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1. Extending the duration of endocrine treatment for early breast cancer: patient-level meta-analysis of 12 randomised trials of aromatase inhibitors in 22 031 postmenopausal women already treated with at least 5 years of endocrine therapy.
In postmenopausal women with oestrogen receptor-positive early breast cancer, 5 years of adjuvant tamoxifen substantially reduces 15-year recurrence and mortality; aromatase inhibitor treatment (AIT) is even more effective. We assess the effects of further AIT among women recurrence-free after at least 5 years of endocrine therapy.
2. Estimating the effect of maternal viral load on perinatal and postnatal HIV transmission: a systematic review and meta-analysis.
作者: Caitlin M Dugdale.;Ogochukwu Ufio.;John Giardina.;Fatma Shebl.;Elif Coskun.;Eden Pletner.;Pamela R Torola.;Duru Cosar.;Roger Shapiro.;Maria Kim.;Lynne Mofenson.;Andrea L Ciaranello.
来源: Lancet. 2025年406卷10501期349-357页
Although a growing body of evidence supports zero risk of sexual HIV transmission from a person with sustained virological suppression, known as U=U (undetectable equals untransmittable), data have been insufficient to determine whether this is also true for vertical HIV transmission. We conducted a systematic review and meta-analysis to quantify vertical transmission risk by maternal HIV viral load (mHVL) and to evaluate the applicability of U=U to perinatal and postnatal HIV transmission.
3. Collaboration on the optimal timing of anticoagulation after ischaemic stroke and atrial fibrillation: a systematic review and prospective individual participant data meta-analysis of randomised controlled trials (CATALYST).
作者: Hakim-Moulay Dehbi.;Urs Fischer.;Signild Åsberg.;Truman J Milling.;Stefanie Abend.;Norin Ahmed.;Mattia Branca.;Lisa A Davis.;Stefan T Engelter.;Nick Freemantle.;Thomas Gattringer.;Tatevik Ghukasyan Lakic.;Ziad Hijazi.;Martin James.;Masatoshi Koga.;Patrick Lawrence.;Robin Lemmens.;Gregory Y H Lip.;Susan Massingham.;Philip S Nash.;Amalia Ndoutoumou.;Bo Norrving.;Georgia Salanti.;Nikola Sprigg.;Götz Thomalla.;Tishok Vanniyasingam.;Per Wester.;Steven J Warach.;Jonas Oldgren.;Jesse Dawson.;David J Werring.
来源: Lancet. 2025年406卷10498期43-51页
The optimal timing of oral anticoagulation for prevention of early ischaemic stroke recurrence in people with acute ischaemic stroke and atrial fibrillation remains uncertain. We aimed to estimate the effects of starting a direct oral anticoagulant (DOAC) early (≤4 days) versus later (≥5 days) after onset of ischaemic stroke.
4. Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis.
作者: Idnan Yunas.;Md Asiful Islam.;Kulandaipalayam N Sindhu.;Adam J Devall.;Marcelina Podesek.;Sayeda Sadia Alam.;Shoumik Kundu.;Kristie-Marie Mammoliti.;Ashraf Aswat.;Malcolm J Price.;Javier Zamora.;Olufemi T Oladapo.;Ioannis Gallos.;Arri Coomarasamy.
来源: Lancet. 2025年405卷10488期1468-1480页
An understanding of the causes of postpartum haemorrhage is needed to provide appropriate treatment and services. Knowledge of the risk factors for postpartum haemorrhage can help address modifiable risk factors. We did a systematic review and meta-analysis to identify and quantify the various causes and risk factors for postpartum haemorrhage.
5. Tranexamic acid for postpartum bleeding: a systematic review and individual patient data meta-analysis of randomised controlled trials.
作者: Katharine Ker.;Loïc Sentilhes.;Haleema Shakur-Still.;Hugo Madar.;Catherine Deneux-Tharaux.;George Saade.;Luis D Pacheco.;François-Xavier Ageron.;Raoul Mansukhani.;Eni Balogun.;Amy Brenner.;Danielle Prowse.;Monica Arribas.;Homa Ahmadzia.;Rizwana Chaudhri.;Oladapo Olayemi.;Ian Roberts.; .
来源: Lancet. 2024年404卷10463期1657-1667页
Tranexamic acid is a recommended treatment for women with a clinical diagnosis of postpartum haemorrhage, but whether it can prevent bleeding is unclear. We conducted a systematic review and individual patient data (IPD) meta-analysis of randomised controlled trials to assess the effects of tranexamic acid in women giving birth.
6. Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis.
作者: Pardeep S Jhund.;Atefeh Talebi.;Alasdair D Henderson.;Brian L Claggett.;Muthiah Vaduganathan.;Akshay S Desai.;Carolyn S P Lam.;Bertram Pitt.;Michele Senni.;Sanjiv J Shah.;Adriaan A Voors.;Faiez Zannad.;Scott D Solomon.;John J V McMurray.
