Table 4.
Main therapeutic findings and conclusions of randomized controlled trials included in the quantitative analysis (meta-analysis)
| Author/s. Year(Ref.no.) | Cyst location | Mean cyst size(cm) | Treatmenta | Endpoint | Main quantitative findings* | ||
|---|---|---|---|---|---|---|---|
| Bildik N, et al....... 2007 [33] | Liver | Non-registered information | G-I: ABZ (10 mg/kg/day 1 month before surgery) G-II: ABZ (10 mg/kg/day 2 months before surgery) G-III: ABZ (10 mg/kg/day 3 months before surgery) G-IV (control gr.): surgery (no preoperative therapy) |
Viability of the scoleces | Intact | Dead | |
| G-I G-II G-III G-IV |
10 7 2 17 |
11 14 19 4 |
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| Cobo F, et al. 1998 [9] | Liver | Non-registered information | G-I: ABZ (10 mg/kg/day 1 month before surgery) G-II: ABZ (20 mg/kg/day 1 months before surgery) G-III: ABZ (10 mg/kg/day) + PZQ (25 mg/kg/day 1 month before surgery) |
Protoscolex viability. ABZ sulphoxide levels in serum and cyst fluid | Protoscoleces viability | ||
| G-III and G-I G-III and G-II |
p = 0.004 p = 0.030 |
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| ABZ sulphoxide levels | |||||||
| G-III and G-I G-III and G-II |
p = 0.016 p = 0.034 |
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| Davis A, et al. 1986 [34] | Liver, lung, other organs | Non-registered information | MBZ (13 to 136.4 mg/kg/day) FBZ (37.5 to 54.5 mg/kg/day) ABZ (9.8 to 15.4 mg/kg/day) |
Results: -success -partial success -improvement -no success |
MBZ | FBZ | ABZ |
| 8 (9.4) 4 (4.7) 40 (47.1) 33 (38.8) |
1 - - 5 |
5 (16.7) 4 (13.3) 14 (46.7) 7 (23.3) |
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| Davis A, et al. 1989 [35] | Liver, lung, other organs | Non-registered information | ABZ (10 mg/kg/day 1 month) MBZ (1.5 to 4.5 g/kg/day, children half of the adult dose) |
Results: -success -favourable effect -no success |
Follow-up | ABZ | MBZ |
| < 12 months: -success -favourable effect -no success no evaluation > 12 months: -success -favourable effect -no success |
21 (100) - 13 (62) 5 (24) 3 (14) 46 (100) 18 (39) 18 (39) 10 (22) |
23 (100) - 6 (26) 13 (57) 4 (17) 22 (100) 3 (14) 14 (64) 5 (23) |
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| Franchi C, et al. 1999 [36] | Liver, abdomen, lung | Non-registered information | G-I: MBZ (50 mg/kg/day) G-II: ABZ (10–12 mg/kg/day) Both drugs in continuous 3- to 6-months cycles |
Chest radiographic, ultrasonography, morphological changes and sonographic classification by Caremani et al | Cysts | G-I | G-II |
| Treated Evaluated Changed Further deg. Relapse |
289 271 152 34 37 |
640 611 502 110 134 |
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| Gil-Grande LA, et al. 1993 [37] | Liver or abdominal | G-A: 10.4 ± 4.1 G-B: 8.9 ± 4.3 G-C: 10.5 ± 5.1 |
G-A: ABZ (10 mg/kg/day 1 month before surgery) G-B: ABZ (10 mg/kg/day 3 months before surgery) G-C (control group): surgery (no ABZ treatment) |
Protoscolex and cyst viability (patients/mice). Echographic changes | p-value | ||
| Viability of protoscolices 0.041 Intraperitoneal inoculation 0.167 Membrane disruption < 0.001 Echographic changes 0.038 | |||||||
| Keshmiri M, et al. 1999 [38] | Lung | E.gr: cm3 ± SD, 29.6 ± 50.5All 27.1 ± 45.8Treat. C.gr: cm3 ± SD, 18.3 ± 49.5All 25.1 ± 63.3Treat. |
Experimental group: ABZ (10–15 mg/kg/day 6 months) Control group: placebo |
