Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis

Kirsten Alexandra Eberhardt; Johannes Mischlinger; Sabine Jordan; Mirjam Groger; Stephan Günther; Michael Ramharter

doi:10.1016/j.ijid.2019.07.015

Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis

Standard

Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis. / Eberhardt, Kirsten Alexandra; Mischlinger, Johannes; Jordan, Sabine; Groger, Mirjam; Günther, Stephan; Ramharter, Michael.

In: INT J INFECT DIS, Vol. 87, 01.10.2019, p. 15-20.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Eberhardt, KA, Mischlinger, J, Jordan, S, Groger, M, Günther, S & Ramharter, M 2019, 'Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis', INT J INFECT DIS, vol. 87, pp. 15-20. https://doi.org/10.1016/j.ijid.2019.07.015

APA

Eberhardt, K. A., Mischlinger, J., Jordan, S., Groger, M., Günther, S., & Ramharter, M. (2019). Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis. INT J INFECT DIS, 87, 15-20. https://doi.org/10.1016/j.ijid.2019.07.015

Vancouver

Eberhardt KA, Mischlinger J, Jordan S, Groger M, Günther S, Ramharter M. Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis. INT J INFECT DIS. 2019 Oct 1;87:15-20. https://doi.org/10.1016/j.ijid.2019.07.015

Bibtex

@article{cf83b3f30c834aafb90d52eb61b6e065,

title = "Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis",

abstract = "OBJECTIVES: Lassa fever (LF) causes annual outbreaks in endemic regions with high mortality of symptomatic patients. Ribavirin is recommended as standard treatment for LF in national and international guidelines but the evidence base for this recommendation has been questioned recently.METHODS: We conducted a systematic review and included 6 studies providing efficacy data of ribavirin treatment for LF (PROSPERO protocol CRD42018103994).RESULTS: Besides retrospective case series, the evidence mostly relies on a single prospective clinical trial with critical risk of bias. In this trial, LF associated mortality is reduced for patients with elevated aspartate aminotransferase (AST) when treated with ribavirin (OR 0.41, 95% CI 0.23-0.73), while mortality is higher for patients without elevated AST (OR 2.37, 95% CI 1.07-5.25).CONCLUSIONS: Based on the available data, current treatment guidelines may therefore put patients with mild LF at increased risk of death. The role of ribavirin in the treatment of LF requires urgent reassessment.",

keywords = "Aspartate Aminotransferases/metabolism, Clinical Trials as Topic, Humans, Lassa Fever/drug therapy, Lassa virus/drug effects, Prospective Studies, Retrospective Studies, Ribavirin/therapeutic use",

author = "Eberhardt, {Kirsten Alexandra} and Johannes Mischlinger and Sabine Jordan and Mirjam Groger and Stephan G{\"u}nther and Michael Ramharter",

year = "2019",

month = oct,

day = "1",

doi = "10.1016/j.ijid.2019.07.015",

language = "English",

volume = "87",

pages = "15--20",

journal = "INT J INFECT DIS",

issn = "1201-9712",

publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Ribavirin for the treatment of Lassa fever: A systematic review and meta-analysis

AU - Eberhardt, Kirsten Alexandra

AU - Mischlinger, Johannes

AU - Jordan, Sabine

AU - Groger, Mirjam

AU - Günther, Stephan

AU - Ramharter, Michael

PY - 2019/10/1

Y1 - 2019/10/1

N2 - OBJECTIVES: Lassa fever (LF) causes annual outbreaks in endemic regions with high mortality of symptomatic patients. Ribavirin is recommended as standard treatment for LF in national and international guidelines but the evidence base for this recommendation has been questioned recently.METHODS: We conducted a systematic review and included 6 studies providing efficacy data of ribavirin treatment for LF (PROSPERO protocol CRD42018103994).RESULTS: Besides retrospective case series, the evidence mostly relies on a single prospective clinical trial with critical risk of bias. In this trial, LF associated mortality is reduced for patients with elevated aspartate aminotransferase (AST) when treated with ribavirin (OR 0.41, 95% CI 0.23-0.73), while mortality is higher for patients without elevated AST (OR 2.37, 95% CI 1.07-5.25).CONCLUSIONS: Based on the available data, current treatment guidelines may therefore put patients with mild LF at increased risk of death. The role of ribavirin in the treatment of LF requires urgent reassessment.

AB - OBJECTIVES: Lassa fever (LF) causes annual outbreaks in endemic regions with high mortality of symptomatic patients. Ribavirin is recommended as standard treatment for LF in national and international guidelines but the evidence base for this recommendation has been questioned recently.METHODS: We conducted a systematic review and included 6 studies providing efficacy data of ribavirin treatment for LF (PROSPERO protocol CRD42018103994).RESULTS: Besides retrospective case series, the evidence mostly relies on a single prospective clinical trial with critical risk of bias. In this trial, LF associated mortality is reduced for patients with elevated aspartate aminotransferase (AST) when treated with ribavirin (OR 0.41, 95% CI 0.23-0.73), while mortality is higher for patients without elevated AST (OR 2.37, 95% CI 1.07-5.25).CONCLUSIONS: Based on the available data, current treatment guidelines may therefore put patients with mild LF at increased risk of death. The role of ribavirin in the treatment of LF requires urgent reassessment.

KW - Aspartate Aminotransferases/metabolism

KW - Clinical Trials as Topic

KW - Humans

KW - Lassa Fever/drug therapy

KW - Lassa virus/drug effects

KW - Prospective Studies

KW - Retrospective Studies

KW - Ribavirin/therapeutic use

U2 - 10.1016/j.ijid.2019.07.015

DO - 10.1016/j.ijid.2019.07.015

M3 - SCORING: Review article

C2 - 31357056

VL - 87

SP - 15

EP - 20

JO - INT J INFECT DIS

JF - INT J INFECT DIS

SN - 1201-9712

ER -