Abstract Details

Title Albendazole-Praziquantel Dual Therapy Compared to Albendazole Monotherapy in Neurocysticercosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Topic Infectious Disease

Presentation(s) S19 - Navigating Neuroinfectious Diseases (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Background Neurocysticercosis, the most common parasitic infection of the central nervous system, is a neglected tropical disease, and remains a significant public health issue in endemic regions. There is good quality evidence that suggests the antihelmintic monotherapy with albendazole shows superior clinical outcomes when compared with placebo or praziquantel. However, to date, there is no sufficient evidence regarding the efficacy and safety of the albendazole-praziquantel combination therapy.

Objective This systematic review and meta-analysis aims to compare the combined antiparasitic therapy of albendazole and praziquantel with albendazole monotherapy, to assess whether it provides superior therapeutic benefits in the management of patients with neurocysticercosis, while preserving an adequate safety profile.

Design/Methods We searched Medline, Embase and Cochrane for randomized controlled trials (RCTs) comparing the albendazole-praziquantel combined therapy with albendazole monotherapy in the treatment of neurocysticercosis. Statistical analysis was performed using R, with odds ratios (OR) reported with 95% confidence intervals (CI). A random-effects model was applied to all endpoints.

Results 5 RCTs were included, with a total of 320 patients, of whom 49% received combined therapy. There was a significant increase in complete cyst resolution in patients treated with the albendazole-praziquantel combined therapy when compared to albendazole monotherapy (OR= 3.06; 95% CI [1.81, 5.19]; p= 0.0001; I²= 5%). There was no significant difference in seizure recurrence between treatment strategies (OR= 1.28, 95% CI [0.56, 2.91], p= 0.55, I²= 0%). Similarly, the incidence of adverse effects did not differ significantly between both groups (OR= 1.40, 95% CI [0.72, 2.72], p= 0.30, I²= 0%).

Conclusions

The results of this systematic review and meta-analysis showed a threefold increase in complete cyst resolution in patients who received combined therapy, suggesting its superiority to albendazole monotherapy in the management of neurocysticercosis. Additionally, there were no differences between both treatment strategies regarding seizure and adverse events.

Authors/Disclosures
Murilo Cruccioli PRESENTER	Mr. Cruccioli has nothing to disclose.
Jorge F. Pitanga, MS	Mr. Pitanga has nothing to disclose.
Pedro H. Teixeira	Mr. Teixeira has nothing to disclose.
Marla R. Pitanga, Mrs	Mrs. Pitanga has nothing to disclose.
Filipe P. Sarmento, MD (University of Florida, Fixel Institute)	Dr. Sarmento has nothing to disclose.

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