{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:42:16Z","timestamp":1785307336020,"version":"3.55.0"},"reference-count":79,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"crossref","award":["202107720033"],"award-info":[{"award-number":["202107720033"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2023,7,31]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Current evidence on the effectiveness of SARS-CoV-2 prophylaxis is inconclusive. We aimed to systematically evaluate published studies on repurposed drugs for the prevention of laboratory-confirmed SARS-CoV-2 infection and\/or COVID-19 among healthy adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Systematic review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Eligibility<\/jats:title>\n                  <jats:p>Quantitative experimental and observational intervention studies that evaluated the effectiveness of repurposed drugs for the primary prevention of SARS-CoV-2 infection and\/or COVID-19 disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data source<\/jats:title>\n                  <jats:p>PubMed and Embase (1 January 2020\u201328 September 2022).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Risk of bias<\/jats:title>\n                  <jats:p>Cochrane Risk of Bias 2.0 and Risk of Bias in Non-Randomised Studies of Interventions tools were applied to assess the quality of studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data analysis<\/jats:title>\n                  <jats:p>Meta-analyses for each eligible drug were performed if \u22652 similar study designs were available.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In all, 65 (25 trials, 40 observational) and 29 publications were eligible for review and meta-analyses, respectively. Most studies pertained to hydroxychloroquine (32), ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) (11), statin (8), and ivermectin (8). In trials, hydroxychloroquine prophylaxis reduced laboratory-confirmed SARS-CoV-2 infection (risk ratio: 0.82 (95% CI 0.74 to 0.90), I<jats:sup>2<\/jats:sup>=48%), a result largely driven by one clinical trial (weight: 60.5%). Such beneficial effects were not observed in observational studies, nor for prognostic clinical outcomes. Ivermectin did not significantly reduce the risk of SARS-CoV-2 infection (RR: 0.35 (95% CI 0.10 to 1.26), I<jats:sup>2<\/jats:sup>=96%) and findings for clinical outcomes were inconsistent. Neither ACEi or ARB were beneficial in reducing SARS-CoV-2 infection. Most of the evidence from clinical trials was of moderate quality and of lower quality in observational studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Results from our analysis are insufficient to support an evidence-based repurposed drug policy for SARS-CoV-2 prophylaxis because of inconsistency. In the view of scarce supportive evidence on repurposing drugs for COVID-19, alternative strategies such as immunisation of vulnerable people are warranted to prevent the future waves of infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42021292797.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2023-001674","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T12:50:35Z","timestamp":1693227035000},"page":"e001674","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-0084","authenticated-orcid":false,"given":"Guiling","family":"Zhou","sequence":"first","affiliation":[{"name":"Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Verweij","sequence":"additional","affiliation":[{"name":"Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands"},{"name":"Dutch Medicines Evaluation Board, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J","family":"Bijlsma","sequence":"additional","affiliation":[{"name":"Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"de Vos","sequence":"additional","affiliation":[{"name":"Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien","family":"Oude Rengerink","sequence":"additional","affiliation":[{"name":"Dutch Medicines Evaluation Board, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria Gerdina","family":"Pasmooij","sequence":"additional","affiliation":[{"name":"Dutch Medicines Evaluation Board, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"van Baarle","sequence":"additional","affiliation":[{"name":"Virology and Immunology Research Group, Department of Medical Microbiology and Infection Prevention, University Medical Centre, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert G M","family":"Niesters","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University Medical Centre Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mol","sequence":"additional","affiliation":[{"name":"Dutch Medicines Evaluation Board, Utrecht, The Netherlands"},{"name":"Department of Clinical Pharmacy and Pharmacology, University Medical Centre, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M","family":"Vonk","sequence":"additional","affiliation":[{"name":"Groningen Research Institute for Asthma and COPD, University Medical Centre, Groningen, The Netherlands"},{"name":"Department of Epidemiology, University Medical Centre, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelko","family":"Hak","sequence":"additional","affiliation":[{"name":"Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"2025083110562000000_10.1.e001674.1","unstructured":"Johns Hopkins University CSSE COVID-19 data. 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