来源: Lancet. 2024年404卷10458期1119-1131页
Mineralocorticoid receptor antagonists (MRAs) reduce hospitalisations and death in patients with heart failure and reduced ejection fraction (HFrEF), but the benefit in patients with heart failure and mildly reduced ejection fraction (HFmrEF) or heart failure and preserved ejection fraction (HFpEF) is unclear. We evaluated the effect of MRAs in four trials that enrolled patients with heart failure across the range of ejection fraction.
7. Antivirals for post-exposure prophylaxis of influenza: a systematic review and network meta-analysis.
作者: Yunli Zhao.;Ya Gao.;Gordon Guyatt.;Timothy M Uyeki.;Ping Liu.;Ming Liu.;Yanjiao Shen.;Xiaoyan Chen.;Shuyue Luo.;Xingsheng Li.;Rongzhong Huang.;Qiukui Hao.
来源: Lancet. 2024年404卷10454期764-772页
Antiviral post-exposure prophylaxis with neuraminidase inhibitors can reduce the incidence of influenza and the risk of symptomatic influenza, but the efficacy of the other classes of antiviral remains unclear. To support an update of WHO influenza guidelines, this systematic review and network meta-analysis evaluated antiviral drugs for post-exposure prophylaxis of influenza.
8. Antivirals for treatment of severe influenza: a systematic review and network meta-analysis of randomised controlled trials.
作者: Ya Gao.;Gordon Guyatt.;Timothy M Uyeki.;Ming Liu.;Yamin Chen.;Yunli Zhao.;Yanjiao Shen.;Jianguo Xu.;Qingyong Zheng.;Zhifan Li.;Wanyu Zhao.;Shuyue Luo.;Xiaoyan Chen.;Jinhui Tian.;Qiukui Hao.
来源: Lancet. 2024年404卷10454期753-763页
The optimal antiviral drug for treatment of severe influenza remains unclear. To support updated WHO influenza clinical guidelines, this systematic review and network meta-analysis evaluated antivirals for treatment of patients with severe influenza.
9. Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019: a systematic review and meta-analysis of aggregated and individual participant data.
作者: Xin Wang.;You Li.;Ting Shi.;Louis J Bont.;Helen Y Chu.;Heather J Zar.;Bhanu Wahi-Singh.;Yiming Ma.;Bingbing Cong.;Emma Sharland.;Richard D Riley.;Jikui Deng.;Josep Figueras-Aloy.;Terho Heikkinen.;Marcus H Jones.;Johannes G Liese.;Joško Markić.;Asuncion Mejias.;Marta C Nunes.;Bernhard Resch.;Ashish Satav.;Kee Thai Yeo.;Eric A F Simões.;Harish Nair.; .; .
来源: Lancet. 2024年403卷10433期1241-1253页
Infants and young children born prematurely are at high risk of severe acute lower respiratory infection (ALRI) caused by respiratory syncytial virus (RSV). In this study, we aimed to assess the global disease burden of and risk factors for RSV-associated ALRI in infants and young children born before 37 weeks of gestation.
10. Undervaccination and severe COVID-19 outcomes: meta-analysis of national cohort studies in England, Northern Ireland, Scotland, and Wales.
Undervaccination (receiving fewer than the recommended number of SARS-CoV-2 vaccine doses) could be associated with increased risk of severe COVID-19 outcomes-ie, COVID-19 hospitalisation or death-compared with full vaccination (receiving the recommended number of SARS-CoV-2 vaccine doses). We sought to determine the factors associated with undervaccination, and to investigate the risk of severe COVID-19 outcomes in people who were undervaccinated in each UK nation and across the UK.
11. Radiotherapy to regional nodes in early breast cancer: an individual patient data meta-analysis of 14 324 women in 16 trials.
Radiotherapy has become much better targeted since the 1980s, improving both safety and efficacy. In breast cancer, radiotherapy to regional lymph nodes aims to reduce risks of recurrence and death. Its effects have been studied in randomised trials, some before the 1980s and some after. We aimed to assess the effects of regional node radiotherapy in these two eras.
12. Effectiveness of handwashing with soap for preventing acute respiratory infections in low-income and middle-income countries: a systematic review and meta-analysis.
作者: Ian Ross.;Sarah Bick.;Philip Ayieko.;Robert Dreibelbis.;Jennyfer Wolf.;Matthew C Freeman.;Elizabeth Allen.;Michael Brauer.;Oliver Cumming.
来源: Lancet. 2023年401卷10389期1681-1690页
Acute respiratory infection (ARI) is a leading cause of morbidity and mortality globally, with 83% of ARI mortality occurring in low-income and middle-income countries (LMICs) before the COVID-19 pandemic. We aimed to estimate the effect of interventions promoting handwashing with soap on ARI in LMICs.
13. Anthracycline-containing and taxane-containing chemotherapy for early-stage operable breast cancer: a patient-level meta-analysis of 100 000 women from 86 randomised trials.
Anthracycline-taxane chemotherapy for early-stage breast cancer substantially improves survival compared with no chemotherapy. However, concerns about short-term and long-term side-effects of anthracyclines have led to increased use of taxane chemotherapy without anthracycline, which could compromise efficacy. We aimed to better characterise the benefits and risks of including anthracycline, and the comparative benefits of different anthracycline-taxane regimens.