Radiological or ultrasonic findings. Response to treatment was classified: -Cured -Improved -No change -Worsened (Caremani et al) |
ABZ | Placebo | |
| No. cysts Worse No change |
124 9 (7) 32 (26) |
26 10 (39) 13 (50) |
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| Decreased | |||||||
| > 25% (p < 0.001) > 50% (p < 0.001) > 75% (p = 0.067) Disappeared (p = 0.075) |
83 (67) 60 (48) 36 (29) 16 (13) |
3 (12) 1 (4) 1 (4) 0 (0) |
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| Keshmiri M, et al. 2001 [39] | Lung, abdomen (including liver) | E.gr: cm3 ± SD, Lung, 29.6 ± 50.5All 27.1 ± 45.8Treat. Abdomen (liver), 198.1 ± 403.7All 212.7 ± 426.2Treat. C.gr: cm3 ± SD, Lung, 18.3 ± 49.5All 25.1 ± 63.3Treat. Abdomen (liver), 74.0 ± 130.8All 91.9 ± 155.4Treat. |
Experimental group: ABZ (400 mg twice a day, in 3 cycles of 6 weeks with 2 weeks between cycles) Control group: placebo |
Volume. Ultrasonography and Computed tomography changes: 7 types, T1-T7. Response to treatment was classified: -Cured -Improved -No change -Worsened (Caremani et al) |
ABZ | Placebo | |
| No. cysts Worse (p < 0.001) No change Improved (p < 0.001) Cure (p = 0.081) |
172 15 (8.7) 23 (13.4) 117 (68) 17 (9.9) |
31 11 (35.5) 16 (51.6) 4 (12.9) 0 (0.0) |
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| Khuroo MS, et al. 1993 [40] | Liver | cm / cm3, mean ± SD At entry into the study vs the end of study PD, 9.2 ± 4.4 vs 5.1 ± 3.9 686 ± 651 vs 297 ± 515 ALB-PD, 10.8 ± 3.0 vs 4.8 ± 3.4 835 ± 528 vs 260 ± 389 ALB, 8.8 ± 4.5 vs 8.0 ± 5.0 642 ± 717 vs 606 ± 741 |
G-I: PD G-II: ABZ (10 mg.kg-1.day-1 for 8 weeks) plus PD G-III: ABZ alone |
At entry into the study vs the end of study: -Clinical response -Cyst size -Cyst echopattern -Hydatid serology -Complications |
p-value | ||
| Clinical response | < 0.001 | ||||||
| < 0.005 | |||||||
| Cyst diameter Cyst volume Cyst echopattern Hydatid serology |
< 0.05 < 0.01 < 0.01 NS |
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| Mohamed AE, et al. 1998 [8] | 1st, Liver(18), lung(1), multiple cyst(3). 2nd, Liver(13), lung(2), others:pelvis, mediastinum, kidney, spinal(4) |
Non-registered information | 1st, ABZ (400 mg twice day four weeks/two-week drug free period) 2nd, ABZ (400 mg twice a day) + PZQ (50 mg/kg) |
Ultrasound and computed tomography changes, magnetic resonance, hydatid serology and chest-X-ray. Complete cure rates |
ABZ | ABZ + PZQ | |
| No. patients | 22 | 19 | |||||
| Disappearance | 8 (36.4) | 9 (47.4) | |||||
| Liver | 7/13 | ||||||
| Lung | 2/2 | ||||||
| Reduction | 5 (22.7) | 9 (47.4) | |||||
| Liver | 5/13 | ||||||
| Others | 4/4 | ||||||
| No change | 2 (9.1) | 1 (5.2) | |||||
| Increase | 0 | 0 | |||||
| Shams-UI-Bari, et al. 2011 [41] | Liver | Non-registered information | Group A: surgery. Group B: ABZ (10 mg/kg/day 12 weeks) + surgery + ABZ (10 mg/kg/day 12 weeks) |
Viability, motility of the scolices and their ability to exclude 5% eosin, under immediate microscopy. Recurrence. |
G-A | G-B | |
| Type I Type II Type III Type IV Viable Non-viable, p < 0.01 Recurrence, p < 0.05 |
12 (33.3) 10 (27.2) 8 (22.2) 6 (16.6) 36 (100) 0 (0) 6 (16.6) |
11 (30.5) 11 (30.5) 10 (27.7) 4 (11.1) 2 (5.5) 34 (94.5) 0 (0) |
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*Statistical significance level of 5% (p < 0.05)
aABZ Albendazole, PZQ Praziquantel, MBZ Mebendazol, FBZ Flubendazole