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Pharmacological treatment for connective tissue disease-associated interstitial lung involvement: Protocol for an overview of systematic reviews and meta-analyses

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  • Fotini B Karassa
  • Konstantinos I Bougioukas
  • Eleftherios Pelechas
  • Anastasia Skalkou
  • Evangelia Argyriou
  • Anna-Bettina Haidich

Abstract

Background: Interstitial lung disease (ILD) is the most important pulmonary manifestation of connective tissue diseases (CTDs) since it is associated with high morbidity and mortality. However, there is uncertainty on what constitutes the optimal treatment options from a variety of competing interventions. The aim of the overview is to summarize existing evidence of the effectiveness and harm of pharmacological therapies for adults with CTD-ILD. Methods: A literature search will be conducted in MEDLINE, the Cochrane Database of Systematic Reviews, DARE, the Centre for Reviews and Dissemination Health Technology Assessment database, Epistemonikos.org, KSR Evidence, and PROSPERO. We will search for systematic reviews with or without meta-analysis that examine pharmacological treatment for CTD-ILD. Updated supplemental search will also be undertaken to identify additional randomized controlled trials. The primary outcomes will be changes in lung function measures and adverse events. The methodological quality of the included reviews will be assessed using the AMSTAR 2 tool. The overall quality of the evidence will be evaluated using the GRADE rating. Summarized outcome data extracted from systematic reviews will be described in narrative form or in tables. For each meta-analysis we will estimate the summary effect size by use of random-effects and fixed-effects models with 95% confidence intervals, the between-study heterogeneity expressed by I², and the 95% prediction interval. If feasible, given sufficient data, network meta-analysis will be conducted to combine direct and indirect evidence of class and agent comparisons. Discussion: While many factors are crucial in selecting an appropriate treatment for patients with CTD-ILD, evidence for the efficacy and safety of a drug is essential in guiding this decision. Thus, this overview will aid clinicians in balancing the risks versus benefits of the available therapies by providing high-quality evidence to support informed decision-making and may contribute to future guideline development. Systematic review registration: MedRxiv: DOI 10.1101/2022.01.25.22269807

Suggested Citation

  • Fotini B Karassa & Konstantinos I Bougioukas & Eleftherios Pelechas & Anastasia Skalkou & Evangelia Argyriou & Anna-Bettina Haidich, 2022. "Pharmacological treatment for connective tissue disease-associated interstitial lung involvement: Protocol for an overview of systematic reviews and meta-analyses," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-14, August.
    • Handle: RePEc:plo:pone00:0272327
    DOI: 10.1371/journal.pone.0272327
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    References listed on IDEAS

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    1. Julian P. T. Higgins & Simon G. Thompson & David J. Spiegelhalter, 2009. "A re‐evaluation of random‐effects meta‐analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(1), pages 137-159, January.
    2. Chao-Hsien Chen & Hui-Chuan Lin & Ya-Hui Wang & Cheng-Yi Wang & You Shuei Lin & Chih-Cheng Lai, 2021. "The safety of nintedanib for the treatment of interstitial lung disease: A systematic review and meta-analysis of randomized controlled trials," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-16, May.
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