Evidence map›Paper›PMID 38466771›Full record

SynthesisPLoS neglected tropical diseases2024

Efficacy and safety of therapeutic strategies for human brucellosis: A systematic review and network meta-analysis.

Sarah Nascimento Silva, Gláucia Cota, Diego Mendes Xavier, Glaciele Maria de Souza, Marina Rocha Fonseca Souza, Moisés Willian Aparecido Gonçalves, Felipe Francisco Tuon, Endi Lanza Galvão

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
6.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Sarah Nascimento SilvaPesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil.ORCID 0000-0002-1087-9819
Gláucia CotaPesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil.
Diego Mendes XavierPrograma de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina Minas Gerais, Brazil.
Glaciele Maria de SouzaPrograma de Pós-Graduação em Odontologia Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina Minas Gerais, Brazil.
Marina Rocha Fonseca SouzaPrograma de Pós-Graduação em Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Moisés Willian Aparecido GonçalvesPrograma de Pós-Graduação em Estomatopatologia da Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Felipe Francisco TuonPontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.ORCID 0000-0003-3471-1786
Endi Lanza GalvãoPesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil.
Universidade Federal dos Vales do Jequitinhonha e Mucuri · BRFundação Oswaldo Cruz · BRPontifícia Universidade Católica do Paraná · BRUniversidade Estadual de Campinas (UNICAMP) · BRUniversidade Federal de Minas Gerais · BR

Funding

Ministry of Health - BrazilNational Counsel Technological and Scientific Developments – CNPq
6 · The paper itself

Abstract

backgroundHuman brucellosis is a neglected, re-emerging, and endemic zoonosis in many countries. The debilitating and disabling potential of the disease is a warning about its morbidity, generating socioeconomic impact. This review aims to update the current evidence on the efficacy and safety of therapeutic options for human brucellosis using the network meta-analysis (NMA). METHODOLOGY: A systematic search was conducted in four different databases by independent reviewers to assess overall therapy failure, adverse events, and time to defervescence associated with different therapies. Randomized clinical trials (RCTs) evaluating any therapeutic drug intervention were selected, excluding non-original studies or studies related to localized forms of the disease or with less than 10 participants. Data were analyzed by frequentist statistics through NMA by random effects model. The risk of bias and certainty of evidence was assessed, this review was registered at PROSPERO.

resultsThirty-one (31) RCTs involving 4167 patients were included. Three networks of evidence were identified to evaluate the outcomes of interest. Triple therapy with doxycycline + streptomycin + hydroxychloroquine for 42 days (RR: 0.08; CI 95% 0.01-0.76) had a lower failure risk than the doxycycline + streptomycin regimen. Doxycycline + rifampicin had a higher risk of failure than doxycycline + streptomycin (RR: 1.96; CI 95% 1.27-3.01). No significant difference was observed between the regimens when analyzing the incidence of adverse events and time to defervescence. In general, most studies had a high risk of bias, and the results had a very low certainty of evidence.

conclusionsThis review confirmed the superiority of drugs already indicated for treating human brucellosis, such as the combination of doxycycline and aminoglycosides. The association of hydroxychloroquine to the dual regimen was identified as a potential strategy to prevent overall therapy failure, which is subject to confirmation in future studies.

Indexed as

Anti-Bacterial AgentsBrucellosisDoxycyclineDrug Therapy, CombinationStreptomycinHumansHydroxychloroquineRandomized Controlled Trials as TopicRifampinTreatment OutcomeAnti-Bacterial AgentsDoxycyclineHydroxychloroquineRifampinStreptomycin

Identifiers

PMID38466771
PMCPMC10978012
OpenAlexW4392663083

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.