新药更好吗？对各代新生儿药物治疗的分析。
Are Newer Drugs Better? An Analysis of Neonatal Pharmacological Treatments across Generations.
机构信息
School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
School of Pharmacy, Department of Pharmacy Practice, International Medical University, Kuala Lumpur, Malaysia.
出版信息
Med Princ Pract. 2024;33(5):471-477. doi: 10.1159/000539729. Epub 2024 Jun 10.
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.
简介
我们评估了新生儿疾病中较新药物与较老药物的相对疗效，以及各代药物优势幅度的变化趋势。
材料与方法
我们评估了从 MEDLINE、Cochrane 和 PROSPERO 中确定的新生儿药理学干预措施的网络荟萃分析（NMAs）。干预措施按最早的研究进行时间排序，并与安慰剂或无治疗以及其直接前一代进行比较。我们使用曼肯德尔检验评估了效应大小的时间趋势。
结果
从 8048 条检索记录中，纳入了 10 项涵盖 352 项试验和 102653 名参与者的新生儿 NMAs。与安慰剂相比，61 项干预措施中有 56 项（91.8%）显示出优越性，其中 23 项（37.7%）具有统计学意义。与前一代相比，72 项干预措施中有 47 项（65.3%）显示出优越性，其中 3 项（4.2%）具有统计学意义。对于大多数情况，各代之间的效应大小没有明显的趋势（p = 0.09-1）。
结论
我们没有发现证据表明新生儿护理中新一代药物在疗效上始终优于老一代药物。
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