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. 2020 Feb 4;86(4):646–667. doi: 10.1111/bcp.14210

Table 3.

GRADE evidence profile question 3: what is the effect of naltrexone–bupropion (N‐B) on the frequency of serious adverse events in overweight and obese subjects?

Quality assessment No of patients Effect Quality Comments
No of studies Design Risk of bias Inconsistency Indirectness Imprecision Other considerations N‐B Placebo Relative (95% CI) Absolute
Overall rates of serious adverse events
4 Randomised trials seriousa No serious inconsistency No serious indirectness No serious imprecision None 375/3088 (12.1%) 101/1448 (7%) RR 1.70 (1.38 to 2.1) 49 more per 1000 (from 27 more to 77 more) ⊕ ⊕ ⊕Ο MODERATE NNTH 21 (13 to 38)
Serious (severe) adverse events reported as related or possibly related to intervention
4 Randomised trials seriousa No serious inconsistency seriousb No serious imprecision Very strong associationc 260/3088 (8.4%) 19/1448 (1.3%) RR 5.72 (3.09 to 10.58) 62 more per 1000 (from 27 more to 126 more) ⊕ ⊕ ⊕ ⊕ HIGH NNTH 16 (8 to 37)

Settings: Academic and primary care centres; academic medical centres; private or institutional practices; research centres

a

High drop‐out rates; several investigators have financial ties to the study sponsor;

b

wide confidence interval;

c

RR >5.

CI: confidence interval; NNTH: number needed to treat to harm; RR: risk ratio