A living WHO guideline on drugs for covid-19
Clinical question What is the role of drug interventions in the treatment of patients with covid-19?New recommendation The latest version of this WHO living guidance focuses on remdesivir, following the 15 October 2020 preprint publication of results from the WHO SOLIDARITY trial. It contains a weak...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020
|
| _version_ | 1797072161626652672 |
|---|---|
| author | Rochwerg, B Agoritsas, T Lamontagne, FCC Leo, Y-S Macdonald, H Agarwal, A Zeng, L Lytvyn, L Appiah, JA Amin, W Arabi, Y Blumberg, L Burhan, E Bausch, F Calfee, CS Cao, B Cecconi, M Chanda, D Cooke, G Dunning, J Du, B Geduld, H Gee, P Hashimi, M Hui, DS Kabra, S Kanda, S Kawano-Dourado, L Kim, Y-J Kissoon, N Kwizera, A Laake, JH Machado, FR Mahaka, I Manai, H Mino, G Nsutebu, E Pshenichnaya, N Qadir, N Sabzwari, S Sarin, R Sharland, M Shen, Y Ranganathan, SS Souza, J Ugarte, S Venkatapuam, S Dat, VQ Vuyiseka, D Wuewickrama, A |
| author_facet | Rochwerg, B Agoritsas, T Lamontagne, FCC Leo, Y-S Macdonald, H Agarwal, A Zeng, L Lytvyn, L Appiah, JA Amin, W Arabi, Y Blumberg, L Burhan, E Bausch, F Calfee, CS Cao, B Cecconi, M Chanda, D Cooke, G Dunning, J Du, B Geduld, H Gee, P Hashimi, M Hui, DS Kabra, S Kanda, S Kawano-Dourado, L Kim, Y-J Kissoon, N Kwizera, A Laake, JH Machado, FR Mahaka, I Manai, H Mino, G Nsutebu, E Pshenichnaya, N Qadir, N Sabzwari, S Sarin, R Sharland, M Shen, Y Ranganathan, SS Souza, J Ugarte, S Venkatapuam, S Dat, VQ Vuyiseka, D Wuewickrama, A |
| author_sort | Rochwerg, B |
| collection | OXFORD |
| description | Clinical question What is the role of drug interventions in the treatment of patients with covid-19?New recommendation The latest version of this WHO living guidance focuses on remdesivir, following the 15 October 2020 preprint publication of results from the WHO SOLIDARITY trial. It contains a weak or conditional recommendation against the use of remdesivir in hospitalised patients with covid-19Recommendations The first version on this living guidance focused on corticosteroids. The strong recommendation for systemic corticosteroids in patients with severe and critical covid-19, and a weak or conditional recommendation against systemic corticosteroids in patients with non-severe covid-19 are unchanged.How this guideline was created WHO has partnered with the non-profit Magic Evidence Ecosystem Foundation (MAGIC) for methodologic support, to develop and disseminate living guidance for covid-19 drug treatments, based on a living systematic review and network analysis. An international standing Guideline Development Group (GDG) of content experts, clinicians, patients, and methodologists produced recommendations following standards for trustworthy guideline development using the GRADE approach. No competing interests were identified for any panel member.Understanding the new recommendation When moving from evidence to the conditional recommendation against the use of remdesivir in patients with covid-19, the panel emphasised the evidence suggesting no important effect on mortality, need for mechanical ventilation, time to clinical improvement, and other patient-important outcomes. Considering the low or very low certainty evidence for all outcomes, the panel interpreted the evidence as not proving that remdesivir is ineffective; rather, there is no evidence based on currently available data that it does improve patient-important outcomes. The panel placed low value on small and uncertain benefits in the presence of the remaining possibility of important harms. In addition, the panel considered contextual factors such as resources, feasibility, acceptability, and equity for countries and health care systems.Updates This is a living guideline. It replaces an earlier version published on 4 September 2020 and the BMJ Rapid Recommendations on remdesivir published on 2 July 2020, and the previous version can be found as a data supplement. Future updates are planned to cover hydroxychloroquine and lopinavir-rotinavir. New recommendations will be published as updates to this guideline.Readers note This version is update 1 of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. |
| first_indexed | 2024-03-06T23:03:42Z |
| format | Journal article |
| id | oxford-uuid:630dd5a2-9584-4bb6-83a4-33564d1fa5d9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:03:42Z |
