534 |
Lamontagne F., Agoritsas T., Siemieniuk R., Rochwerg B., Bartoszko J., Askie L., MacDonald H., Amin W., Bausch F.J., Burhan E., Cecconi M., Chanda D., Dat V.Q., Du B., Geduld H., Gee P., Nerina H., Hashimi M., Hunt B.J., Kabra S., Kanda S., Kawano-Dourado L., Kim Y.-J., Kissoon N., Kwizera A., Leo Y.-S., Mahaka I., Manai H., Mino G., Nsutebu E., Pshenichnaya N., Qadir N., Ranganathan S.S., Sabzwari S., Sarin R., Sharland M., Shen Y., Souza J.P., Stegemann M., Ugarte S., Venkatapuram S., Vuyiseka D., Preller J., Brignardello-Petersen R., Kum E., Qasim A., Zeraatkar D., Owen A., Guyatt G., Lytvyn L., Diaz J., Vandvik P.O., Jacobs M. |
15829826700;9734624300;23981410900;24345132600;56940778900;6603045596;57223601603;57221910483;57192706123;36058554600;16505953800;26029327700;56046962100;36131305900;36544760800;57204935223;57222260351;57222257762;55246203600;36488033400;57218352115;45561384900;7410198066;57221100878;35208486000;7004240142;56957092900;57211044922;57222258682;6603293930;6504380233;55622346400;6506124670;35240808700;23006204200;57203106412;16744841200;13205307600;23480876400;25654264800;25937500100;57079260800;55318241800;45161122100;57221470276;57206787520;57190033017;7202052634;8841196600;56600867200;13404130400;6602321455;36848322200; |
A living WHO guideline on drugs to prevent covid-19 |
2021 |
The BMJ |
372 |
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n526 |
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29 |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102047389&doi=10.1136%2fbmj.n526&partnerID=40&md5=4b6b72a2cd8535abedd1f2abe649c5ac |
Université de Sherbrooke, Centre de Recherche Due Chu de Sherbrooke, Sherbrooke, QC, Canada; Division of General Internal Medicine, Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Magic Evidence Ecosystem Foundation, Oslo, Norway; Department of Medicine, McMaster University, Hamilton, ON, Canada; World Health Organization, Geneva, Switzerland; The Bmj, London, United Kingdom; Ministry of Health and Population, Cairo, Egypt; Geneva University Hospital, Switzerland; Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Indonesia; Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy; Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Viet Nam; Peking Union Medical College Hospital, Beijing, China; Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; United States; Royal Melbourne Hospital, Melbourne, Australia; Ziauddin University, Karachi, Pakistan; Guy's and St Thomas' Nhs Foundation Trust, London, United Kingdom; All India Institute of Medical Sciences, New Delhi, India; McMaster University (Alumnus), Canada; Pulmonary Division, Heart Institute (InCor)- Hcfmusp, Medical School, University of Sao Paulo, São Paulo, Brazil; Sungkyunkwan University, School of Medicine, Samsung Medical Center, Seoul, South Korea; Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada; Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda; National Center for Infectious Diseases, Singapore, Singapore; Pangaea Harare, Zimbabwe; Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia; Alcivar Hospital, Guayaquil, Ecuador; Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russian Federation; Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States; University of Colombo, Colombo, Sri Lanka; Aga Khan University, Karachi, Pakistan; National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India; St. George's University Hospital, London, United Kingdom; Shanghai Public Health Clinical Center, Fudan University, Shanghai, China; University of Sao Paulo, Sao Paulo, Brazil; Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; Faculty of Medicine, Andres Bello University, Indisa Clinic, Santiago, Chile; King's College, London, United Kingdom; University of Stellenbosch, South Africa; University of Liverpool, Liverpool, United Kingdom; Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway; Royal Free London Nhs Foundation Trust, London, United Kingdom; Research Institute, Hospital Do Coração (HCor), São Paulo, Brazil |
