Lefamulin versus omadacycline for community acquired bacterial pneumonia: a systematic review and anchored indirect treatment comparison using moxifloxacin as the common comparator
Abstract
Aim: Community-acquired bacterial pneumonia (CABP) remains a major cause of morbidity and mortality worldwide, particularly among elderly and susceptible populations. Escalating antimicrobial resistance among prevalent CABP pathogens in China, combined with safety limitations of existing regimens, underscores the urgent need for novel therapeutic strategies. Lefamulin (LEF) and omadacycline (OMA), recently approved in mainland China, offer promising alternatives, but direct comparative evidence is lacking. This study aims to indirectly compare the clinical efficacy and safety outcomes of LEF versus OMA in the treatment of CABP and to explore subgroup differences in high-risk populations. Materials & methods: A systematic literature review was conducted across PubMed, Embase, the Cochrane Library and ClinicalTrials.gov from inception through March 2024, limited to English-language studies, to identify phase III randomized controlled trials evaluating LEF or OMA in adults with CABP. The Bucher method was used for the indirect comparison, with effect estimates reported as risk ratios (RRs) and 95% CIs. Similarities in trial design and populations supported the transitivity assumption. Primary end points were early clinical response (ECR), investigator-assessed clinical response (IACR) at test of cure (TOC) and treatment-emergent adverse events leading to death. Subgroup analyses were further stratified by patient age (elderly patients), presence of comorbidities and causative…
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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: 2,063 participants or records.
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