Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis

Table 2 GRADE evidence profile

Quality assessment							No. of patients		Effect		Quality	Importance
# of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other	Psychostimulants	Placebo	Relative (95% CI)	Absolute (95% CI)	Quality	Importance
Abstinence from illicit amphetamines and methamphetamines (final 2 weeks of treatment) (assessed with: urinalysis)
5	RCTs	Very serious^a,b	Serious^c	Serious^d	Very serious^e	None	70/353 (19.8%)	62/289 (21.5%)	OR 0.97 (0.65 to 1.45)	5 fewer per 1000 (from 64 fewer to 69 more)	⨁◯◯◯ Very low	Critical
Retention in treatment (end of trial) (follow-up: range 8 to 24 weeks)
14	RCTs	Serious^b	Serious ^c	Very serious^d,f	Serious^e	None	332/626 (53.0%)	268/558 (48.0%)	OR 1.20 (0.91 to 1.58)	46 more per 1000 (from 23 fewer to 113 more)	⨁◯◯◯ Very low	Critical

CI confidence interval, OR odds ratio
^aThe majority of studies had high attrition bias (>50% dropout rate) and small sample sizes
^b80% of studies did not mention allocation concealment, which may be a source of bias
^cHeterogeneity was not explained by subgroup analyses, as indicated by non-significant tests for subgroup differences
^dStudies investigating the efficacy of different psychostimulant drugs at varying doses were pooled
^e95% confidence intervals are wide and there is a varying range of effect, with little overlap of confidence intervals from some studies
^fPopulations varied across studies with certain studies including injection drug users, incarcerated individuals, or participants with ADHD

ISSN: 2046-4053