Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Standard

Fever therapy in febrile adults : systematic review with meta-analyses and trial sequential analyses. / Holgersson, Johan; Ceric, Ameldina; Sethi, Naqash; Nielsen, Niklas; Jakobsen, Janus Christian.

I: The BMJ, Bind 378, e069620, 2022.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Holgersson, J, Ceric, A, Sethi, N, Nielsen, N & Jakobsen, JC 2022, 'Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses', The BMJ, bind 378, e069620. https://doi.org/10.1136/bmj-2021-069620

APA

Holgersson, J., Ceric, A., Sethi, N., Nielsen, N., & Jakobsen, J. C. (2022). Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses. The BMJ, 378, [e069620]. https://doi.org/10.1136/bmj-2021-069620

Vancouver

Holgersson J, Ceric A, Sethi N, Nielsen N, Jakobsen JC. Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses. The BMJ. 2022;378. e069620. https://doi.org/10.1136/bmj-2021-069620

Author

Holgersson, Johan ; Ceric, Ameldina ; Sethi, Naqash ; Nielsen, Niklas ; Jakobsen, Janus Christian. / Fever therapy in febrile adults : systematic review with meta-analyses and trial sequential analyses. I: The BMJ. 2022 ; Bind 378.

Bibtex

@article{a1de0f579143473bba9743fab33e2359,
title = "Fever therapy in febrile adults: systematic review with meta-analyses and trial sequential analyses",
abstract = "Objective: To investigate the effects of fever therapy compared with no fever therapy in a wide population of febrile adults. Design: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Data sources: CENTRAL, BIOSIS, CINAHL, MEDLINE, Embase, LILACS, Scopus, and Web of Science Core Collection, searched from their inception to 2 July 2021. Eligibility criteria: Randomised clinical trials in adults diagnosed as having fever of any origin. Included experimental interventions were any fever therapy, and the control intervention had to be no fever therapy (with or without placebo/sham). Data extraction and synthesis: Two authors independently selected studies, extracted data, and assessed the risk of bias. Primary outcomes were all cause mortality and serious adverse events. Secondary outcomes were quality of life and non-serious adverse events. Aggregate data were synthesised with meta-analyses, subgroup analyses, and trial sequential analyses, and the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: Forty two trials assessing 5140 participants were included. Twenty three trials assessed 11 different antipyretic drugs, 11 trials assessed physical cooling, and eight trials assessed a combination of antipyretic drugs and physical cooling. Of the participants, 3007 were critically ill, 1892 were non-critically ill, 3277 had infectious fever, and 1139 had non-infectious fever. All trials were assessed as being at high risk of bias. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of death (risk ratio 1.04, 95% confidence interval 0.90 to 1.19; I2=0%; P=0.62; 16 trials; high certainty evidence) and the risk of serious adverse events (risk ratio 1.02, 0.89 to 1.17; I2=0%; P=0.78; 16 trials; high certainty evidence) could be rejected. One trial assessing quality of life was included, showing no difference between fever therapy and control. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of non-serious adverse events could be neither confirmed nor rejected (risk ratio 0.92, 0.67 to 1.25; I2=66.5%; P=0.58; four trials; very low certainty evidence). Conclusions: Fever therapy does not seem to affect the risk of death and serious adverse events. ",
author = "Johan Holgersson and Ameldina Ceric and Naqash Sethi and Niklas Nielsen and Jakobsen, {Janus Christian}",
note = "Publisher Copyright: {\textcopyright} 2019 Author(s) (or their employer(s)).",
year = "2022",
doi = "10.1136/bmj-2021-069620",
language = "English",
volume = "378",
journal = "The BMJ",
issn = "0959-8146",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Fever therapy in febrile adults

T2 - systematic review with meta-analyses and trial sequential analyses

AU - Holgersson, Johan

AU - Ceric, Ameldina

AU - Sethi, Naqash

AU - Nielsen, Niklas

AU - Jakobsen, Janus Christian

N1 - Publisher Copyright: © 2019 Author(s) (or their employer(s)).