14. Past SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis.
Understanding the level and characteristics of protection from past SARS-CoV-2 infection against subsequent re-infection, symptomatic COVID-19 disease, and severe disease is essential for predicting future potential disease burden, for designing policies that restrict travel or access to venues where there is a high risk of transmission, and for informing choices about when to receive vaccine doses. We aimed to systematically synthesise studies to estimate protection from past infection by variant, and where data allow, by time since infection.
15. Effects of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries: an individual participant data meta-analysis of 2 198 655 pregnancies.
作者: Jameela Sheikh.;John Allotey.;Tania Kew.;Borja M Fernández-Félix.;Javier Zamora.;Asma Khalil.;Shakila Thangaratinam.; .
来源: Lancet. 2022年400卷10368期2049-2062页
Existing evidence on the effects of race and ethnicity on pregnancy outcomes is restricted to individual studies done within specific countries and health systems. We aimed to assess the impact of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries, and to ascertain whether the magnitude of disparities, if any, varied across geographical regions.
16. Pregnancy outcomes after first-trimester treatment with artemisinin derivatives versus non-artemisinin antimalarials: a systematic review and individual patient data meta-analysis.
作者: Makoto Saito.;Rose McGready.;Halidou Tinto.;Toussaint Rouamba.;Dominic Mosha.;Stephen Rulisa.;Simon Kariuki.;Meghna Desai.;Christine Manyando.;Eric M Njunju.;Esperanca Sevene.;Anifa Vala.;Orvalho Augusto.;Christine Clerk.;Edwin Were.;Sigilbert Mrema.;William Kisinza.;Josaphat Byamugisha.;Mike Kagawa.;Jan Singlovic.;Mackensie Yore.;Anna Maria van Eijk.;Ushma Mehta.;Andy Stergachis.;Jenny Hill.;Kasia Stepniewska.;Melba Gomes.;Philippe J Guérin.;Francois Nosten.;Feiko O Ter Kuile.;Stephanie Dellicour.
来源: Lancet. 2023年401卷10371期118-130页
Malaria in the first trimester of pregnancy is associated with adverse pregnancy outcomes. Artemisinin-based combination therapies (ACTs) are a highly effective, first-line treatment for uncomplicated Plasmodium falciparum malaria, except in the first trimester of pregnancy, when quinine with clindamycin is recommended due to concerns about the potential embryotoxicity of artemisinins. We compared adverse pregnancy outcomes after artemisinin-based treatment (ABT) versus non-ABTs in the first trimester of pregnancy.
17. Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials.
Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes.
18. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials.
Statin therapy is effective for the prevention of atherosclerotic cardiovascular disease and is widely prescribed, but there are persisting concerns that statin therapy might frequently cause muscle pain or weakness. We aimed to address these through an individual participant data meta-analysis of all recorded adverse muscle events in large, long-term, randomised, double-blind trials of statin therapy.
19. Angiotensin receptor blockers and β blockers in Marfan syndrome: an individual patient data meta-analysis of randomised trials.
作者: Alex Pitcher.;Enti Spata.;Jonathan Emberson.;Kelly Davies.;Heather Halls.;Lisa Holland.;Kate Wilson.;Christina Reith.;Anne H Child.;Tim Clayton.;Matthew Dodd.;Marcus Flather.;Xu Yu Jin.;George Sandor.;Maarten Groenink.;Barbara Mulder.;Julie De Backer.;Arturo Evangelista.;Alberto Forteza.;Gisela Teixido-Turà.;Catherine Boileau.;Guillaume Jondeau.;Olivier Milleron.;Ronald V Lacro.;Lynn A Sleeper.;Hsin-Hui Chiu.;Mei-Hwan Wu.;Stefan Neubauer.;Hugh Watkins.;Hal Dietz.;Colin Baigent.; .
来源: Lancet. 2022年400卷10355期822-831页
Angiotensin receptor blockers (ARBs) and β blockers are widely used in the treatment of Marfan syndrome to try to reduce the rate of progressive aortic root enlargement characteristic of this condition, but their separate and joint effects are uncertain. We aimed to determine these effects in a collaborative individual patient data meta-analysis of randomised trials of these treatments.
20. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials.
作者: Muthiah Vaduganathan.;Kieran F Docherty.;Brian L Claggett.;Pardeep S Jhund.;Rudolf A de Boer.;Adrian F Hernandez.;Silvio E Inzucchi.;Mikhail N Kosiborod.;Carolyn S P Lam.;Felipe Martinez.;Sanjiv J Shah.;Akshay S Desai.;John J V McMurray.;Scott D Solomon.
来源: Lancet. 2022年400卷10354期757-767页
SGLT2 inhibitors are strongly recommended in guidelines to treat patients with heart failure with reduced ejection fraction, but their clinical benefits at higher ejection fractions are less well established. Two large-scale trials, DELIVER and EMPEROR-Preserved, in heart failure with mildly reduced or preserved ejection fraction have been done, providing power to examine therapeutic effects on cardiovascular mortality and in patient subgroups when combined with the earlier trials in reduced ejection fraction.
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