Key Message

Evidence suggested high-dose mesalamine was more likely to induce remission in patients with mild to moderate active Crohn disease than placebo. There was no significant difference between low-dose mesalamine and placebo for induction of remission. Evidence comparing mesalamine to budesonide on remission was mixed. There was some evidence suggesting that high-dose budesonide was more likely to induce remission in patients with mild to moderate active Crohn disease than low-dose mesalamine. However, no significant differences were observed between budesonide and mesalamine at comparable doses (high or low), and when high-dose mesalamine was compared with low-dose budesonide.

Evidence suggested unspecified corticosteroids were more likely to induce remission in patients with mild to moderate active Crohn disease than mesalamine.

Evidence suggested there were no differences in withdrawals due to adverse events for mesalamine versus placebo, budesonide, or corticosteroids. Limited evidence suggested there were no significant differences in pancreatitis between patients with active Crohn disease treated with mesalamine versus azathioprine. No evidence was identified that evaluated the clinical effectiveness of mesalamine for the treatment of severe active Crohn disease.

Key Message

• Limited evidence describing the clinical utility of 2 types of portable bone imaging devices suggest that they may be comparable to DXA for predicting the incidence of fracture, but the findings are uncertain.
• Incorporating 1 type of portable bone imaging device into a screening and diagnosis management pathway for osteoporosis was more cost-effective in a Finnish context, compared to an osteoporosis management approach that did not include the portable bone imaging device.
• Two guidelines were found that have recommendations about portable bone imaging devices for screening and diagnosing osteoporosis. Both guidelines reported limited evidence on the use of portable bone imaging devices.

Key Message

• One randomized control trial and 2 retrospective cohort studies found no significant differences between tenofovir and entecavir in the prophylaxis of hepatitis B virus reactivation in patients who were hepatitis B surface antigen positive and/or hepatitis B core antibody positive receiving chemotherapy or immunosuppressive therapy. There were no significant differences between these 2 drugs regarding renal function and other side effects.
• One randomized controlled trial found no patients in the tenofovir prophylaxis group had HBV reactivation compared to 10.7% in the observational group. However, the difference did not reach the level of statistical significance, probably owing to a small sample size. There were no significant differences between groups in terms of renal function, liver function, and other side effects.
• All 8 included guidelines strongly recommend the use of tenofovir or entecavir as antiviral prophylaxis in all patients with high risk of hepatitis B virus reactivation (hepatitis B surface antigen positive and/or hepatitis B core antibody positive) during chemotherapy or immunosuppressive therapy.

Key Message

The review did not find any studies exclusively on the clinical effectiveness and safety of low-dose ipilimumab in combination with nivolumab for the treatment of advanced melanoma that met the criteria for this review.

The review found limited evidence, from 1 single-arm phase II trial of 70 adults and 1 retrospective cohort study of 9 adults, on the clinical benefits and safety of low-dose ipilimumab in combination with pembrolizumab (or nivolumab for an unspecified number of patients in the retrospective cohort study) for the treatment of advanced melanoma.

In the single-arm study, 20 of 70 enrolled patients (29%) achieved a confirmed response, including 5 complete (7.2%) and 15 partial responses (21.4%). In the retrospective cohort study, 3 of 9 patients (33%) achieved a partial response.

The review did not find any studies on the cost-effectiveness of low-dose ipilimumab in combination with nivolumab or pembrolizumab for the treatment of advanced melanoma that met our criteria for this review.

Key Message

• Six evidence-based guidelines regarding the use of real-time continuous glucose monitoring in people living with type 1 or type 2 diabetes were included in this report. Three included guidelines were of high quality, while 3 guidelines were of moderate quality due to unclear reporting of methodological details.
• Four evidence-based guidelines strongly recommended the use of real-time continuous glucose monitoring in adults for the management of type 1 diabetes, based on intermediate- to high-quality evidence.
• Four guidelines recommended real-time continuous glucose monitoring for adults living with type 2 diabetes, based on low- to high-quality evidence.
• Three guidelines strongly recommended the use of real-time continuous glucose monitoring in children and young people living with type 1 diabetes, based on intermediate to high-quality evidence.
• One guideline recommended real-time continuous glucose monitoring for children and young people with type 2 diabetes, based on expert consensus rather than evidence of clinical effectiveness.

