Efficacy and resistance of different artemisinin-based combination therapies: a systematic review and network meta-analysis.

Autor: Mathenge PG; Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan., Low SK; Online Research Club, Japan; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia., Vuong NL; Online Research Club, Japan; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. Electronic address: nguyenlamvuong@ump.edu.vn., Mohamed MYF; Online Research Club, Japan; Faculty of Medicine, University of Khartoum, Sudan., Faraj HA; Online Research Club, Japan; Faculty of Medicine, University of Tripoli, Tripoli, Libya., Alieldin GI; Online Research Club, Japan; Faculty of Pharmacy, Zagazig University, Zagazig, Egypt., Al Khudari R; Online Research Club, Japan; Faculty of Medicine, Damascus University, Damascus, Syria., Yahia NA; Online Research Club, Japan; Faculty of Medicine, Omdurman Islamic University, Khartoum, Sudan., Khan A; Online Research Club, Japan; Paediatrics, Rehman Medical Institute, Peshawar, Pakistan., Diab OM; Online Research Club, Japan; Jordan University of Science and Technology, Irbid, Jordan., Mohamed YM; Online Research Club, Japan; Faculty of Medicine, Misr University for Science and Technology, Cairo, Egypt., Zayan AH; Online Research Club, Japan; Department of Otolaryngology, Menoufia University, Menoufia, Egypt., Tawfik GM; Online Research Club, Japan; Faculty of Medicine, Ain Shams University, Cairo, Egypt., Huy NT; Evidence Based Medicine Research Group, Ton Duc Thang University, Ho Chi Minh City 70000, Viet Nam; Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City 70000, Viet Nam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan. Electronic address: nguyentienhuy4@duytan.edu.vn., Hirayama K; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan. Electronic address: hiraken@nagasaki-u.ac.jp.
Jazyk: angličtina
Zdroj: Parasitology international [Parasitol Int] 2020 Feb; Vol. 74, pp. 101919. Date of Electronic Publication: 2019 Apr 20.
DOI: 10.1016/j.parint.2019.04.016
Abstrakt: Background: Malaria parasites have developed resistance to most of the known antimalarial drugs in clinical practice, with reports of artemisinin resistance emerging in South East Asia (SEA). We sort to find the status of artemisinin resistance and efficacy of different modalities of the current artemisinin-based combination therapies (ACTs).
Methods: We carried out a systematic search in 11 electronic databases to identify in vivo studies published between 2001 and 2017 that reported artemisinin resistance. This was then followed by A network meta-analysis to compare the efficacy of different ACTs. Quality assessment was performed using the Cochrane Risk of Bias (ROB) tool for randomized controlled trials and National Institute of Health (NIH) tool for cross-sectional studies. The study protocol was registered in PROSPERO under number CRD42018087574.
Results: With 8400 studies initially identified, 82 were eligible for qualitative and quantitative analysis. Artemisinin resistance was only reported in South East Asia. K13 mutation C580Y was the most abundant mutation associated with resistance having an abundance of 63.1% among all K13 mutations reported. Although the overall network meta-analysis had shown good performance of dihydroartemisinin piperaquine in the early years, a subgroup analysis of the recent years revealed a poor performance of the drug in relation to recrudescence, clinical failure and parasitological failure especially in the artemisinin resistant regions.
Conclusion: With report of high resistance and treatment failure against the leading artemisinin combination therapy in South East Asia, it is imperative that a new drug or a formulation is developed before further spread of resistance.
(Copyright © 2019. Published by Elsevier B.V.)
Databáze: MEDLINE
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