Comparative Efficacy and Safety of the Artemisinin Derivatives in Severe Malaria treatment; a network meta-analysis (Data)
Description
Introduction This data was produced for a systematic review update and Network Meta-analyses (NMA) which was conducted according to the PRISMA guidelines extension. The NMA protocol was registered with PROSPERO registration number CRD42020218190 . Our objective was to evaluate the efficacy and safety of the artemisinin derivatives and quinine for treating severe Plasmodium falciparum malaria. Outcomes Assessed Outcomes have pharmacological and clinical relevance. Primary Outcome 1. Mortality. The proportion of death from all causes was compared between all interventions from onset of treatment. Secondary Outcomes 1. Neurological Sequela Events among survivors The proportion of patients developing neurological sequela was evaluated among those who survived. Subgroup analyses included time-point of neurological sequela assessment (acute vs persistent). 2. Coma Recovery time Mean time in hours from start of treatment to coma recovery was compared among interventions. 3. Parasite Clearance time The mean time in hours from initial administration of antimalarial absence of malaria parasites in blood-film was compared between treatments. 4. Fever Clearance Time The mean time in hours from initial administration of antimalarial to consecutive normothermia (defined in some studies as < 37.5 Degrees Celsius) was compared between treatments. 5. Adverse events The proportion of patients experiencing adverse events after treatment was initiated was compared. Both specific events and composite measures were explored. The most frequently reported adverse events were included in the NMA and the others were reported in a table as number of events and proportion experiencing the event. Data was prepared suitable for NMA random effect model in a frequentist framework using R (version 3.6.0) netmeta package (version 1.2-1). R script for the analyses can be found in the following link; https://github.com/nyaaba-nick/A-Comparative-Efficacy-and-Safety-of-the-Artemisinin-Derivatives-a-Network-Meta-Analyses-R-Script-
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Search We included all published and unpublished RCTs from three Cochrane systematic reviews that compared artemisinin derivatives to quinine in treating severe malaria. In addition, we combined the search strategies of these previous reviews and updated them by searching the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library; MEDLINE, Embase, LILACS, ISI Web of Science, and trial registers from inception up to February 2021. There were no limitations regarding language, geographical setting and year of publication. An example of search terms is shared as part of the files. Method of Collection Screening the title and abstract, and full-text for eligible studies were completed in duplicate using Rayyan review software by the reviewing team independently, blinded to each other. Disagreements were resolved by the other co-reviewers. Data Extraction Mortality, neurological sequela, and adverse events were assessed as binary outcomes whilst the rest as continuous outcomes. The data were extracted using a structured data form into an MS Excel workbook independently by NEA, GA, DSYA, MA and NN. This was designed and reviewed by NN, JOM and JH. Name of first author, year of publication, sample size, length of follow up, age group, summary estimate of age and geographical location was recorded for every study. Intervention specific data collected included name of intervention, dose, route of administration, sample size randomised to group and summary age provided. This same information was collected for comparator(s). For binary outcomes, the number of participants experiencing the event and the number assessed in each intervention group was recorded. For continuous outcomes, arithmetic means and standard deviations for each intervention group, with the numbers assessed in each group were extracted. If the number assessed in each group was not reported, the number randomised in the intervention arm was used. Where medians and range or interquartile range were reported instead of the means and standard deviations, they were extracted and the arithmetic means and standard deviations were estimated from the medians and range or interquartile range respectively using methods from ; Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014;14(1):1-13. All authors read and approved the last versions of these datasets and this manuscript.