Tseng, Ping‐Tao ORCID: https://orcid.org/0000-0001-5761-7800, Zeng, Bing‐Syuan, Thompson, Trevor ORCID: https://orcid.org/0000-0001-9880-782X, Stubbs, Brendon, Hsueh, Po‐Ren, Su, Kuan‐Pin ORCID: https://orcid.org/0000-0002-4501-2502, Chen, Yen‐Wen, Chen, Tien‐Yu, Wu, Yi‐Cheng, Lin, Pao‐Yen, Carvalho, Andre F., Hsu, Chih‐Wei ORCID: https://orcid.org/0000-0002-8650-4060, Li, Dian‐Jeng, Yeh, Ta‐Chuan, Sun, Cheuk‐Kwan, Cheng, Yu‐Shian, Shiue, Yow‐Ling, Liang, Chih‐Sung ORCID: https://orcid.org/0000-0003-1138-5586 and Tu, Yu‐Kang ORCID: https://orcid.org/0000-0002-2461-474X (2023) Placebo effects on all‐cause mortality of patients with COVID‐19 in randomized controlled trials of interleukin 6 antagonists: a systematic review and network meta‐analysis. Psychiatry and Clinical Neurosciences (PCN). ISSN 1323-1316 (Print), 1440-1819 (Online) (doi:10.1111/pcn.13592)

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Abstract

Aim: Many randomized controlled trials (RCTs) have investigated the use of interleukin 6 antagonists for the treatment of coronavirus disease 2019 (COVID-19), yielding inconsistent results. This network meta-analysis (NMA) aimed to identify the source of these inconsistent results by reassessing whether participants treated with standard of care (SoC) plus placebo have different all-cause mortality from those treated with SoC alone and to reevaluate the efficacy of interleukin 6 antagonists in the treatment of COVID-19.
Methods: We conducted a systematic search for relevant RCTs from the inception of electronic databases through 1 September 2022. The primary outcome was all-cause mortality. The secondary outcomes were the incidences of major medical events, secondary infections, all-cause discontinuation, and serious adverse events.
Results: The results of NMA of 33 RCTs showed that patients with COVID-19 treated with SoC plus placebo had lower odds of all-cause mortality than those who received SoC alone (OR, 0.75 [95% confidence interval, 0.58-0.97]). This finding remained consistent after excluding studies with no incident deaths. In addition, when we consider the impact of the widely promoted COVID-19 vaccination and newly developed antiviral treatment strategy, the results from the analysis of the RCT published in 2021 and 2022 remained similar.
Conclusion: These findings suggest the potential influence of placebo effects on the treatment outcomes of COVID-19 in RCTs. When evaluating the efficacy of treatment strategies for COVID-19, it is crucial to consider the use of placebo in the design of clinical trials.

Item Type:	Article
Uncontrolled Keywords:	coronavirus disease 2019; COVID-19; interleukin; network meta-analysis; placebo effect
Subjects:	B Philosophy. Psychology. Religion > BF Psychology Q Science > QR Microbiology > QR355 Virology R Medicine > RS Pharmacy and materia medica
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	28 Sep 2024 01:38
URI:	http://gala.gre.ac.uk/id/eprint/44344

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