| publishDate | 2020 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:630dd5a2-9584-4bb6-83a4-33564d1fa5d92022-03-26T18:10:29ZA living WHO guideline on drugs for covid-19Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:630dd5a2-9584-4bb6-83a4-33564d1fa5d9EnglishSymplectic ElementsBMJ Publishing Group2020Rochwerg, BAgoritsas, TLamontagne, FCCLeo, Y-SMacdonald, HAgarwal, AZeng, LLytvyn, LAppiah, JAAmin, WArabi, YBlumberg, LBurhan, EBausch, FCalfee, CSCao, BCecconi, MChanda, DCooke, GDunning, JDu, BGeduld, HGee, PHashimi, MHui, DSKabra, SKanda, SKawano-Dourado, LKim, Y-JKissoon, NKwizera, ALaake, JHMachado, FRMahaka, IManai, HMino, GNsutebu, EPshenichnaya, NQadir, NSabzwari, SSarin, RSharland, MShen, YRanganathan, SSSouza, JUgarte, SVenkatapuam, SDat, VQVuyiseka, DWuewickrama, AClinical question What is the role of drug interventions in the treatment of patients with covid-19?New recommendation The latest version of this WHO living guidance focuses on remdesivir, following the 15 October 2020 preprint publication of results from the WHO SOLIDARITY trial. It contains a weak or conditional recommendation against the use of remdesivir in hospitalised patients with covid-19Recommendations The first version on this living guidance focused on corticosteroids. The strong recommendation for systemic corticosteroids in patients with severe and critical covid-19, and a weak or conditional recommendation against systemic corticosteroids in patients with non-severe covid-19 are unchanged.How this guideline was created WHO has partnered with the non-profit Magic Evidence Ecosystem Foundation (MAGIC) for methodologic support, to develop and disseminate living guidance for covid-19 drug treatments, based on a living systematic review and network analysis. An international standing Guideline Development Group (GDG) of content experts, clinicians, patients, and methodologists produced recommendations following standards for trustworthy guideline development using the GRADE approach. No competing interests were identified for any panel member.Understanding the new recommendation When moving from evidence to the conditional recommendation against the use of remdesivir in patients with covid-19, the panel emphasised the evidence suggesting no important effect on mortality, need for mechanical ventilation, time to clinical improvement, and other patient-important outcomes. Considering the low or very low certainty evidence for all outcomes, the panel interpreted the evidence as not proving that remdesivir is ineffective; rather, there is no evidence based on currently available data that it does improve patient-important outcomes. The panel placed low value on small and uncertain benefits in the presence of the remaining possibility of important harms. In addition, the panel considered contextual factors such as resources, feasibility, acceptability, and equity for countries and health care systems.Updates This is a living guideline. It replaces an earlier version published on 4 September 2020 and the BMJ Rapid Recommendations on remdesivir published on 2 July 2020, and the previous version can be found as a data supplement. Future updates are planned to cover hydroxychloroquine and lopinavir-rotinavir. New recommendations will be published as updates to this guideline.Readers note This version is update 1 of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. |
| spellingShingle | Rochwerg, B Agoritsas, T Lamontagne, FCC Leo, Y-S Macdonald, H Agarwal, A Zeng, L Lytvyn, L Appiah, JA Amin, W Arabi, Y Blumberg, L Burhan, E Bausch, F Calfee, CS Cao, B Cecconi, M Chanda, D Cooke, G Dunning, J Du, B Geduld, H Gee, P Hashimi, M Hui, DS Kabra, S Kanda, S Kawano-Dourado, L Kim, Y-J Kissoon, N Kwizera, A Laake, JH Machado, FR Mahaka, I Manai, H Mino, G Nsutebu, E Pshenichnaya, N Qadir, N Sabzwari, S Sarin, R Sharland, M Shen, Y Ranganathan, SS Souza, J Ugarte, S Venkatapuam, S Dat, VQ Vuyiseka, D Wuewickrama, A A living WHO guideline on drugs for covid-19 |
| title | A living WHO guideline on drugs for covid-19 |
| title_full | A living WHO guideline on drugs for covid-19 |
| title_fullStr | A living WHO guideline on drugs for covid-19 |
| title_full_unstemmed | A living WHO guideline on drugs for covid-19 |
| title_short | A living WHO guideline on drugs for covid-19 |
| title_sort | living who guideline on drugs for covid 19 |