PY - 2022

Y1 - 2022

N2 - Objective: To investigate the effects of fever therapy compared with no fever therapy in a wide population of febrile adults. Design: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Data sources: CENTRAL, BIOSIS, CINAHL, MEDLINE, Embase, LILACS, Scopus, and Web of Science Core Collection, searched from their inception to 2 July 2021. Eligibility criteria: Randomised clinical trials in adults diagnosed as having fever of any origin. Included experimental interventions were any fever therapy, and the control intervention had to be no fever therapy (with or without placebo/sham). Data extraction and synthesis: Two authors independently selected studies, extracted data, and assessed the risk of bias. Primary outcomes were all cause mortality and serious adverse events. Secondary outcomes were quality of life and non-serious adverse events. Aggregate data were synthesised with meta-analyses, subgroup analyses, and trial sequential analyses, and the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: Forty two trials assessing 5140 participants were included. Twenty three trials assessed 11 different antipyretic drugs, 11 trials assessed physical cooling, and eight trials assessed a combination of antipyretic drugs and physical cooling. Of the participants, 3007 were critically ill, 1892 were non-critically ill, 3277 had infectious fever, and 1139 had non-infectious fever. All trials were assessed as being at high risk of bias. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of death (risk ratio 1.04, 95% confidence interval 0.90 to 1.19; I2=0%; P=0.62; 16 trials; high certainty evidence) and the risk of serious adverse events (risk ratio 1.02, 0.89 to 1.17; I2=0%; P=0.78; 16 trials; high certainty evidence) could be rejected. One trial assessing quality of life was included, showing no difference between fever therapy and control. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of non-serious adverse events could be neither confirmed nor rejected (risk ratio 0.92, 0.67 to 1.25; I2=66.5%; P=0.58; four trials; very low certainty evidence). Conclusions: Fever therapy does not seem to affect the risk of death and serious adverse events.

AB - Objective: To investigate the effects of fever therapy compared with no fever therapy in a wide population of febrile adults. Design: Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Data sources: CENTRAL, BIOSIS, CINAHL, MEDLINE, Embase, LILACS, Scopus, and Web of Science Core Collection, searched from their inception to 2 July 2021. Eligibility criteria: Randomised clinical trials in adults diagnosed as having fever of any origin. Included experimental interventions were any fever therapy, and the control intervention had to be no fever therapy (with or without placebo/sham). Data extraction and synthesis: Two authors independently selected studies, extracted data, and assessed the risk of bias. Primary outcomes were all cause mortality and serious adverse events. Secondary outcomes were quality of life and non-serious adverse events. Aggregate data were synthesised with meta-analyses, subgroup analyses, and trial sequential analyses, and the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: Forty two trials assessing 5140 participants were included. Twenty three trials assessed 11 different antipyretic drugs, 11 trials assessed physical cooling, and eight trials assessed a combination of antipyretic drugs and physical cooling. Of the participants, 3007 were critically ill, 1892 were non-critically ill, 3277 had infectious fever, and 1139 had non-infectious fever. All trials were assessed as being at high risk of bias. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of death (risk ratio 1.04, 95% confidence interval 0.90 to 1.19; I2=0%; P=0.62; 16 trials; high certainty evidence) and the risk of serious adverse events (risk ratio 1.02, 0.89 to 1.17; I2=0%; P=0.78; 16 trials; high certainty evidence) could be rejected. One trial assessing quality of life was included, showing no difference between fever therapy and control. Meta-analysis and trial sequential analysis showed that the hypothesis that fever therapy reduces the risk of non-serious adverse events could be neither confirmed nor rejected (risk ratio 0.92, 0.67 to 1.25; I2=66.5%; P=0.58; four trials; very low certainty evidence). Conclusions: Fever therapy does not seem to affect the risk of death and serious adverse events.

U2 - 10.1136/bmj-2021-069620

DO - 10.1136/bmj-2021-069620

M3 - Journal article

C2 - 35820685

AN - SCOPUS:85133946626

VL - 378

JO - The BMJ

JF - The BMJ

SN - 0959-8146

M1 - e069620

ER -

ID: 321641783