systematic review

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-020005 ◽

2018 ◽

Vol 12 (2) ◽

pp. 133-142 ◽

Cited By ~ 7

Author(s):

Shirlene Vianna Moreira ◽

Francis Ricardo dos Reis Justi ◽

Marcos Moreira

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Randomized Trials ◽

Positive Outcome ◽

Memory Deficit ◽

Cochrane Library ◽

Controlled Trials ◽

Exclusion Criteria ◽

Randomized Controlled

ABSTRACT Treatment with music has shown effectiveness in the treatment of general behavioural and cognitive symptoms of patients with various types of dementia. Objective: To assess the effectiveness of treatment with music on the memory of patients with Alzheimer’s disease (AD). Methods: A systematic search was performed on PubMed (Medline), Cochrane Library, PsycINFO and Lilacs databases up to June 2017 and included all randomized controlled trials that assessed memory using musical interventions in patients with AD. Results: Forty-two studies were identified, and 24 studies were selected. After applying the exclusion criteria, four studies involving 179 patients were included. These studies showed the benefits of using music to treat memory deficit in patients with AD. Conclusion: To the best of our knowledge, this is the first systematic review focusing on randomized trials found in the literature that analysed the role of musical interventions specifically in the memory of patients with AD. Despite the positive outcome of this review, the available evidence remains inconsistent due to the small number of randomized controlled trials.

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Ear Acupressure for Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6699749 ◽

2021 ◽

Vol 2021 ◽

pp. 1-20

Author(s):

Juan Zhong ◽

Shuqin Liu ◽

Dan Lai ◽

Tao Lu ◽

Yifeng Shen ◽

...

Keyword(s):

Systematic Review ◽

Allergic Rhinitis ◽

Randomized Controlled Trials ◽

Symptom Score ◽

Latin American ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Randomized Controlled

Background. The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. Objective. To evaluate the effects and safety of EAP in AR patients. Design. Systematic review of published studies. Methods. A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses. Results. A total of 203 trials were identified and eleven studies involved 1094 participants aged 3–70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36–0.70; P < 0.0001 ). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: −0.50; 95% CI: −0.96–0.05; P = 0.03), sneezing score (RR: −0.36; 95% CI: −0.59–0.12; P = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04–0.08; P = 0.03), and eye symptom score (RR: −0.36; 95% CI: −0.67–0.05; P = 0.02). Conclusions. Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.

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Systematic Review and Network Meta-Analysis: Comparative Efficacy and Safety of Biosimilars, Biologics and JAK1 Inhibitors for Active Crohn Disease

Frontiers in Pharmacology ◽

10.3389/fphar.2021.655865 ◽

2021 ◽

Vol 12 ◽

Author(s):

Guozhi Wu ◽

Yuan Yang ◽

Min Liu ◽

Yuping Wang ◽

Qinghong Guo

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Crohn Disease ◽

Meta Analysis ◽

Certolizumab Pegol ◽

Cochrane Library ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Maintenance Of Remission