Lamontagne, F., Université de Sherbrooke, Centre de Recherche Due Chu de Sherbrooke, Sherbrooke, QC, Canada; Agoritsas, T., Division of General Internal Medicine, Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Magic Evidence Ecosystem Foundation, Oslo, Norway; Siemieniuk, R., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Department of Medicine, McMaster University, Hamilton, ON, Canada; Rochwerg, B., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Department of Medicine, McMaster University, Hamilton, ON, Canada; Bartoszko, J., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Askie, L., World Health Organization, Geneva, Switzerland; MacDonald, H., The Bmj, London, United Kingdom; Amin, W., Ministry of Health and Population, Cairo, Egypt; Bausch, F.J., Geneva University Hospital, Switzerland; Burhan, E., Infection Division, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Indonesia; Cecconi, M., Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy; Chanda, D., Adult Infectious Disease Centre, University Teaching Hospital, Lusaka, Zambia; Dat, V.Q., Department of Infectious Diseases, Hanoi Medical University, Hanoi, Viet Nam; Du, B., Peking Union Medical College Hospital, Beijing, China; Geduld, H., Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Gee, P., United States; Nerina, H., Royal Melbourne Hospital, Melbourne, Australia; Hashimi, M., Ziauddin University, Karachi, Pakistan; Hunt, B.J., Guy's and St Thomas' Nhs Foundation Trust, London, United Kingdom; Kabra, S., All India Institute of Medical Sciences, New Delhi, India; Kanda, S., McMaster University (Alumnus), Canada; Kawano-Dourado, L., Pulmonary Division, Heart Institute (InCor)- Hcfmusp, Medical School, University of Sao Paulo, São Paulo, Brazil, Research Institute, Hospital Do Coração (HCor), São Paulo, Brazil; Kim, Y.-J., Sungkyunkwan University, School of Medicine, Samsung Medical Center, Seoul, South Korea; Kissoon, N., Department of Paediatrics and Emergency Medicine, University of British Columbia, Vancouver, Canada; Kwizera, A., Department of Anaesthesia and Critical Care, College of Health Sciences, Makerere University, Kampala, Uganda; Leo, Y.-S., National Center for Infectious Diseases, Singapore, Singapore; Mahaka, I., Pangaea Harare, Zimbabwe; Manai, H., Emergency Medical Services, Faculty of Medicine, Tunis, Tunisia; Mino, G., Alcivar Hospital, Guayaquil, Ecuador; Nsutebu, E., Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; Pshenichnaya, N., Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow, Russian Federation; Qadir, N., Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States; Ranganathan, S.S., University of Colombo, Colombo, Sri Lanka; Sabzwari, S., Aga Khan University, Karachi, Pakistan; Sarin, R., National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India; Sharland, M., St. George's University Hospital, London, United Kingdom; Shen, Y., Shanghai Public Health Clinical Center, Fudan University, Shanghai, China; Souza, J.P., University of Sao Paulo, Sao Paulo, Brazil; Stegemann, M., Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Berlin, Germany; Ugarte, S., Faculty of Medicine, Andres Bello University, Indisa Clinic, Santiago, Chile; Venkatapuram, S., King's College, London, United Kingdom; Vuyiseka, D., University of Stellenbosch, South Africa; Preller, J., World Health Organization, Geneva, Switzerland; Brignardello-Petersen, R., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Kum, E., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Qasim, A., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Zeraatkar, D., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Owen, A., University of Liverpool, Liverpool, United Kingdom; Guyatt, G., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Department of Medicine, McMaster University, Hamilton, ON, Canada; Lytvyn, L., Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Diaz, J., World Health Organization, Geneva, Switzerland; Vandvik, P.O., Magic Evidence Ecosystem Foundation, Oslo, Norway, Department of Health Economics and Health Management, Institute for Health and Society, University of Oslo, Oslo, Norway; Jacobs, M., Royal Free London Nhs Foundation Trust, London, United Kingdom |
Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity. © Published by the BMJ Publishing Group Limited. |
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hydroxychloroquine; hydroxychloroquine; immunologic factor; coronavirus disease 2019; drug use; health care policy; high risk patient; human; immune response; infection prevention; nonhuman; practice guideline; Review; Severe acute respiratory syndrome coronavirus 2; World Health Organization; chemoprophylaxis; clinical decision making; drug effect; epidemiology; practice guideline; prevention and control; procedures; risk assessment; uncertainty; Chemoprevention; Clinical Decision-Making; COVID-19; Humans; Hydroxychloroquine; Immunologic Factors; Risk Assessment; SARS-CoV-2; Uncertainty; World Health Organization |
BMJ Publishing Group |
09598146 |
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33649077 |
Review |
Q1 |
1831 |
1579 |
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