Treating neurocysticercosis medically: a systematic review of randomized, controlled trials
Open Access
- 1 November 1999
- journal article
- research article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 4 (11) , 713-718
- https://doi.org/10.1046/j.1365-3156.1999.00477.x
Abstract
Summary objective To summarize the evidence from randomized controlled trials on the effects of cysticidal therapy used for treating human cysticercosis. methods Published and unpublished studies in any language identified through MEDLINE (1966 – June 1999) specialized databases, abstracts, proceedings and contact with experts were analysed. Those which compared, using randomized or quasi‐randomized methods, any cysticidal drug with placebo or symptomatic therapy were entered in the study. Data were extracted independently by two reviewers and trial quality assessed. Meta‐analysis using fixed effects models calculated provided there was no significant heterogeneity, expressed as relative risk. results Four trials met the inclusion criteria, treating intraparenchymatous neurocysticercosis with either albendazole or praziquantel compared to placebo or no treatment. In the two trials reporting clinical outcomes, treatment was not associated with a reduction in the risk of seizures, although numbers were small (RR 0.95, 95% CI 0.59–1.51). Four trials reported radiological outcomes, and cysticidal treatment was associated with a lower risk of cyst persistence of scans taken within six months of start of treatment (RR 0.83, 95% CI 0.70–0.99). Subsidiary analysis assuming different outcomes in patients lost to follow‐up did not alter the findings of the main analysis. conclusions There is insufficient evidence to determine whether cysticidal therapy is of any clinical benefit to patients with neurocysticercosis. The review does not exclude the possibility that more patients remain seizure‐free when treated with cysticidal drugs. Further testing through placebo‐controlled trials is required.Keywords
This publication has 17 references indexed in Scilit:
- Neurocysticercosis: A Major Cause of Neurological Disease WorldwideClinical Infectious Diseases, 1997
- Proposal of diagnostic criteria for human cysticercosis and neurocysticercosisJournal of the Neurological Sciences, 1996
- NeurocysticercosisArchives of Neurology, 1996
- Is the course of neurocysticercosis modified by treatment with antihelminthic agents?Archives of internal medicine (1960), 1995
- Medical Treatment of CysticercosisArchives of Neurology, 1995
- Albendazole in single CT ring lesions in epilepsyNeurology, 1994
- Neurocysticercosis as the main cause of late-onset epilepsy in MexicoArchives of internal medicine (1960), 1990
- Albendazole therapy for neurocysticercosisArchives of internal medicine (1960), 1987
- Therapy of Parenchymal Brain Cysticercosis with PraziquantelNew England Journal of Medicine, 1984
- Spontaneous radiographic disappearance of cerebral cysticercosisNeurology, 1983