ArticlePharmacotherapy2007
Adverse events associated with high-dose ribavirin: evidence from the Toronto outbreak of severe acute respiratory syndrome.
Article in Pharmacotherapy, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Sofosbuvir/daclatasvir regimens for the treatment of COVID-19: an individual patient data meta-analysis.The Journal of antimicrobial chemotherapy · 2021Pooled it
- Pooled it
- Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- Efficacy and safety of current therapeutic options for COVID-19 - lessons to be learnt from SARS and MERS epidemic: A systematic review and meta-analysis.Pharmacological research · 2020Pooled it
- Favipiravir for Lassa fever: an open-label, randomized controlled phase 2 trial.Nature medicine · 2026Trial
- The impact of sofosbuvir/daclatasvir or ribavirin in patients with severe COVID-19.The Journal of antimicrobial chemotherapy · 2020Trial
- Review
- Integrated Functions of Cardiac Energetics, Mechanics, and Purine Nucleotide Metabolism.Comprehensive Physiology · 2023Article
- Extracts ofPharmaceutical biology · 2023Article
- Structure-Based Drug Design of RdRp Inhibitors against SARS-CoV-2.Topics in current chemistry (Cham) · 2023Review
- Antitarget, Anti-SARS-CoV-2 Leads, Drugs, and the Drug Discovery-Genetics Alliance Perspective.Journal of medicinal chemistry · 2023Review
- Nucleoside analogs for management of respiratory virus infections: mechanism of action and clinical efficacy.Current opinion in virology · 2022Review
- Treatment outcomes and costs of a simplified antiretroviral treatment strategy for hepatitis C among Hepatitis C Virus and Human Immuno deficiency Virus co-infected patients in Ukraine.JGH open : an open access journal of gastroenterology and hepatology · 2022Article
- Characteristics of bradyarrhythmia in patients with COVID-19: Systematic scoping review.Pacing and clinical electrophysiology : PACE · 2022Article
- The relevance of magnesium homeostasis in COVID-19.European journal of nutrition · 2022Review
- RdRp inhibitors and COVID-19: Is molnupiravir a good option?Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2022Review
- Bradyarrhythmias in patients with SARS-CoV-2 infection: A narrative review and a clinical report.Pacing and clinical electrophysiology : PACE · 2021Review
- Adverse Cardiovascular Effects of Anti-COVID-19 Drugs.Frontiers in pharmacology · 2021Review
- Utilization of Intravenous Ribavirin Among Reproductive Age Adults in 2010-2017: A Population-Based Study in the Yinzhou District, Ningbo City of China.Frontiers in public health · 2021Article
- Cardiovascular sequalae in uncomplicated COVID-19 survivors.PloS one · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesTo distinguish adverse events related to ribavirin therapy from those attributable to severe acute respiratory syndrome (SARS), and to determine the rate of potential ribavirin-related adverse events.
designRetrospective cohort study.
settingHospitals in Toronto, Ontario, Canada. PATIENTS: A cohort of 306 patients with confirmed or probable SARS, 183 of whom received ribavirin and 123 of whom did not, between February 23, 2003, and July 1, 2003. Of the 183 treated patients, 155 (85%) received very high-dose ribavirin; the other 28 treated patients received lower-dose regimens. MEASUREMENTS AND MAIN
resultsData on all patients with SARS admitted to hospitals in Toronto were abstracted from charts and electronic databases onto a standardized form by trained research nurses. Logistic regression was used to evaluate the association between ribavirin use and each adverse event (progressive anemia, hypomagnesemia, hypocalcemia, bradycardia, transaminitis, and hyperamylasemia) after adjusting for SARS-related prognostic factors and corticosteroid use. In the primary logistic regression analysis, ribavirin use was strongly associated with anemia (odds ratio [OR] 3.0, 99% confidence interval [CI] 1.5-6.1, p<0.0001), hypomagnesemia (OR 21, 99% CI 5.8-73, p<0.0001), and bradycardia (OR 2.3, 99% CI 1.0-5.1, p=0.007). Hypocalcemia, transaminitis, and hyperamylasemia were not associated with ribavirin use. The risk of anemia, hypomagnesemia, and bradycardia attributable to ribavirin use was 27%, 45%, and 17%, respectively.
conclusionsHigh-dose ribavirin is associated with a high rate of adverse events. The use of high-dose ribavirin is appropriate only for the treatment of infectious diseases for which ribavirin has proven clinical efficacy, or in the context of a clinical trial. Ribavirin should not be used empirically for the treatment of viral syndromes of unknown origin.
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