| work_keys_str_mv | AT rochwergb alivingwhoguidelineondrugsforcovid19 AT agoritsast alivingwhoguidelineondrugsforcovid19 AT lamontagnefcc alivingwhoguidelineondrugsforcovid19 AT leoys alivingwhoguidelineondrugsforcovid19 AT macdonaldh alivingwhoguidelineondrugsforcovid19 AT agarwala alivingwhoguidelineondrugsforcovid19 AT zengl alivingwhoguidelineondrugsforcovid19 AT lytvynl alivingwhoguidelineondrugsforcovid19 AT appiahja alivingwhoguidelineondrugsforcovid19 AT aminw alivingwhoguidelineondrugsforcovid19 AT arabiy alivingwhoguidelineondrugsforcovid19 AT blumbergl alivingwhoguidelineondrugsforcovid19 AT burhane alivingwhoguidelineondrugsforcovid19 AT bauschf alivingwhoguidelineondrugsforcovid19 AT calfeecs alivingwhoguidelineondrugsforcovid19 AT caob alivingwhoguidelineondrugsforcovid19 AT cecconim alivingwhoguidelineondrugsforcovid19 AT chandad alivingwhoguidelineondrugsforcovid19 AT cookeg alivingwhoguidelineondrugsforcovid19 AT dunningj alivingwhoguidelineondrugsforcovid19 AT dub alivingwhoguidelineondrugsforcovid19 AT geduldh alivingwhoguidelineondrugsforcovid19 AT geep alivingwhoguidelineondrugsforcovid19 AT hashimim alivingwhoguidelineondrugsforcovid19 AT huids alivingwhoguidelineondrugsforcovid19 AT kabras alivingwhoguidelineondrugsforcovid19 AT kandas alivingwhoguidelineondrugsforcovid19 AT kawanodouradol alivingwhoguidelineondrugsforcovid19 AT kimyj alivingwhoguidelineondrugsforcovid19 AT kissoonn alivingwhoguidelineondrugsforcovid19 AT kwizeraa alivingwhoguidelineondrugsforcovid19 AT laakejh alivingwhoguidelineondrugsforcovid19 AT machadofr alivingwhoguidelineondrugsforcovid19 AT mahakai alivingwhoguidelineondrugsforcovid19 AT manaih alivingwhoguidelineondrugsforcovid19 AT minog alivingwhoguidelineondrugsforcovid19 AT nsutebue alivingwhoguidelineondrugsforcovid19 AT pshenichnayan alivingwhoguidelineondrugsforcovid19 AT qadirn alivingwhoguidelineondrugsforcovid19 AT sabzwaris alivingwhoguidelineondrugsforcovid19 AT sarinr alivingwhoguidelineondrugsforcovid19 AT sharlandm alivingwhoguidelineondrugsforcovid19 AT sheny alivingwhoguidelineondrugsforcovid19 AT ranganathanss alivingwhoguidelineondrugsforcovid19 AT souzaj alivingwhoguidelineondrugsforcovid19 AT ugartes alivingwhoguidelineondrugsforcovid19 AT venkatapuams alivingwhoguidelineondrugsforcovid19 AT datvq alivingwhoguidelineondrugsforcovid19 AT vuyisekad alivingwhoguidelineondrugsforcovid19 AT wuewickramaa alivingwhoguidelineondrugsforcovid19 AT rochwergb livingwhoguidelineondrugsforcovid19 AT agoritsast livingwhoguidelineondrugsforcovid19 AT lamontagnefcc livingwhoguidelineondrugsforcovid19 AT leoys livingwhoguidelineondrugsforcovid19 AT macdonaldh livingwhoguidelineondrugsforcovid19 AT agarwala livingwhoguidelineondrugsforcovid19 AT zengl livingwhoguidelineondrugsforcovid19 AT lytvynl livingwhoguidelineondrugsforcovid19 AT appiahja livingwhoguidelineondrugsforcovid19 AT aminw livingwhoguidelineondrugsforcovid19 AT arabiy livingwhoguidelineondrugsforcovid19 AT blumbergl livingwhoguidelineondrugsforcovid19 AT burhane livingwhoguidelineondrugsforcovid19 AT bauschf livingwhoguidelineondrugsforcovid19 AT calfeecs livingwhoguidelineondrugsforcovid19 AT caob livingwhoguidelineondrugsforcovid19 AT cecconim livingwhoguidelineondrugsforcovid19 AT chandad livingwhoguidelineondrugsforcovid19 AT cookeg livingwhoguidelineondrugsforcovid19 AT dunningj livingwhoguidelineondrugsforcovid19 AT dub livingwhoguidelineondrugsforcovid19 AT geduldh livingwhoguidelineondrugsforcovid19 AT geep livingwhoguidelineondrugsforcovid19 AT hashimim livingwhoguidelineondrugsforcovid19 AT huids livingwhoguidelineondrugsforcovid19 AT kabras livingwhoguidelineondrugsforcovid19 AT kandas livingwhoguidelineondrugsforcovid19 AT kawanodouradol livingwhoguidelineondrugsforcovid19 AT kimyj livingwhoguidelineondrugsforcovid19 AT kissoonn livingwhoguidelineondrugsforcovid19 AT kwizeraa livingwhoguidelineondrugsforcovid19 AT laakejh livingwhoguidelineondrugsforcovid19 AT machadofr livingwhoguidelineondrugsforcovid19 AT mahakai livingwhoguidelineondrugsforcovid19 AT manaih livingwhoguidelineondrugsforcovid19 AT minog livingwhoguidelineondrugsforcovid19 AT nsutebue livingwhoguidelineondrugsforcovid19 AT pshenichnayan livingwhoguidelineondrugsforcovid19 AT qadirn livingwhoguidelineondrugsforcovid19 AT sabzwaris livingwhoguidelineondrugsforcovid19 AT sarinr livingwhoguidelineondrugsforcovid19 AT sharlandm livingwhoguidelineondrugsforcovid19 AT sheny livingwhoguidelineondrugsforcovid19 AT ranganathanss livingwhoguidelineondrugsforcovid19 AT souzaj livingwhoguidelineondrugsforcovid19 AT ugartes livingwhoguidelineondrugsforcovid19 AT venkatapuams livingwhoguidelineondrugsforcovid19 AT datvq livingwhoguidelineondrugsforcovid19 AT vuyisekad livingwhoguidelineondrugsforcovid19 AT wuewickramaa livingwhoguidelineondrugsforcovid19 |