Background: Crohn disease (CD) is a chronic inflammatory disease that affects quality of life. There are several drugs available for the treatment of CD, but their relative efficacy is unknown due to a lack of high-quality head-to-head randomized controlled trials.Aim: To perform a mixed comparison of the efficacy and safety of biosimilars, biologics and JAK1 inhibitors for CD.Methods: We searched PubMed, Web of Science, embase and the Cochrane Library for randomized controlled trials (RCTs) up to Dec. 28, 2020. Only RCTs that compared the efficacy or safety of biosimilars, biologics and JAK1 inhibitors with placebo or another active agent for CD were included in the comparative analysis. Efficacy outcomes were the induction of remission, maintenance of remission and steroid-free remission, and safety outcomes were serious adverse events (AEs) and infections. The Bayesian method was utilized to compare the treatments. The registration number is CRD42020187807.Results: Twenty-eight studies and 29 RCTs were identified in our systematic review. The network meta-analysis demonstrated that infliximab and adalimumab were superior to certolizumab pegol (OR 2.44, 95% CI 1.35–4.97; OR 2.96, 95% CI 1.57–5.40, respectively) and tofacitinib (OR 2.55, 95% CI 1.27–5.97; OR 3.10, 95% CI 1.47–6.52, respectively) and revealed the superiority of CT-P13 compared with placebo (OR 2.90, 95% CI 1.31–7.59) for the induction of remission. Infliximab (OR 7.49, 95% CI 1.85–34.77), adalimumab (OR 10.76, 95% CI 2.61–52.35), certolizumab pegol (OR 4.41, 95% CI 1.10–21.08), vedolizumab (OR 4.99, 95% CI 1.19–25.54) and CT-P13 (OR 10.93, 95% CI 2.10–64.37) were superior to filgotinib for the maintenance of remission. Moreover, infliximab (OR 3.80, 95% CI 1.49–10.23), adalimumab (OR 4.86, 95% CI 1.43–16.95), vedolizumab (OR 2.48, 95% CI 1.21–6.52) and CT-P13 (OR 5.15, 95% CI 1.05–27.58) were superior to placebo for steroid-free remission. Among all treatments, adalimumab ranked highest for the induction of remission, and CT-P13 ranked highest for the maintenance of remission and steroid-free remission.Conclusion: CT-P13 was more efficacious than numerous biological agents and JAK1 inhibitors and should be recommended for the treatment of CD. Further head-to-head RCTs are warranted to compare these drugs.

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The Efficacy and Tolerability of Ubrogepant for Acute Migraine: A Systematic Review and Meta-Analysis

10.21203/rs.2.20666/v1 ◽

2020 ◽

Author(s):

Yun Diao ◽

Hang Yang ◽

Yang Chun Zhou ◽

Biao Du

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Acute Attack ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Acute Migraine ◽

High Quality ◽

Randomized Controlled

Abstract Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound，the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45，P<0.00001, RR=1.63,95%CI:1.46~1.82，P<0.00001, RR=1.22,95%CI:1.15~1.29，P<0.00001, RR=1.32,95%CI:1.22~1.42，P<0.00001, RR=1.16,95%CI:1.05~1.27，P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.

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Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

BMC Surgery ◽

10.1186/s12893-021-01461-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liping Gou ◽

Zhenghao Wang ◽

Ye Zhou ◽

Xiaofeng Zheng

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Operative Time ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Significant Heterogeneity ◽

Bladder Stones ◽

Randomized Controlled ◽

Significant Difference

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficiency of nephroscopy and cystoscopy in transurethral cystolithotripsy (TUCL) for bladder stones (BS). Methods The PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases were searched up to January 2021 for studies assessing the effect of different types of endoscopes among patients who underwent TUCL. The search strategy and study selection process were in accordance with the PRISMA statement. Results Five randomized controlled trials were included in the meta-analysis. The results showed no difference in stone-free rate (RR = 1.00, CI = 0.98–1.02, p = 1.00) between the two groups and nonsignificant heterogeneity (I2 = 0%, p = 1.00), and all patients were rendered stone free. Use of the nephroscope significantly shortened the operative time compared with the cystoscope group (RR= − 26.26, CI = − 35.84 to − 16.68, p < 0.00001), and there was significant heterogeneity (I2= 87%, p < 0.00001). There was no significant difference in mean urethral entries (RR = 0.66, CI = − 0.71 to − 2.04, p = 0.35), hospitalization (MD = 0.08, 95% CI = − 0.07 to 0.23, p = 0.31) or total complication rate (RR=1.37, 95% CI = 0.47–4.00, p = 0.56) between the two groups. Conclusions In conclusion, this systematic review demonstrates that both nephroscopy and cystoscopy have high stone clearance efficiency, low rates of complications and short hospitalizations. The mean urethral entries depend on the treatment method for large stone fragments. However, the use of nephroscopy can significantly reduce the operative time.

