Etanercept

Early intrauterine death (< 22 weeks)

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S4994
R13062		 Drechsel, 2020 Miscarriage 1st trimester prospective cohort unexposed, sick Adjustment: No 0.46 [0.06;3.86] C 1/13   13/85 14 13
ref
S4996
R13096		 Fu, 2019 Miscarriages 1st trimester randomized controlled trial unexposed, sick Adjustment: Randomisation 0.30 [0.14;0.67] C 10/95   26/93 36 95
ref
S3011
R8687		 Carman (Control unexposed, disease free), 2017 Spontaneous abortion (miscarriages, ectopic pregnancies, and trophoblastic pregnancies) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: No 1.06 [0.79;1.42] C
excluded (control group) 		69/337   329/1,685 398 337
ref
S3010
R8681		 Carman (Control unexposed, sick), 2017 Spontaneous abortion (miscarriages, ectopic pregnancies, and trophoblastic pregnancies) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No 1.22 [0.92;1.62] C 69/337   498/2,861 567 337
ref
S3137
R4913		 Chambers, 2015 Spontaneous abortion (NOS) at least 1st trimester prospective cohort unexposed, sick Adjustment: Yes 0.47 [0.20;1.12] -/370   -/164 - 370
ref
S4998
R13104		 Hyrich, 2006 First-trimester miscarriages 1st trimester retrospective cohort unexposed, sick Adjustment: No 2.46 [0.23;26.11] C 4/17   1/9 5 17
ref
Total 5 studies 0.66 [0.30;1.45] 622 832
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Drechsel, 2020Drechsel, 2020 0.46[0.06; 3.86]141310%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Fu, 2019Fu, 2019 0.30[0.14; 0.67]369525%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Carman (Control unexposed, sick), 2017Carman, 2017 1 1.22[0.92; 1.62]56733732%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Chambers, 2015Chambers, 2015 0.47[0.20; 1.12]-37024%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Hyrich, 2006Hyrich, 2006 2.46[0.23; 26.11]5178%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (5 studies) I2 = 73% 0.66[0.30; 1.45]6228320.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Control unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.89[0.45; 1.73]58673744%NADrechsel, 2020 Carman (Control unexposed, sick), 2017 Chambers, 2015 Hyrich, 2006 4 case control studiescase control studies 0 RCTRCT 0.30[0.14; 0.67]3695 -NAFu, 2019 1 Type of controls unexposed, sickunexposed, sick 0.66[0.30; 1.45]62283273%NADrechsel, 2020 Fu, 2019 Carman (Control unexposed, sick), 2017 Chambers, 2015 Hyrich, 2006 5 Tags Adjustment   - No  - No 1.21[0.92; 1.60]5863670%NADrechsel, 2020 Carman (Control unexposed, sick), 2017 Hyrich, 2006 3   - Randomisation  - Randomisation 0.30[0.14; 0.67]3695 -NAFu, 2019 1   - Yes  - Yes 0.47[0.20; 1.11]-370 -NAChambers, 2015 1 All studiesAll studies 0.66[0.30; 1.45]62283273%NADrechsel, 2020 Fu, 2019 Carman (Control unexposed, sick), 2017 Chambers, 2015 Hyrich, 2006 50.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-2.82.41.4460.000Drechsel, 2020Fu, 2019Carman (Control unexposed, sick), 2017Chambers, 2015Hyrich, 2006

Asymetry test p-value = 0.3560 (by Egger's regression)

slope=0.2877 (0.3727); intercept=-1.4193 (1.3039); t=1.0885; p=0.3560

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 3011

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.06[0.79; 1.42]398337 -NACarman (Control unexposed, disease free), 2017 1 unexposed, sick controlsunexposed, sick controls 0.66[0.30; 1.45]62283273%NADrechsel, 2020 Fu, 2019 Carman (Control unexposed, sick), 2017 Chambers, 2015 Hyrich, 2006 50.510.01.0