Proton pump inhibitor on susceptibility to COVID-19 and its severity: a systematic review and meta-analysis

Pranata, Raymond; Huang, Ian; Lawrensia, Sherly; Henrina, Joshua; Lim, Michael Anthonius; Lukito, Antonia Anna; Kuswardhani, RA Tuty; Wibawa, I Dewa Nyoman

doi:10.1007/s43440-021-00263-x

Cited by 18 publications

(25 citation statements)

References 41 publications

(29 reference statements)

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“…Meta-regression analysis was performed to explore potential source of heterogeneity, several comorbidities [ [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] ] and its associated medications [ 33 , 37 , 38 ] have been shown to affect mortality in patients with COVID-19, thus may alter the benefit. The meta-regression showed that all covariates we analyzed did not significantly contribute to heterogeneity of the pooled effect estimate.…”

Section: Discussionmentioning

confidence: 99%

Effect of colchicine on mortality in patients with COVID-19 – A systematic review and meta-analysis

Zein

Raffaello

2022

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aim This systematic review and meta-analysis aimed to evaluate the latest evidence on the association between colchicine and mortality in patients with COVID-19. Methods We performed a comprehensive literature search from the PubMed, Scopus, Embase, EuropePMC, and Clinicaltrials.gov up until 02 January 2022. We include randomized controlled trials (RCTs) and observational studies reporting colchicine use in patients with COVID-19 and mortality within 30 days. The intervention group was patients given colchicine during the course of treatment. The control group was patients given placebo or standard of care at the respective institutions. The outcome was mortality. The effect estimate was reported as risk ratio (RR). Results There were 12 studies comprising of 6953 patients included in this meta-analysis. Mortality rate was 0.18 [95%CI 0.10, 0.26] in the colchicine group and 0.26 [95%CI 0.15, 0.38] in the control group. Colchicine was associated with reduction in mortality (RR 0.66 [95%CI 0.53, 0.83], p < 0.001; I 2 : 42%). Sensitivity analysis using fixed-effect model (RR 0.73 [95%CI 0.63, 0.83], p < 0.001; I 2 : 42%. Subgroup analysis on the four RCTs showed non-significant result (RR 0.81 [95%CI 0.54, 1.20], p = 0.29; I 2 : 10%). Meta-regression showed that the association between colchicine and reduced mortality was not affected by age (p = 0.613) [Fig. 3], sex (p = 0.915), diabetes (p = 0.795), and hypertension (p = 0.403). Conclusion Though the meta-analysis showed decreased mortality with colchicine in patients with COVID-19, the meta-analysis of randomized trials did not show any significant effect of colchicine on mortality.

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Section: Discussionmentioning

confidence: 99%

Effect of colchicine on mortality in patients with COVID-19 – A systematic review and meta-analysis

Zein

Raffaello

2022

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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“…Despite the fact that most conditions require only short‐term treatment, many patients continue therapy for longer periods, raising concerns about potential associated risks 5 . In addition, several adverse clinical outcomes of COVID‐19 associated with PPI use have been documented in recent meta‐analyses of observational studies 6–8 ; however, there is no consensus on these effects due to the lack of certainty of the evidence.…”

Section: Introductionmentioning

confidence: 99%

Association of proton‐pump inhibitor use with adverse health outcomes: A systematic umbrella review of meta‐analyses of cohort studies and randomised controlled trials