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Systematic Review of Fire Needling or Warm Needling Treatment for Ankle Sprain

Journal of Acupuncture Research ◽

10.13045/jar.2019.00332 ◽

2020 ◽

Vol 37 (1) ◽

pp. 19-27 ◽

Cited By ~ 1

Author(s):

Hong Je Ko ◽

Jae Hee Yoo ◽

Min Wook Kim ◽

Jeong Cheol Shin

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Ankle Sprain ◽

Cochrane Library ◽

Controlled Trials ◽

Ankle Sprains ◽

Control Groups ◽

Beneficial Effects ◽

Randomized Controlled ◽

Warm Needling

The effectiveness of fire needling or warm needling treatment in clinical studies for the treatment of ankle sprains was reviewed using 4 international (PubMed, Cochrane library, EMBASE, CNKI) and 5 Korean databases (NDSL, RISS, KISS, OASIS, KTKP). Randomized controlled trials, that performed fire needling or warm needling treatment for ankle sprains until October, 2018 were retrieved (<i>n</i> = 8). All studies were performed in China, and 7 out of 8 studies were published within the last 5 years. There were 4 studies that used fire needling treatment, 3 studies used warm needling treatment, and 1 study used fire and warm needling treatment. The ashi-points and gallbladder meridian were the most frequently selected acupoint and meridian each. All intervention groups in the 8 studies showed statistically significant beneficial effects compared with control groups. The results of this study could provide preliminary data as the basis for welldesigned randomized controlled trials on fire needling or warm needling treatment for ankle sprains.

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Efficacy of remdesivir versus placebo for the treatment of COVID-19: A protocol for systematic review and meta-analysis of randomized controlled trials

10.1101/2020.04.09.20059196 ◽

2020 ◽

Cited By ~ 1

Author(s):

Desye Gebrie ◽

Desalegn Getnet ◽

Tsegahun Manyazewal

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Antiviral Drug ◽

Risk Of Bias ◽

Cochrane Library ◽

Controlled Trials ◽

Significant Heterogeneity ◽

List Type ◽

Randomized Controlled

AbstractBackgroundIn spite of the global containment on prevention efforts, the spread of coronavirus disease 2019 (COVID-19) is continuing to rise, with 1.1 million confirmed cases and 60,124 deaths recorded worldwide since 04 April 2020. The outbreak has a significant threat to international health and economy. At present, there is no approved vaccine or treatment for the disease, while efforts are underway. Remdesivir, a nucleotide-analogue antiviral drug developed for Ebola, is determined to prevent and stop infections with COVID-19, while results are yet controversial. Here, we aim to conduct a systematic review and meta-analysis of randomized controlled trials to compare the effectiveness of remdesivir and placebo in patients with COVID-19.Method and analysisWe will search MEDLINE-PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and Google scholar databases without restriction in year of publication. We will include randomized controlled trials that assessed the effectiveness of remdesivir versus placebo for patients confirmed with COVID-19. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2015) guidelines for the design and reporting of the results. The primary endpoint will be time to clinical recovery. The secondary endpoints will be all cause mortality, discharged date, frequency of respiratory progression, and treatment-emergent adverse events. Two independent authors will perform study selection, data extraction, and methodology quality assessment. RevMan 5.3 software will be used for statistical analysis. Random/fixed effect model will be carried out to calculate mean differences for continuous outcomes and risk ratio for dichotomous outcomes between remdesivir and placebo.Ethics and disseminationThis study does not require ethical approval, because no participant’s data will be involved in this systematic review and meta-analysis. The findings of this study will be published in reputable and peer-reviewed journal.RegistrationThis review protocol is submitted in PROSPERO database for registration and we will include the registration number in the revised version of the manuscript.Strengths and limitations of this study➣This systematic review and meta-analysis will be derived from only randomized controlled trials which will increase the quality of evidences.➣This systematic review and meta-analysis will be derived from only randomized controlled trials which will reduce between study heterogeneity.➣Subgroup and sensitivity analysis will be carried out to identify possible reasons that may cause significant heterogeneity between studies.➣The use of Cochrane risk of bias tool to assess risk of bias for each included studies to extract and synthesize evidence based conclusions.➣One of the limitation of this study might be the restriction of trials published in English language.

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