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AuthorClarke, Naomi E
AuthorDoi, Suhail A R
AuthorWangdi, Kinley
AuthorChen, Yingxi
AuthorClements, Archie C A
AuthorNery, Susana V
Available date2019-01-01T05:58:10Z
Publication Date2019-01-01
Publication NameClinical Infectious Diseases
Identifierhttp://dx.doi.org/10.1093/cid/ciy423
CitationNaomi E Clarke, Suhail A R Doi, Kinley Wangdi, Yingxi Chen, Archie C A Clements, Susana V Nery; Efficacy of Anthelminthic Drugs and Drug Combinations Against Soil-transmitted Helminths: A Systematic Review and Network Meta-analysis, Clinical Infectious Diseases, Volume 68, Issue 1, 1 January 2019, Pages 96–105, https://doi.org/10.1093/cid/ciy423
ISSN1058-4838
URIhttp://hdl.handle.net/10576/11238
AbstractPeriodic mass distribution of benzimidazole anthelminthic drugs is the key strategy to control soil-transmitted helminths (STHs) globally. However, benzimidazoles have low efficacy against Trichuris trichiura, and there are concerns about benzimidazole resistance potentially emerging in humans. Therefore, identifying alternative drug regimens is a pressing priority. We present a systematic review and network meta-analysis comparing the efficacy of 21 different anthelminthic drug regimens, including standard, novel, and combination treatments. We searched PubMed, Medline, Embase, Web of Science, and Cochrane databases and identified studies comparing anthelminthic treatments to each other or placebo. The outcomes calculated were relative risk (RR) of cure and difference in egg reduction rates (dERR). We used an automated generalized pairwise modeling framework to generate mixed treatment effects against a common comparator, the current standard treatment (single-dose albendazole). Our search identified 4876 studies, of which 114 were included in the meta-analysis. Results identified several drug combinations with higher efficacy than single-dose albendazole for T. trichiura, including albendazole-ivermectin (RR of cure, 3.22 [95% confidence interval {CI}, 1.84-5.63]; dERR, 0.97 [95% CI, .21-1.74]), albendazole-oxantel pamoate (RR, 5.07 [95% CI, 1.65-15.59]; dERR, 0.51 [95% CI, .50-.52]), mebendazole-ivermectin (RR, 3.37 [95% CI, 2.20-5.16]), and tribendimidine-oxantel pamoate (RR, 4.06 [95% CI, 1.30-12.64]). There are several promising drug combinations that may enhance the impact of STH control programs on T. trichiura, without compromising efficacy against Ascaris lumbricoides and hookworm. We suggest further, large-scale trials of these drug combinations and consideration of their use in STH control programs where T. trichiura is present. CRD42016050739.
Languageen
PublisherOxford University Press
SubjectSoil - transmitted helminths
drug efficacy
benzimidazoles
TitleEfficacy of Anthelminthic Drugs and Drug Combinations Against Soil-transmitted Helminths: A Systematic Review and Network Meta-analysis.
TypeArticle
Pagination96–105
Issue Number1
Volume Number68
ESSN1537-6591
dc.accessType Abstract Only


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