Are Newer Drugs Better? An Analysis of Neonatal Pharmacological Treatments across Generations.

IF 2.2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Principles and Practice Pub Date : 2024-01-01 Epub Date: 2024-06-10 DOI:10.1159/000539729

Nai Ming Lai, Sajesh Kalkandi Veettil, Nathorn Chaiyakunapruk, Paul Glasziou

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Abstract

Introduction: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations.

Materials and methods: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from MEDLINE, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test.

Results: From 8,048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09-1).

Conclusions: We found no evidence that newer generation medications in neonatal care are consistently more effective than older generation medications.

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新药是否更好？新生儿跨代药物治疗分析。

介绍：我们评估了新生儿疾病新药与旧药的相对效果，以及各代药物的优势趋势：我们评估了 Medline、Cochrane 和 PROSPERO 中有关新生儿药物干预的网络荟萃分析 (NMA)。根据最早的研究，按时间顺序排列干预措施，并将其效果与安慰剂或无治疗及其前身进行比较。我们使用 Mann-Kendall 检验法评估了效应大小的时间趋势：从检索到的 8048 条记录中，共纳入了 10 项新生儿 NMA，涵盖 352 项试验和 102,653 名参与者。与安慰剂相比，56/61（91.8%）项干预措施显示出优越性，其中 23 项（37.7%）具有显著的统计学意义。与上一代干预措施相比，47/72（65.3%）项干预措施显示出优越性，其中3项（4.2%）具有统计学意义。在大多数情况下，各代疗法的效果大小没有明显趋势（P = 0.09 至 1）：我们没有发现新生儿护理中新一代药物比老一代药物更有效的证据。

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来源期刊

Medical Principles and Practice 医学-医学：内科

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Medical Principles and Practice'', as the journal of the Health Sciences Centre, Kuwait University, aims to be a publication of international repute that will be a medium for dissemination and exchange of scientific knowledge in the health sciences.