Evidence of efficacy the various management methods in paraquat poisoning: an umbrella review

Abstract

This umbrella review presents different therapeutic approaches for Paraquat (PQ) poisoning to reach a general conclusion on what is the best treatment to reduce mortality. A comprehensive electronic search of relevant databases was conducted from inception to April 2022. Only systematic reviews with or without meta‐analysis were eligible for this review. Initially, 123 titles were retrieved, and after removing the duplicates, 89 titles and abstracts were reviewed. Finally, 34 full texts were screened, and of these, 11 qualitative systematic reviews and quantitative meta-analyses (including 12 trials) were eligible. The mortality rate following all included interventions was 24% less likely to occur than in routine management (RR: 0.763, 95% CI 0.649–0.897; p = 0.001). In subgroup analysis, the efficacy of immunosuppressive therapy and Ambroxol was higher than other interventions. The mortality rate following Ambroxol was 31% less likely to occur than routine management (RR: 0.690, 95% CI 0.552–0.863; p = 0.001). This rate was similar to the immunosuppressive therapy (RR: 0.700, 95% CI: 0.627–0.782; p < 0.001). Other interventions did not affect the reduction of the mortality rate (p > 0.05). To conclude the accurate result, further studies are recommended to evaluate the efficacy and safety of immunosuppressive therapy.