Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies1

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Cheng, Hung-Yuan ; French, Clare E. ; Salam, Alex P. ; Dawson, Sarah ; McAleenan, Alexandra ; McGuinness, Luke A. ; Savović, Jelena ; Horby, Peter W. ; Sterne, Jonathan A.C.
• Description:
  Ribavirin has been used widely to treat Lassa fever in West Africa since the 1980s. However, few studies have systematically appraised the evidence for its use. We conducted a systematic review of published and unpublished literature retrieved from electronic databases and gray literature from inception to March 8, 2022. We identified 13 studies of the comparative effectiveness of ribavirin versus no ribavirin treatment on mortality outcomes, including unpublished data from a study in Sierra Leone provided through a US Freedom of Information Act request. Although ribavirin was associated with decreased mortality rates, results of these studies were at critical or serious risk for bias when appraised using the ROBINS-I tool. Important risks for bias related to lack of control for confounders, immortal time bias, and missing outcome data. Robust evidence supporting the use of ribavirin in Lassa fever is lacking. Well-conducted clinical trials to elucidate the effectiveness of ribavirin for Lassa fever are needed.
• Subjects:
  Humans Lassa Fever Lassa Virus Ribavirin Sierra Leone
• Source:
  Emerg Infect Dis. 28(8):1559-1568
• Pubmed ID:
  35876478
• Pubmed Central ID:
  PMC9328902
• Document Type:
  Journal Article
• Funding:
  WT_/Wellcome TrustUnited Kingdom/
• Place as Subject:
  Africa, Western
• Volume:
  28
• Issue:
  8
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:de3b1d96839e6c24d3edd8b83b63f6ca267e2b70de90680e95dc6a51877d08c7
• Download URL:
  https://stacks.cdc.gov/view/cdc/120171/cdc_120171_DS1.pdf
• File Type:
  [PDF - 2.08 MB ]