No abstract

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.

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.