SynthesisArthritis & rheumatology (Hoboken, N.J.)2021
Antirheumatic Disease Therapies for the Treatment of COVID-19: A Systematic Review and Meta-Analysis.
Synthesis in Arthritis & rheumatology (Hoboken, N.J.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Anakinra for the treatment of COVID-19 patients: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Efficacy of tocilizumab in the treatment of COVID-19: An umbrella review.Reviews in medical virology · 2022Pooled it
- SARS-CoV-2 Infection and COVID-19 Outcomes in Rheumatic Diseases: A Systematic Literature Review and Meta-Analysis.Arthritis & rheumatology (Hoboken, N.J.) · 2022Pooled it
- Interleukin-1 blocking agents for treating COVID-19.The Cochrane database of systematic reviews · 2022Pooled it
- Mortality, viral clearance, and other clinical outcomes of hydroxychloroquine in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.Clinical and translational science · 2021Pooled it
- Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data.Autoimmunity reviews · 2021Pooled it
- Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review ofTheranostics · 2021Pooled it
- A Randomized Clinical Trial of Linagliptin vs. Standard of Care in Patients Hospitalized With Diabetes and COVID-19.Frontiers in endocrinology · 2021Trial
- Article
- Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the "fail-and-learn" strategy during the first two waves of the pandemic in 2020.Patient safety in surgery · 2023Article
- A dynamic Bayesian network-based emergency decision-making framework highlighting emergency propagations: Illustrated using the Fukushima nuclear accidents and the Covid-19 pandemic.Risk analysis : an official publication of the Society for Risk Analysis · 2023Article
- Benefit-risk evaluation of COVID-19 vaccination in special population groups of interest.Vaccine · 2022Review
- COVID-19 outcomes among rheumatic disease patients in Kuwait: Data from the COVID-19 Global Rheumatology Alliance (C19-GRA) physician registry.International journal of rheumatic diseases · 2022Article
- Anti-Rheumatic Drugs May Ameliorate the Clinical Course and Outcome of COVID-19 In Rheumatoid Arthritis Patients.Mediterranean journal of rheumatology · 2022Article
- COVID-19 and rheumatic diseases: A mini-review.Frontiers in medicine · 2022Review
- Mortality related to COVID-19 in patients with rheumatic and musculoskeletal diseases, first wave of the outbreak: a single-center study.Therapeutic advances in musculoskeletal disease · 2022Article
- Role of targeted therapies in rheumatic patients on COVID-19 outcomes: results from the COVIDSER study.RMD open · 2021Article
- Article
- Epigenetic targeting of the ACE2 and NRP1 viral receptors limits SARS-CoV-2 infectivity.Clinical epigenetics · 2021Article
- The role of immunomodulatory medications in the treatment of COVID-19.Current opinion in rheumatology · 2021Review
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
objectiveAntirheumatic disease therapies have been used to treat coronavirus disease 2019 (COVID-19) and its complications. We conducted a systematic review and meta-analysis to describe the current evidence.
methodsA search of published and preprint databases in all languages was performed. Included studies described ≥1 relevant clinical outcome for ≥5 patients who were infected with severe acute respiratory syndrome coronavirus 2 and were treated with antirheumatic disease therapy between January 1, 2019 and May 29, 2020. Pairs of reviewers screened articles, extracted data, and assessed risk of bias. A meta-analysis of effect sizes using random-effects models was performed when possible.
resultsThe search identified 3,935 articles, of which 45 were included (4 randomized controlled trials, 29 cohort studies, and 12 case series). All studies evaluated hospitalized patients, and 29 of the 45 studies had been published in a peer-reviewed journal. In a meta-analysis of 3 cohort studies with a low risk of bias, hydroxychloroquine use was not significantly associated with mortality (pooled hazard ratio [HR] 1.41 [95% confidence interval (95% CI) 0.83, 2.42]). In a meta-analysis of 2 cohort studies with some concerns/higher risk of bias, anakinra use was associated with lower mortality (pooled HR 0.25 [95% CI 0.12, 0.52]). Evidence was inconclusive with regard to other antirheumatic disease therapies, and the majority of other studies had a high risk of bias.
conclusionIn this systematic review and meta-analysis, hydroxychloroquine use was not associated with benefit or harm regarding COVID-19 mortality. The evidence supporting the effect of other antirheumatic disease therapies in COVID-19 is currently inconclusive.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.