Ribavirin treatment for respiratory syncytial virus infection in patients with hematologic malignancy and hematopoietic stem cell transplant recipients: A systematic review and meta-analysis
Abstract
BACKGROUND
Ribavirin use for respiratory syncytial virus (RSV) infection in patients with hematologic malignancies (HM) and hematopoietic stem cell transplant (HSCT) recipients remains controversial.
OBJECTIVES
To summarize the current evidence of ribavirin treatment in association with mortality and progression to lower respiratory tract infection (LRTI) among HM/HSCT patients with RSV infection.
DATA SOURCES
MEDLINE, Embase, and ISI Web of Science.
STUDY ELIGIBILITY CRITERIA
Randomized controlled trials (RCTs) and observational studies investigating the effects of ribavirin, compared to treatment without ribavirin, for RSV infection in patients with HM/HSCT were included.
METHODS
The random-effects model was used to calculate the pooled odds ratio (pOR) with 95% confidence interval (CI) for the pooled effect estimates of ribavirin benefits. The risk of bias in non-randomized studies of exposure (ROBINS-E) was used for assessing the risk of bias in the studies. Grading of recommendation assessment, development, and evaluation (GRADE) was used to evaluate the certainty of evidence.
RESULTS
One RCT and 14 observational studies were included, representing 1,125 patients with HM/HSCT. Ribavirin use was not associated with lower all-cause nor RSV-associated mortality with pORs [95% CI] of 0.81 [0.40,1.66], I2=55% (low certainty of evidence) and 0.48 [0.11,2.15], I2=64% (very low certainty of evidence), respectively. In subgroup analyses, ribavirin use was associated with lower…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,125 participants or records.
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