Medical treatment of cystic echinococcosis: systematic review and meta-analysis
Abstract Background Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions...
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doaj-a9af0be7d32e4b2bb1a7bfca2e35e3fb2020-11-25T03:43:19ZengBMCBMC Infectious Diseases1471-23342018-07-0118111910.1186/s12879-018-3201-yMedical treatment of cystic echinococcosis: systematic review and meta-analysisVirginia Velasco-Tirado0Montserrat Alonso-Sardón1Amparo Lopez-Bernus2Ángela Romero-Alegría3Francisco Javier Burguillo4Antonio Muro5Adela Carpio-Pérez6Juan Luis Muñoz Bellido7Javier Pardo-Lledias8Miguel Cordero9Moncef Belhassen-García10Servicio de Dermatologia, Complejo Asistencial Universitario de Salamanca (CAUSA), Universidad de SalamancaCentro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de SalamancaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaDepartamento Química-Física, Facultad de Farmacia, Universidad de SalamancaLaboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de SalamancaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaServicio de Medicina Interna, Hospital Marqués de ValdecillaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaInstituto de investigación Biomédica de Salamanca (IBSAL), Universidad de SalamancaAbstract Background Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions regarding medical treatment of CE. Methods A thorough electronic search of the relevant literature without language restrictions was carried out using PubMed (Medline), Cochrane Central Register of Controlled Trials, BioMed, Database of Abstracts of Reviews of Effects, and Cochrane Plus databases up to February 1, 2017. All descriptive studies reporting an assessment of CE treatment and published in a peer-reviewed journal with available full-text were considered for a qualitative analysis. Randomized controlled trials were included in a quantitative meta-analysis. We used the standard methodological procedures established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results We included 33 studies related to the pharmacological treatment of CE in humans. Of these, 22 studies with levels of evidence 2 to 4 were qualitatively analysed, and 11 randomized controlled trials were quantitatively analysed by meta-analysis. Conclusions Treatment outcomes are better when surgery or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Reaspiration) is combined with benzimidazole drugs given pre- and/or post-operation. Albendazole chemotherapy was found to be the primary pharmacological treatment to consider in the medical management of CE. Nevertheless, combined treatment with albendazole plus praziquantel resulted in higher scolicidal and anti-cyst activity and was more likely to result in cure or improvement relative to albendazole alone.http://link.springer.com/article/10.1186/s12879-018-3201-yEchinococcus granulosusCystic echinococcosisAlbendazoleMebendazolePraziquantel |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Virginia Velasco-Tirado Montserrat Alonso-Sardón Amparo Lopez-Bernus Ángela Romero-Alegría Francisco Javier Burguillo Antonio Muro Adela Carpio-Pérez Juan Luis Muñoz Bellido Javier Pardo-Lledias Miguel Cordero Moncef Belhassen-García |
spellingShingle |
Virginia Velasco-Tirado Montserrat Alonso-Sardón Amparo Lopez-Bernus Ángela Romero-Alegría Francisco Javier Burguillo Antonio Muro Adela Carpio-Pérez Juan Luis Muñoz Bellido Javier Pardo-Lledias Miguel Cordero Moncef Belhassen-García Medical treatment of cystic echinococcosis: systematic review and meta-analysis BMC Infectious Diseases Echinococcus granulosus Cystic echinococcosis Albendazole Mebendazole Praziquantel |
author_facet |
Virginia Velasco-Tirado Montserrat Alonso-Sardón Amparo Lopez-Bernus Ángela Romero-Alegría Francisco Javier Burguillo Antonio Muro Adela Carpio-Pérez Juan Luis Muñoz Bellido Javier Pardo-Lledias Miguel Cordero Moncef Belhassen-García |
author_sort |
Virginia Velasco-Tirado |
title |
Medical treatment of cystic echinococcosis: systematic review and meta-analysis |
title_short |
Medical treatment of cystic echinococcosis: systematic review and meta-analysis |
title_full |
Medical treatment of cystic echinococcosis: systematic review and meta-analysis |
title_fullStr |
Medical treatment of cystic echinococcosis: systematic review and meta-analysis |
title_full_unstemmed |
Medical treatment of cystic echinococcosis: systematic review and meta-analysis |
title_sort |
medical treatment of cystic echinococcosis: systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2018-07-01 |
description |
Abstract Background Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions regarding medical treatment of CE. Methods A thorough electronic search of the relevant literature without language restrictions was carried out using PubMed (Medline), Cochrane Central Register of Controlled Trials, BioMed, Database of Abstracts of Reviews of Effects, and Cochrane Plus databases up to February 1, 2017. All descriptive studies reporting an assessment of CE treatment and published in a peer-reviewed journal with available full-text were considered for a qualitative analysis. Randomized controlled trials were included in a quantitative meta-analysis. We used the standard methodological procedures established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results We included 33 studies related to the pharmacological treatment of CE in humans. Of these, 22 studies with levels of evidence 2 to 4 were qualitatively analysed, and 11 randomized controlled trials were quantitatively analysed by meta-analysis. Conclusions Treatment outcomes are better when surgery or PAIR (Puncture, Aspiration, Injection of protoscolicidal agent and Reaspiration) is combined with benzimidazole drugs given pre- and/or post-operation. Albendazole chemotherapy was found to be the primary pharmacological treatment to consider in the medical management of CE. Nevertheless, combined treatment with albendazole plus praziquantel resulted in higher scolicidal and anti-cyst activity and was more likely to result in cure or improvement relative to albendazole alone. |
topic |
Echinococcus granulosus Cystic echinococcosis Albendazole Mebendazole Praziquantel |
url |
http://link.springer.com/article/10.1186/s12879-018-3201-y |
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