Eight trials were in children known to be infected, and 37 trials were carried out in endemic areas, including areas of high (15 trials), moderate (12 trials), and low prevalence (10 trials).
A single dose also probably has no effect on average haemoglobin (MD 0.06 g/dL, 95% CI -0.05 lower to 0.17 higher; 1005 participants, three trials, moderate quality evidence), or average cognition (1361 participants, two trials, low quality evidence).
In phase II and III trials, moderate elevations of LDL-C, HDL-C and triglycerides were apparent in RA patients treated with TCZ. 7 The atherogenic implications of these changes are unknown.
Community deworming programmes Treating all children living in endemic areas with a dose of deworming drugs probably has little or no effect on average weight gain (MD 0.04 kg less, 95% CI 0.11 kg less to 0.04 kg more; trials 2719 participants, seven trials, moderate quality evidence), even in settings with high prevalence of infection (290 participants, two trials).
We also determined whether the level of spin in abstract conclusions was high (spin reported without uncertainty or recommendations for further trials), moderate (spin reported with some uncertainty or recommendations for further trials) or low (spin reported with uncertainty and recommendations for further trials).
[ Based on high and moderate quality meta-analyses and randomised controlled trials, moderate quality cohort studies, health economic modelling, and the GDG's opinion] If combination therapy with disease modifying drugs is not appropriate (for example, owing to comorbidities or pregnancy), start monotherapy, focusing on fast escalation to a clinically effective dose rather than choice of drug.
[ Based on high and moderate quality meta-analyses and randomised controlled trials, moderate quality cohort studies, health economic modelling, and the GDG's opinion] Offer short term oral, intramuscular, or intra-articular glucocorticoids to rapidly improve symptoms (if the individual is not already receiving glucocorticoids as part of the combination therapy).
[ Based on high and moderate quality meta-analyses and randomised controlled trials, moderate quality cohort studies, and the GDG's opinion] If disease is stable, cautiously reduce dosages of disease modifying or biological drugs; return promptly to disease controlling doses at the first sign of a flare-up.
Overall, RDT supported diagnosis had little or no effect on the number of participants remaining unwell at four to seven days after treatment (6990 participants, five trials, low quality evidence); but using RDTs reduced prescribing of antimalarials by up to three-quarters (17,287 participants, seven trials, moderate quality evidence).
Clinical heterogeneity among included trials was moderate and all trials were at unclear or high risk of bias.
