Antimycotic Azoles (all routes except local only) updated on 01-29-2025

Limb defects

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.
S17739
R75015
Zhu - Fluconazole, 2020 Limb defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: Yes Fluconazole not specified or mixed dose 0.98 [0.85;1.13] 195/37,648   9,857/1,872,961 10,052 37,648
ref
S17833
R75266
Berard - Fluconazole, 2019 Musculoskeletal malformations 1st trimester nested case control unexposed (general population or NOS) Adjustment: Yes Fluconazole not specified or mixed dose 1.16 [0.83;1.62] 58/1,313   8,223/224,031 8,281 1,313
ref
S17735
R74921
Molgaard-Nielsen - Fluconazole, 2013 Limb defects 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Fluconazole not specified or mixed dose 0.84 [0.57;1.23] 27/7,352   4,143/968,236 4,170 7,352
ref
S17745
R75031
Jick - Fluconazole and Itraconazole (Oral), 1999 Limb disorders (polydactyly, syndactyly, hip dislocation, talipes or others) 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No 1.27 [0.27;5.99] C 2/322   8/1,629 10 322
ref
Total 4 studies 0.99 [0.87;1.12] 22,513 46,635
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 Zhu - Fluconazole, 2020Zhu - Fluconazole, 2020 0.98[0.85; 1.13]10,05237,64875%ROB confusion: lowROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Berard - Fluconazole, 2019Berard - Fluconazole, 2019 1.16[0.83; 1.62]8,2811,31314%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Molgaard-Nielsen - Fluconazole, 2013Molgaard-Nielsen - Fluconazole, 2013 0.84[0.57; 1.23]4,1707,35210%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Jick - Fluconazole and Itraconazole (Oral), 1999Jick - Fluconazole and Itraco..., 1999 1 1.27[0.27; 5.99]103221%ROB confusion: criticalROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Total (4 studies) I2 = 0% 0.99[0.87; 1.12]22,51346,6350.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Oral;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.96[0.84; 1.10]14,23245,3220%NAZhu - Fluconazole, 2020 Molgaard-Nielsen - Fluconazole, 2013 Jick - Fluconazole and Itraconazole (Oral), 1999 3 case control studiescase control studies 1.16[0.83; 1.62]8,2811,313 -NABerard - Fluconazole, 2019 1 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.99[0.87; 1.12]22,51346,6350%NAZhu - Fluconazole, 2020 Berard - Fluconazole, 2019 Molgaard-Nielsen - Fluconazole, 2013 Jick - Fluconazole and Itraconazole (Oral), 1999 4 Tags Adjustment   - No  - No 1.27[0.27; 5.99]10322 -NAJick - Fluconazole and Itraconazole (Oral), 1999 1   - Yes  - Yes 0.99[0.87; 1.12]22,50346,3130%NAZhu - Fluconazole, 2020 Berard - Fluconazole, 2019 Molgaard-Nielsen - Fluconazole, 2013 3 Fluconazole not specified or mixed doseFluconazole not specified or mixed dose 0.99[0.87; 1.12]22,50346,3130%NAZhu - Fluconazole, 2020 Berard - Fluconazole, 2019 Molgaard-Nielsen - Fluconazole, 2013 3 All studiesAll studies 0.99[0.87; 1.12]22,51346,6350%NAZhu - Fluconazole, 2020 Berard - Fluconazole, 2019 Molgaard-Nielsen - Fluconazole, 2013 Jick - Fluconazole and Itraconazole (Oral), 1999 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-1.91.90.9520.000Zhu - Fluconazole, 2020Berard - Fluconazole, 2019Molgaard-Nielsen - Fluconazole, 2013Jick - Fluconazole and Itraconazole (Oral), 1999

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

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.99[0.87; 1.12]22,51346,6350%NAZhu - Fluconazole, 2020 Berard - Fluconazole, 2019 Molgaard-Nielsen - Fluconazole, 2013 Jick - Fluconazole and Itraconazole (Oral), 1999 40.510.01.0