Quadruple versus triple combination antiretroviral therapies for treatment naive people with HIV: systematic review and meta-analysis of randomised controlled trials

Feng, Qi; Zhou, Aoshuang; Zou, Huachun; Ingle, Suzanne M; May, Margaret T; Cai, Weiping; Cheng, Chien-Yu; Yang, Zu‐Yao; Tang, Jin‐Ling

doi:10.1136/bmj.l4179

Cited by 24 publications

(22 citation statements)

References 41 publications

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“…Sensitivity analysis that pooled the outcome data reported at 48 weeks, which also showed consistent results, was performed for undetectable HIV-1 RNA and increase in CD4 T cell count only (supplement 3J and 3K) and not for other outcomes owing to lack of relevant data. When the standard deviations for increase in CD4 T cell count were replaced by those estimated by different methods, the results of figure 3 either remained similar (that is, quadruple and triple arms not statistically different) or favoured triple therapies (supplement 2).”192…”

Section: Results Of Synthesesmentioning

confidence: 98%

“…For an example of individual study results presented for a dichotomous outcome, see figure 2. For an example of individual study results presented for a continuous outcome, see figure 3 192…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…The figure displays for each study included in the meta-analysis the summary statistics (mean, standard deviation, and sample size) for the quadruple and triple combination antiretroviral therapies (cART) groups, and the mean difference and its 95% confidence interval for the continuous outcome, CD4 T cell count (cells/μL). Reproduced from Feng et al192…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

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PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

Page

Moher

Bossuyt

et al. 2021

BMJ

4,773

2,786

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The PRISMA 2020 statement includes a checklist of 27 items to guide reporting of systematic reviews In this article we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews We hope that uptake of the PRISMA 2020 statement will lead to more transparent, complete, and accurate reporting of systematic reviews, thus facilitating evidence based decision making on 15 April 2021 by guest. Protected by copyright.

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Section: Results Of Synthesesmentioning

confidence: 98%

Section: Results Of Individual Studiesmentioning

confidence: 99%

Section: Results Of Individual Studiesmentioning

confidence: 99%

See 1 more Smart Citation

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

Page

Moher

Bossuyt

et al. 2021

BMJ

4,773

2,786

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“…The tool includes evaluation in seven areas: random sequence generation, allocation blinding, blinding of participants, blinding of outcome measures, incomplete outcome data, selective reporting, and other biases. The risk of bias in each area was judged to be low, high or unclear [16]. For cohort studies, the Newcastle-Ottawa Scale (NOS) was used for quality assessment.…”

Section: Risk Of Bias Assessment Of the Included Studiesmentioning

confidence: 99%

Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis

Zhao

Huang

Liang

et al. 2020

BMC Musculoskelet Disord

109

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Background: Studies have shown that the combined application of hyaluronic acid (HA) and platelet-rich plasma (PRP) can repair degenerated cartilage and delay the progression of knee osteoarthritis (KOA). The purpose of this study was to explore the efficacy and safety of the intra-articular injection of PRP combined with HA compared with the intra-articular injection of PRP or HA alone in the treatment of KOA. Methods: The PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure (CNKI) databases were searched from inception to December 2019. Randomized controlled trials and cohort studies of PRP combined with HA for KOA were included. Two orthopaedic surgeons conducted the literature retrieval and extracted the data. Outcome indicators included the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Lequesne Index, the visual analogue scale (VAS) for pain, and adverse events (AEs). Review Manager 5.3 was used to calculate the relative risk (RR) or standardized mean difference (SMD) of the pooled data. STATA 14.0 was used for quantitative publication bias evaluation. (Continued on next page)Results: Seven studies (5 randomized controlled trials, 2 cohort studies) with a total of 941 patients were included. In the VAS comparison after 6 months of follow-up, PRP combined with HA was more likely to reduce knee pain than PRP alone (SMD: − 0.31; 95% confidence interval (CI): − 0.55 to − 0.06; P = 0.01 < 0.05). PRP combined with HA for KOA achieved better improvements in the WOMAC Function Score (SMD: -0.32; 95% CI: − 0.54 to − 0.10; P < 0.05) and WOMAC Total Score (SMD: -0.42; 95% CI: − 0.67 to − 0.17; P < 0.05) at the 12-month follow-up than did the application of PRP alone. In a comparison of Lequesne Index scores at the 6-month follow-up, PRP combined with HA improved knee pain scores more than PRP alone (SMD: -0.42; 95% CI: − 0.67 to − 0.17; P < 0.05). In terms of AEs, PRP combined with HA was not significantly different from PRP or HA alone (P > 0.05). Conclusions: Compared with intra-articular injection of PRP alone, that of PRP combined with HA can improve the WOMAC Function Scores, WOMAC Total Score, 6-month follow-up VAS ratings, and Lequesne Index scores. However, in terms of the incidence of AEs, PRP combined with HA is not significantly different from PRP or HA alone.

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“…24 weeks), which was not sufficient for evaluating clinically significant outcomes for intervention. The timeframe was applied in the previous systematic reviews on HIV treatment [ 32 ]. If the same study were overlapped in multiple publications, only the complete or most recent literature was included in the present study.…”

Section: Methodsmentioning

confidence: 99%

Integrase inhibitors versus efavirenz combination antiretroviral therapies for TB/HIV coinfection: a meta-analysis of randomized controlled trials

et al. 2021

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Background Integrase inhibitors (INIs)-based antiretroviral therapies (ART) are more recommended than efavirenz (EFV)-based ART for people living with HIV/AIDS (PLWHA). Yet, the advantage of integrase inhibitors in treating TB/HIV coinfection is uncertain. Therefore, the objective of this systematic review is to evaluate the effects and safety of INIs- versus EFV-based ART in TB/HIV coinfection, and demonstrate the feasibility of the regimens. Methods Four electronic databases were systematically searched through September 2020. Fixed-effects models were used to calculate pooled effect size for all outcomes. The primary outcomes were virologic suppression and bacteriology suppression for INIs- versus EFV-based ART. Secondary outcomes included CD4+ cell counts change from baseline, adherence and safety. Results Three trials (including 672 TB/HIV patients) were eligible. ART combining INIs and EFV had similar effects for all outcomes, with none of the point estimates argued against the INIs-based ART on TB/HIV patients. Compared to EFV-based ART as the reference group, the RR was 0.94 (95% CI 0.85 to 1.05) for virologic suppression, 1.00 (95% CI 0.95 to 1.05) for bacteriology suppression, 0.98 (95% CI 0.95 to 1.01) for adherence. The mean difference in CD4+ cell counts increase between the two groups was 14.23 cells/μl (95% CI 0− 6.40 to 34.86). With regard to safety (adverse events, drug-related adverse events, discontinuation for drugs, grade 3–4 adverse events, IRIS (grade 3–4), and death), INIs-based regimen was broadly similar to EFV-based regimens. The analytical results in all sub-analyses of raltegravir- (RAL) and dolutegravir (DTG) -based ART were valid. Conclusion This meta-analysis demonstrates similar efficacy and safety of INIs-based ART compared with EFV-based ART. This finding supports INIs-based ART as a first-line treatment in TB/HIV patients. The conclusions presented here still await further validation owing to insufficient data.

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Quadruple versus triple combination antiretroviral therapies for treatment naive people with HIV: systematic review and meta-analysis of randomised controlled trials

Cited by 24 publications

References 41 publications

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews

Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis

Integrase inhibitors versus efavirenz combination antiretroviral therapies for TB/HIV coinfection: a meta-analysis of randomized controlled trials

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