Veettil

Sadoyu²,

Bald

et al. 2021

Brit J Clinical Pharma

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The aim was to perform an umbrella review to summarise the existing evidence on proton-pump inhibitor (PPI) use and adverse outcomes and to grade the certainty of evidence.Methods: Electronic databases were searched up to July 2021 for meta-analyses of cohort studies and/or randomised controlled trials (RCTs). Summary effect sizes from a random-effects model, between-study heterogeneity, 95% prediction interval, small-study effect, excess significance and credibility ceilings were devised to classify the credibility of evidence from meta-analyses of cohort studies, whereas the GRADE approach was used for meta-analyses of RCTs.Results: In meta-analyses of cohort studies, 52 of the 91 examined associations were statistically significant (P ≤ .05). Convincing evidence emerged from main analysis for the association between PPI use and risk of all-site fracture and chronic kidney disease in the elderly population. However, none of these associations remained supported by convincing evidence after sensitivity analyses. The use of PPI is also associated with an increased risk of mortality due to COVID-19 infection and other related adverse outcomes, but the quality of evidence was weak. In meta-analyses of RCTs, 38 of the 63 examined associations were statistically significant. However, no associations were supported by high or moderate-quality evidence.Conclusion: This study's findings imply that most putative adverse outcomes associated with PPI use may not be supported by high-quality evidence and are likely to have been affected by underlying confounding factors. Future research is needed to confirm the causal association between PPI use and risk of fracture and chronic kidney disease.

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“…Both metformin and ACEI/ARB have been shown to be associated with better prognosis in patients with COVID-19 [ 13 , 34 , 35 ], thus, the proportion of benefit from DPP-IV inhibitor may be lower when combined with other medications that may improve prognosis. Comorbidities are important to be analyzed in meta-regression because they are associated with poor outcome in patients with COVID-19 [ [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ]. One of the study was excluded because the outcome was composite of mortality and intensive care unit admission, there was no separate data on mortality, the study showed that DPP-IV inhibitor was associated with better clinical outcome [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…Comorbidities are important to be analyzed in meta-regression because they are associated with poor outcome in patients with COVID-19 [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] . One of the study was excluded because the outcome was composite of mortality and intensive care unit admission, there was no separate data on mortality, the study showed that DPP-IV inhibitor was associated with better clinical outcome 51 .…”

Section: Discussionmentioning

confidence: 99%

Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 — A systematic review and meta-analysis

Zein

Raffaello

2022

Primary Care Diabetes

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Introduction This systematic review and meta-analysis aimed to synthesize the latest evidence on the effect of dipeptidyl peptidase-4 (DPP-IV) inhibitor in patients with COVID-19. Methods We performed a systematic literature search from the PubMed, Scopus, Embase, and Clinicaltrials.gov up until 15 July 2021. Studies that met the following criteria were included: prospective or retrospective observational studies or case series or randomized controlled trials (RCTs) reporting DPP-IV inhibitor use in patients with COVID-19 and mortality. The intervention group was patients receiving DPP-IV inhibitor. The control group was patients that did not receive DPP-IV inhibitor. The outcome was mortality reported as odds ratio (OR). Results There were 11 studies consisting of 5,950 patients in this meta-analysis. DPP-IV inhibitor use was associated with reduced mortality (OR 0.75 [0.56, 0.99], p = 0.043, I 2 : 42.9, p = 0.064) compared to those that did not receive DPP-IV inhibitor. Sensitivity analysis using the fixed-effect model (OR 0.75 [0.63, 0.88], p < 0.001, I 2 : 42.9, p = 0.064) also showed mortality benefit. The association between DPP-IV inhibitor and mortality was not significantly affected by age (p = 0.540), sex (p = 0.054), hypertension (p = 0.320), location (continent; p = 0.532), and retrospective/prospective nature of the study (p = 0.840). However, the association was affected by metformin (OR 1.03 [95% CI 1.01, 1.06], p = 0.010) and ACEI/ARB use (OR 1.06 [95% CI 1.02, 1.10], p = 0.004). Conclusion This meta-analysis showed that DPP-IV inhibitor was associated with reduced mortality in patients with COVID-19.

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Proton pump inhibitor on susceptibility to COVID-19 and its severity: a systematic review and meta-analysis

Cited by 18 publications

References 41 publications

Effect of colchicine on mortality in patients with COVID-19 – A systematic review and meta-analysis

Effect of colchicine on mortality in patients with COVID-19 – A systematic review and meta-analysis

Association of proton‐pump inhibitor use with adverse health outcomes: A systematic umbrella review of meta‐analyses of cohort studies and randomised controlled trials

Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 — A systematic review and meta-analysis

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