Key Message

• Five evidence-based guidelines met the eligibility criteria for this report. Of the 5 guidelines, 2 provided recommendations on rheumatology practice, 1 on stroke, 1 on oncology, and 1 on digital innovations for all areas of health; none of them focused on primary care specifically. Three were developed in the context of COVID-19.
• While all 5 guidelines were informed by a systematic literature search, some specific recommendations were based on expert consensus, given the absence of literature on the respective topics. The quality of evidence and strength of recommendations, where available, were generally assessed to be low across the guidelines.
• The evidence-based guidelines provided recommendations across various aspects of virtual care delivery including population considerations, patient conditions, and the types of care that can be offered virtually. They also provided recommendations on when to offer or discontinue virtual care, on patient privacy, and on staff training. One guideline provided a recommendation on fees and reimbursement.
• Multiple evidence-based guidelines stated that virtual care should complement rather than replace in-person care, and that virtual care should only be implemented when adequate resources and personnel are available and patient privacy can be secured.

Key Message

With the continued COVID-19 pandemic and the resurgence of seasonal influenza, there is the potential that some populations may need drugs for the prevention and/or treatment of COVID-19 and/or influenza at the same time (i.e., concurrent use) or close together (i.e., sequential use).

No evidence was identified regarding the clinical effectiveness, safety, or evidence-based guidelines for the concurrent or sequential use of cilgavimab and tixagevimab, nirmatrelvir and ritonavir, and/or oseltamivir that met the criteria for this review.

Key Message

1. Evidence suggested there was no significant difference in mortality between patients with or at risk of acute respiratory distress syndrome treated with airway pressure release ventilation versus other mechanical ventilation strategies.
2. The evidence of the clinical effectiveness of airway pressure release ventilation in patients with or at risk of acute respiratory distress syndrome is uncertain for several outcomes (length of intensive care unit stay, oxygenation, ventilator-free days, mean arterial pressure). Evidence from some studies suggested there was a significant benefit favouring airway pressure release ventilation versus other mechanical ventilation strategies for these outcomes, other studies suggested there was a significant benefit favouring other mechanical ventilation strategies, and some studies found no significant differences between treatment groups.
3. Results from 1 study suggested there were no significant differences in incidence of acute respiratory distress syndrome between patients treated with airway pressure release ventilation versus pressure-controlled synchronized intermittent mandatory ventilation and pressure support.
4. Evidence suggested there was no significant difference in tracheostomy between patients with or at risk of acute respiratory distress syndrome treated with airway pressure release ventilation versus control. In 1 study significantly more patients treated with airway pressure release ventilation experienced severe hypercapnia than those treated with low tidal volume ventilation.
5. One guideline suggests considering the use of airway pressure release ventilation in patients without severe acute respiratory distress syndrome.

Key Message

The evidence regarding clinical and cost-effectiveness of real-time continuous glucose monitoring (rtCGM) compared to self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus is summarized in this report.

Results from 5 systematic reviews and 1 randomized controlled study suggest that in adult patients, rtCGM may be favoured over SMBG in improving glycated hemoglobin levels, and in lowering time with extreme low or high blood glucose levels. However, the evidence is uncertain due to limited quality evidence.

In adults, limited safety evidence suggests that rtCGM is safe with low rates of adverse events.

A cost-effectiveness analysis conducted in Spain found that rtCGM is not a cost-effective option compared to SMBG in adults with type 2 diabetes mellitus.

No evidence was identified regarding clinical or cost-effectiveness of rtCGM in pediatric patients with type 2 diabetes mellitus.