Summary of findings 2. Cysteamine compared with no intervention for paracetamol (acetaminophen) overdose.
| Cysteamine compared with no intervention (randomised trials) for paracetamol (acetaminophen) overdose | ||||||
| Patient or population: people with paracetamol (acetaminophen) overdose Settings: Royal Victoria Infirmary, Newcastle, UK Intervention: cysteamine Comparison: no intervention | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| No intervention | Cysteamine | |||||
| Mortality | Study population | Peto OR 0.53 (0.05 to 5.22) | 65 (2 RCTs) | ⊕⊝⊝⊝ Very low1,2 | ‐ | |
| 61 per 1000 | 33 per 1000 (3 to 252) | |||||
| Hepatotoxicity (aspartate aminotransferase > 1000 IU/L) | Study population | OR 0.09 (0.02 to 0.35) | 65 (2 RCTs) | ⊕⊕⊝⊝ Low1,3 | Trial Sequential Analysis‐adjusted CI ranged from 0.00 to 24.0. | |
| 545 per 1000 | 97 per 1000 (23 to 290) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RCT: randomised clinical trial. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1Downgraded one level because of risk of bias (method of randomisation had potential for bias and allocation concealment not specified). 2Downgraded two levels because of serious imprecision (due to small sample studied, low number of deaths, and confidence intervals are wide). 3Downgraded one level because of imprecision (due to small sample studied).