{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:33:04Z","timestamp":1773005584142,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the effect of add\u2010on corticosteroids on treatment outcomes in lymph node tuberculosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      After registering the protocol on PROSPERO (CRD420251104064), we systematically searched Cochrane, MEDLINE, Embase and Web of Science for randomised controlled trials on adjunct corticosteroids for lymph node tuberculosis up to 20 October 2025. A random\u2010effects model was applied, with heterogeneity quantified using I\n                      <jats:sup>2<\/jats:sup>\n                      and between\u2010study variance (\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) estimated by the Paule\u2013Mandel method. Pooled effects were obtained using inverse\u2010variance weighting, and confidence intervals were calculated with the Hartung\u2013Knapp\u2013Sidik\u2013Jonkman (HKSJ) adjustment. Study quality was assessed using RoB 2, and the certainty of evidence was graded using the GRADE framework.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of a total of 485 articles, removing duplicates and irrelevant articles yielded three articles that fulfilled PICOTS criteria. Adjunctive oral prednisone was used as the intervention in all three trials, and treatment outcomes were compared with standard antitubercular treatment. Pooled estimates indicated no significant benefit from the use of adjunctive corticosteroids for complete resolution at 6\u2009months (RR\u2009=\u20091.61; 95% CI: 0.73, 3.56; very low\u2010quality evidence) or symptomatic relief at 2\u2009months (RR\u2009=\u20091.21; 95% CI: 0.92\u20131.58; low\u2010quality evidence). Adjunctive corticosteroid therapy reduced complications by 77% during the course of treatment in the primary analysis (RR\u2009=\u20090.23; 95% CI: 0.18\u20130.29). The three studies were at high risk of bias. The certainty of evidence was rated as very low for the outcome of complete resolution at 6\u2009months, low for symptomatic relief at 2\u2009months, and moderate for complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Though lymph node tuberculosis contributes to a significant portion of all tuberculosis cases, high\u2010quality research related to the use of adjunctive corticosteroids is limited. There is a need for further studies to investigate this promising possibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70065","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T03:41:05Z","timestamp":1765597265000},"page":"274-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Add\u2010On Corticosteroids on Treatment Outcomes in Lymph Node Tuberculosis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Chayanika","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Community Medicine Grant Government Medical College and Sir JJ Group of Hospitals  Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. S.","family":"Supriya","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Grant Government Medical College and Sir JJ Group of Hospitals  Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3898-5450","authenticated-orcid":false,"given":"Aravind","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine All India Institute of Medical Sciences  Nagpur Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geeta","family":"Pardeshi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Grant Government Medical College and Sir JJ Group of Hospitals  Mumbai Maharashtra India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13970"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201014\u20109"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/605559"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.12.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232134"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5588\/pha.24.0012"},{"key":"e_1_2_9_8_1","volume-title":"Module 4: Treatment\u2014Drug\u2010Susceptible Tuberculosis Treatment","author":"WHO Consolidated Guidelines on Tuberculosis","year":"2022"},{"key":"e_1_2_9_9_1","volume-title":"Training Module on Extrapulmonary Tuberculosis [Internet]","year":"2023"},{"key":"e_1_2_9_10_1","unstructured":"\u201cTask Force: Clinical Practice Guidelines for the Diagnosis Treatment Prevention and Control of Tuberculosis in Adult Filipinos: 2016 Update (CPGTB2016) \u201dPhilippine Coalition Against Tuberculosis (PhilCAT) Philippine Society for Microbiology and Infectious Diseases (PSMID) Philippine College of Chest Physicians (PCCP) [Internet] https:\/\/thepafp.org\/wp\u2010content\/uploads\/2017\/05\/2016\u2010PTB\u2010by\u2010PSMID.pdf."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.47895\/amp.v58i16.4900"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2018.1515628"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473\u20103099(12)70321\u20103"},{"key":"e_1_2_9_14_1","unstructured":"Cochrane Bias \u201cRoB 2: A Revised Cochrane Risk\u2010of\u2010Bias Tool for Randomized Trials [Internet] \u201d2025 https:\/\/methods.cochrane.org\/bias\/resources\/rob\u20102\u2010revised\u2010cochrane\u2010risk\u2010bias\u2010tool\u2010randomized\u2010trials."},{"key":"e_1_2_9_15_1","unstructured":"Cochrane \u201cChapter\u00a010: Analysing Data and Undertaking Meta\u2010Analyses [Internet] \u201d2025 https:\/\/www.cochrane.org\/authors\/handbooks\u2010and\u2010manuals\/handbook\/current\/chapter\u201010."},{"key":"e_1_2_9_16_1","unstructured":"Cochrane \u201cChapter\u00a013: Assessing Risk of Bias due to Missing Evidence in a Meta\u2010Analysis | Cochrane [Internet] \u201d2025 https:\/\/www.cochrane.org\/authors\/handbooks\u2010and\u2010manuals\/handbook\/current\/chapter\u201013."},{"key":"e_1_2_9_17_1","unstructured":"\u201cGRADEpro \u201daccessed on September 13 2025 https:\/\/www.gradepro.org\/."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2015.05.002"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049475520984745"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.13175\/swjpcc067\u201020"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrd.2017.162"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215647"},{"key":"e_1_2_9_23_1","first-page":"1","volume-title":"Module 3: Diagnosis\u2014Rapid Diagnostics for Tuberculosis Detection, 2024 Update","author":"WHO Consolidated Guidelines on Tuberculosis","year":"2021"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-024-02310-0"},{"key":"e_1_2_9_25_1","unstructured":"F. 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