RT Journal Article
SR Electronic
T1 A living WHO guideline on drugs to prevent covid-19
JF BMJ
JO BMJ
FD British Medical Journal Publishing Group
SP n526
DO 10.1136/bmj.n526
VO 372
A1 Lamontagne, François
A1 Stegemann, Miriam
A1 Agarwal, Arnav
A1 Agoritsas, Thomas
A1 Siemieniuk, Reed
A1 Rochwerg, Bram
A1 Bartoszko, Jessica
A1 Askie, Lisa
A1 Macdonald,  Helen
A1 Al-Maslamani, Muna
A1 Amin, Wagdy
A1 Araujo Da Silva, Andre Ricardo
A1 Barragan, Fabian Alberto Jaimes
A1 Bausch, Frederique Jacquerioz
A1 Burhan, Erlina
A1 Cecconi, Maurizio
A1 Chacko, Binila
A1 Chanda, Duncan
A1 Dat, Vu Quoc
A1 Du, Bin
A1 Geduld, Heike
A1 Gee, Patrick
A1 Haider, Muhammad
A1 Harley,  Nerina
A1 Hashimi, Madiha
A1 Jehan, Fyezah
A1 Hui, David
A1 Hunt,  Beverley J
A1 Ismail, Mohamed
A1 Kabra,  Sushil
A1 Kanda, Seema
A1 Kawano-Dourado, Leticia
A1 Kim, Yae-Jean
A1 Kissoon, Niranjan
A1 Krishna, Sanjeev
A1 Kwizera,  Arthur
A1 Lisboa, Thiago
A1 Leo,  Yee-Sin
A1 Mahaka, Imelda
A1 Hela, Manai
A1 Battista Migliori, Giovanni
A1 Mino,  Greta
A1 Nsutebu, Emmanuel
A1 Pshenichnaya, Natalia
A1 Qadir, Nida
A1 Ranganathan, Shalini Sri
A1 Sabzwari, Saniya
A1 Sarin, Rohit
A1 Shankar-Hari, Manu
A1 Sharland,  Michael
A1 Shen, Yinzhong
A1 Souza, Joao Paulo
A1 Tshokey, Tshokey
A1 Ugarte, Sebastian
A1 Uyeki, Tim
A1 Venkatapuram,  Sridhar
A1 Wachinou, Ablo Prudence
A1 Wijewickrama,  Ananda
A1 Vuyiseka,  Dubula
A1 Preller, Jacobus
A1 Brignardello-Petersen, Romina
A1 Kum, Elena
A1 Qasim, Anila
A1 Zeraatkar, Dena
A1 Owen, Andrew
A1 Guyatt, Gordon
A1 Lytvyn, Lyubov
A1 Jacobs, Michael
A1 Vandvik, Per Olav
A1 Diaz, Janet
YR 2021
UL https://www.bmj.com/content/372/bmj.n526.abstract
AB Clinical question What is the role of drugs in preventing covid-19?Why does this matter?There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective.Recommendations The second version of this living guideline reiterates the previous strong recommendation against the use of hydroxychloroquine and includes a new conditional recommendation against the use of tixagevimab-cilgavimab in individuals who do not have covid-19.How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provides methodological support. A living systematic review with network analysis informs the recommendations. An international guideline development group (GDG) of content experts, clinicians, patients, an ethicist and methodologists produces recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Understanding the recommendations The living network meta-analysis informing this guideline included 12 trials (8379 participants) comparing hydroxychloroquine to standard care/placebo, and one trial (5197 participants) comparing tixagevimab-cilgavimab to standard care/placebo. When moving from evidence to the continued strong recommendation against the use of hydroxychloroquine, the GDG emphasised additional evidence suggesting no or little effect on mortality and hospital admission, and an increased risk of adverse effects. For the new conditional recommendation against the use of tixagevimab-cilgavimab, the GDG emphasised in vitro evidence reducing the applicability of available trial data. While trial results demonstrated modest reduction in the occurrence of laboratory confirmed symptomatic covid-19, lack of in vitro neutralisation of new SARS-CoV-2 sub-lineages was considered to have rendered these results obsolete.Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline.Readers note This is the second version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19 and living guidance regarding covid-19 related clinical management. When citing this article, please consider adding the update number and date of access for clarity.