Albendazole in the treatment of Ancylostoma duodenale and Ascaris lumbricoides infections

El-Masry, N. A.; Trabolsi, B.; Bassily, S.; Farid, Z.

doi:10.1016/0035-9203(83)90056-1

Cited by 10 publications

(4 citation statements)

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“…We evaluated 44 studies with an average Jadad score of 2.5 and a total of 7273 participants positive for A lumbricoides (table N in appendix 2 gives detailed numbers) to evaluate the effect of the four anthelmintic drugs against A lumbricoides (fig 1 ). Pooled estimates were based on 19 studies with only one treatment, 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 22 studies with two treatments, 12 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 and three studies with three eligible treatments. 64 65 66…”

Section: Resultsmentioning

confidence: 99%

“…Thirty three studies reported egg reduction rates 12 25 26 29 31 32 34 35 36 37 38 43 44 45 46 47 48 49 51 52 54 55 56 57 58 59 60 61 62 64 66 67 (fig 3 ). All treatment arms showed significantly higher rates (P<0.001) than placebo (20.7%, 95% confidence interval 14.7% to 26.7%; table 1 ), while there were no significant differences between the rates with the four treatments (fig 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…For estimating the drug efficacy against hookworm, we looked at data from 7178 individuals from 38 studies (table 1 ; table N in appendix 2) with an average Jadad score of 2.8. Pooled estimates included 12 studies with one treatment, 25 26 30 31 32 34 36 38 42 43 68 21 studies with two treatments, 12 43 44 46 47 48 49 50 51 52 53 54 55 56 57 58 62 63 68 69 70 and five studies with three treatments. 64 65 66 71 72 …”

Section: Resultsmentioning

confidence: 99%

“…We used data from 34 studies 12 25 26 30 31 32 34 36 38 43 44 46 47 48 49 51 52 54 55 56 57 58 62 64 66 67 68 69 70 71 72 (fig 3 ) to determine an egg reduction rate of 16.2% (95% confidence interval 5.3% to 27.1%) for placebo, which was significantly lower than the rates for all active treatments (table 1 ). Albendazole had the highest average rate of 89.6% (81.9% to 97.3%), followed by pyrantel pamoate (71.9%, 54.7% to 89.0%), levamisole (61.8%, 30.3% to 93.3%), and mebendazole (61.0%, 52.0% to 69.9%).…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis

Moser

Schindler

Keiser

2017

BMJ

268

249

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Objective To evaluate efficacies of anthelmintic drugs against soil transmitted helminths in terms of cure rates and egg reduction rates. Design Systematic review and network meta-analysis. Data Sources PubMed, ISI Web of Science, Embase, ScienceDirect, the Cochrane Central Register of Clinical Trials, and the World Health Organization library database from 1960 until 31 December 2016. Study selection Randomised controlled trials evaluating the efficacy of a single dose regimen of albendazole, mebendazole, levamisole, and pyrantel pamoate against Ascaris lumbricoides, hookworm (Necator americanus and Ancylostoma duodenale) and Trichuris trichiura. The primary outcomes included cure rates analysed by network meta-analysis with mixed logistic regression models and egg reduction rates with mixed linear models. Results 55 and 46 randomised controlled trials were included in the analysis of cure rates and egg reduction rates, respectively. All drugs were highly efficacious against A lumbricoides. Albendazole showed the highest efficacy against hookworm infections with a cure rate of 79.5% (95% confidence interval 71.5% to 85.6%) and an egg reduction rate of 89.6% (81.9% to 97.3%). All drugs had low efficacy against T trichiura, with mebendazole showing the highest cure rate of 42.1% (25.9% to 60.2%) and egg reduction rate of 66.0% (54.6% to 77.3%). Estimates for the years 1995 and 2015 showed significant reductions in efficacy of albendazole against T trichiura: by 2015 the egg reduction rates fell from 72.6% (53.7% to 91.5%) to 43.4% (23.5% to 63.3%; P=0.049) and the cure rates fell from 38.6% (26.2% to 52.7%) to 16.4 (7.7% to 31.3%; P=0.027). Conclusions All four currently recommended drugs show limitations in their efficacy profile. While only albendazole showed good efficacy against hookworm infection, all drugs had low efficacy against T trichiura. The decrease in efficacy of albendazole against T trichiura over the past two decades is of concern. The findings indicate the need for strengthening efforts to develop new drug treatments, with a particular focus on drugs against T trichiura.

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