Are newer drugs better? An analysis of neonatal pharmacological treatments across generations

Nai Ming Lai; Sajesh K Veettil; Nathorn Chaiyakunapruk; Paul Glasziou

doi:10.1159/000539729

Are newer drugs better? An analysis of neonatal pharmacological treatments across generations

Nai Ming Lai, Sajesh K Veettil, Nathorn Chaiyakunapruk, Paul Glasziou

Research output: Contribution to journal › Article › Research › peer-review

Abstract

INTRODUCTION: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations.

MATERIALS AND METHODS: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from Medline, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test.

RESULTS: From 8048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09 to 1).

CONCLUSIONS: We found no evidence that newer-generation medications in neonatal care are consistently more effective than older-generation medications.

Original language	English
Pages (from-to)	1-11
Number of pages	11
Journal	Medical Principles and Practice
DOIs	https://doi.org/10.1159/000539729
Publication status	Accepted/In press - 4 Jun 2024

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10.1159/000539729Licence: CC BY-NC

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title = "Are newer drugs better? An analysis of neonatal pharmacological treatments across generations",

abstract = "INTRODUCTION: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations.MATERIALS AND METHODS: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from Medline, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test.RESULTS: From 8048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09 to 1).CONCLUSIONS: We found no evidence that newer-generation medications in neonatal care are consistently more effective than older-generation medications.",

author = "Lai, {Nai Ming} and Veettil, {Sajesh K} and Nathorn Chaiyakunapruk and Paul Glasziou",

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T1 - Are newer drugs better? An analysis of neonatal pharmacological treatments across generations

AU - Lai, Nai Ming

AU - Veettil, Sajesh K

AU - Chaiyakunapruk, Nathorn

AU - Glasziou, Paul

N1 - The Author(s). Published by S. Karger AG, Basel.

PY - 2024/6/4

Y1 - 2024/6/4

N2 - INTRODUCTION: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations.MATERIALS AND METHODS: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from Medline, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test.RESULTS: From 8048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09 to 1).CONCLUSIONS: We found no evidence that newer-generation medications in neonatal care are consistently more effective than older-generation medications.

AB - INTRODUCTION: We evaluated the relative effects of newer versus older medications for neonatal conditions and trends in margin of superiority across generations.MATERIALS AND METHODS: We assessed network meta-analyses (NMAs) on neonatal pharmacological interventions identified from Medline, Cochrane, and PROSPERO. Interventions were chronologically arranged based on the earliest study and compared for their effects against placebo or no treatment and their immediate predecessor. We assessed the time trend in effect sizes using the Mann-Kendall test.RESULTS: From 8048 retrieved records, 10 neonatal NMAs covering 352 trials and 102,653 participants were included. Compared to placebo, 56/61 (91.8%) interventions showed superiority with 23 (37.7%) statistically significant. Compared to previous generation, 47/72 (65.3%) showed superiority with 3 (4.2%) statistically significant. No significant trends in effect sizes were observed across generations for most conditions (p = 0.09 to 1).CONCLUSIONS: We found no evidence that newer-generation medications in neonatal care are consistently more effective than older-generation medications.

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DO - 10.1159/000539729

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JO - Medical Principles and Practice

JF - Medical Principles and Practice

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Are newer drugs better? An analysis of neonatal pharmacological treatments across generations

Abstract

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