Identification of the crucial parameters regarding the efficacy of ribavirin therapy in Crimean-Congo haemorrhagic fever (CCHF) patients: a systematic review and meta-analysis.

Abstract

OBJECTIVES:

Recently, ribavirin has been suggested as a therapeutic approach in Crimean-Congo haemorrhagic fever (CCHF) patients; however, there are controversial findings about its efficacy. In the current study, a meta-analysis was systematically performed to assess the effectiveness of ribavirin administration regarding CCHF patient survival and to explore the most important influential parameters for its efficacy.

METHODS:

All of the outcomes of the clinically studied CCHF patients who were treated with ribavirin were included in the meta-analysis.

RESULTS:

Overall, 24 studies met our criteria. Although the studies did not have high quality there was no heterogeneity and publication bias across studies. The results indicated that the administration of ribavirin to CCHF patients significantly decreased the mortality rate (by 1.7-fold) compared with those who did not receive this medication. Furthermore, it was found that the prescription of ribavirin in the initial phase of disease was more effective, and a delay in the start of treatment resulted in a 1.6-fold increase in mortality rate. In addition, interventional therapy resulted in an ∼2.3-fold reduction in the mortality rate of those who received ribavirin along with corticosteroids compared with those who were treated with ribavirin monotherapy.

CONCLUSIONS:

This meta-analysis reveals that ribavirin should be considered as a crucial antiviral drug in the therapeutic approach used for CCHF patients, especially in early phases of the disease. Additionally, it seems that the administration of corticosteroids alongside ribavirin can play an effective role in alleviation of the disease status, particularly in haemorrhagic phases.

• Authors: Zahra Arab-Bafrani, Ali Jabbari, Mohammad Mostakhdem Hashemi, Ali Mohammad Arabzadeh, Atena Gilanipour, Elham Mousavi
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 74 Issue 12 Pg. 3432-3439 (12 01 2019) ISSN: 1460-2091 [Electronic] England
• PMID: 31369086 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)
• Copyright: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Adrenal Cortex Hormones
• Antiviral Agents
• Ribavirin

Topics

• Administration, Oral
• Adrenal Cortex Hormones (therapeutic use)
• Antiviral Agents (therapeutic use)
• Controlled Clinical Trials as Topic
• Drug Therapy, Combination
• Hemorrhagic Fever Virus, Crimean-Congo (drug effects)
• Hemorrhagic Fever, Crimean (drug therapy, mortality)
• Humans
• Observational Studies as Topic
• Ribavirin (therapeutic use)
• Time Factors