Outcome |
Relative effect (95% CI) |
Absolute effect (95% CI)1 |
Certainty of the Evidence (GRADE) |
Clinical improvement D28 |
RR: 1.03 (0.94 - 1.13) |
27 more per 1000 (from 54 fewer to 117 more)
|
Moderate certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious Multicentre study conducted across several countries, therefore not downgraded for indirectness Imprecision: Serious due to low number of participants
|
1 trials
Gunst J, 2021
208 participants
|
|
Camostat Mesilate 926 per 1,000 (845 - 1000) |
Placebo 899 per 1,000 |
|
Clinical improvement D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above) D28 |
RR: 0.99 (0.35 - 2.79) |
0 fewer per 1000 (from 22 fewer to 61 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm and low number of participants
|
2 trials
Kinoshita T, 2022; Gunst J, 2021
363 participants
|
|
Camostat Mesilate 34 per 1,000 (12 - 96) |
Placebo 34 per 1,000 |
|
WHO progression score (level 7 or above) D60 |
Outcome not yet measured or reported
|
|
All-cause mortality D28 |
RR: 0.99 (0.31 - 3.18) |
0 fewer per 1000 (from 19 fewer to 60 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm and low number of participants
|
2 trials
Kinoshita T, 2022; Gunst J, 2021
363 participants
|
|
Camostat Mesilate 27 per 1,000 (8 - 87) |
Placebo 27 per 1,000 |
|
All-cause mortality D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion D7 |
RR: 0.96 (0.74 - 1.23) |
25 fewer per 1000 (from 165 fewer to 146 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious due to very wide confidence interval consistent with the possibility for no effect and the possibility for harm and low number of participants
|
1 trials
Kinoshita T, 2022
148 participants
|
|
Camostat Mesilate 610 per 1,000 (470 - 781) |
Placebo 635 per 1,000 |
|
Adverse events
|
RR: 0.83 (0.61 - 1.12) |
62 fewer per 1000 (from 142 fewer to 44 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, and outcome measurement Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for benefit and the possibility for no effect and low number of participants
|
2 trials
Kinoshita T, 2022; Gunst J, 2021
363 participants
|
|
Camostat Mesilate 301 per 1,000 (221 - 407) |
Placebo 363 per 1,000 |
|
Serious adverse events
|
RR: 1.64 (0.84 - 3.23) |
39 more per 1000 (from 10 fewer to 137 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, and outcome measurement Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious due to very wide confidence interval consistent with the possibility for no effect and the possibility for harm and low number of participants
|
2 trials
Kinoshita T, 2022; Gunst J, 2021
363 participants
|
|
Camostat Mesilate 101 per 1,000 (52 - 199) |
Placebo 62 per 1,000 |
|
1The risk in the intervention group (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; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect