Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials

Introduction Inflammation is emerging as an important risk factor for atherosclerotic cardiovascular disease and has been a recent target for many novel therapeutic agents. However, comparative evidence regarding efficacy of these anti-inflammatory treatment options is currently lacking.Methods and...

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Main Authors: George A Wells, Kevin Emery Boczar, Sheojung Shin, Kathryn A Bezzina, Aishwarya Geejo, Alexander Liam Pearson, Saba Shahab, Christophe A Fehlmann, Sarah Visintini, Rob Beanlands
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e062702.full
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author George A Wells
Kevin Emery Boczar
Sheojung Shin
Kathryn A Bezzina
Aishwarya Geejo
Alexander Liam Pearson
Saba Shahab
Christophe A Fehlmann
Sarah Visintini
Rob Beanlands
author_facet George A Wells
Kevin Emery Boczar
Sheojung Shin
Kathryn A Bezzina
Aishwarya Geejo
Alexander Liam Pearson
Saba Shahab
Christophe A Fehlmann
Sarah Visintini
Rob Beanlands
author_sort George A Wells
collection DOAJ
description Introduction Inflammation is emerging as an important risk factor for atherosclerotic cardiovascular disease and has been a recent target for many novel therapeutic agents. However, comparative evidence regarding efficacy of these anti-inflammatory treatment options is currently lacking.Methods and analysis This systematic review will include randomised controlled trials evaluating the effect of anti-inflammatory agents on cardiovascular outcomes in patients with known cardiovascular disease. Studies will be retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, as well as clinical trial registry websites, Europe PMC and conference abstract handsearching. No publication date or language restrictions will be imposed. Eligible interventions must have some component of anti-inflammatory agent. These include (but are not limited to): non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, prednisone, methotrexate, canakinumab, pexelizumab, anakinra, succinobucol, losmapimod, inclacumab, atreleuton, LP-PLA2 (darapladib) and sPLA2 (varespladib). The primary outcomes will include major adverse cardiac events (MACE), and each individual component of MACE (myocardial infarction, stroke and cardiovascular death). Key secondary outcomes will include unstable angina, heart failure, all-cause mortality, cardiac arrest and revascularisation. Screening, inclusion, data extraction and quality assessment will be performed independently by two reviewers. Network meta-analysis based on the random effects model will be conducted to compare treatment effects both directly and indirectly. The quality of the evidence will be assessed with appropriate tools including the Grading of Recommendations, Assessment, Development and Evaluation profiler or Confidence in Network Meta-Analysis tool.Ethics and dissemination Ethics approval is not required for this systematic review. The findings will be disseminated through a peer-reviewed journal.PROSPERO registration number CRD42022303289.
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spelling doaj-art-865c691889874f278ee42f3faaa132232025-01-24T19:50:18ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2022-062702Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trialsGeorge A Wells0Kevin Emery Boczar1Sheojung Shin2Kathryn A Bezzina3Aishwarya Geejo4Alexander Liam Pearson5Saba Shahab6Christophe A Fehlmann7Sarah Visintini8Rob Beanlands9Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaEpidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, CanadaUniversity of Ottawa Heart Institute, Ottawa, Ontario, CanadaMedicine, Elisabeth Bruyere Hospital, Ottawa, Ontario, CanadaCardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaCardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Medicine, University of Ottawa, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, Canada8 Berkman Library, University of Ottawa Heart Institute, Ottawa, ON, CanadaUniversity of Ottawa Heart Institute, Ottawa, Ontario, CanadaIntroduction Inflammation is emerging as an important risk factor for atherosclerotic cardiovascular disease and has been a recent target for many novel therapeutic agents. However, comparative evidence regarding efficacy of these anti-inflammatory treatment options is currently lacking.Methods and analysis This systematic review will include randomised controlled trials evaluating the effect of anti-inflammatory agents on cardiovascular outcomes in patients with known cardiovascular disease. Studies will be retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, as well as clinical trial registry websites, Europe PMC and conference abstract handsearching. No publication date or language restrictions will be imposed. Eligible interventions must have some component of anti-inflammatory agent. These include (but are not limited to): non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, prednisone, methotrexate, canakinumab, pexelizumab, anakinra, succinobucol, losmapimod, inclacumab, atreleuton, LP-PLA2 (darapladib) and sPLA2 (varespladib). The primary outcomes will include major adverse cardiac events (MACE), and each individual component of MACE (myocardial infarction, stroke and cardiovascular death). Key secondary outcomes will include unstable angina, heart failure, all-cause mortality, cardiac arrest and revascularisation. Screening, inclusion, data extraction and quality assessment will be performed independently by two reviewers. Network meta-analysis based on the random effects model will be conducted to compare treatment effects both directly and indirectly. The quality of the evidence will be assessed with appropriate tools including the Grading of Recommendations, Assessment, Development and Evaluation profiler or Confidence in Network Meta-Analysis tool.Ethics and dissemination Ethics approval is not required for this systematic review. The findings will be disseminated through a peer-reviewed journal.PROSPERO registration number CRD42022303289.https://bmjopen.bmj.com/content/12/6/e062702.full
spellingShingle George A Wells
Kevin Emery Boczar
Sheojung Shin
Kathryn A Bezzina
Aishwarya Geejo
Alexander Liam Pearson
Saba Shahab
Christophe A Fehlmann
Sarah Visintini
Rob Beanlands
Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
BMJ Open
title Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
title_full Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
title_fullStr Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
title_full_unstemmed Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
title_short Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials
title_sort examining anti inflammatory therapies in the prevention of cardiovascular events protocol for a systematic review and network meta analysis of randomised controlled trials
url https://bmjopen.bmj.com/content/12/6/e062702.full
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