Asian Pacific Journal of Tropical Medicine

SYSTEMATIC REVIEW
Year
: 2022  |  Volume : 15  |  Issue : 8  |  Page : 343--353

Efficacy and safety of pharmacotherapeutic interventions used in visceral leishmaniasis clinical trials: A systematic review and network meta-analysis


Aamir Bashir, Gautam Sahu, Ishfaq Rashid, Pramil Tiwari 
 Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar Mohali, 160062, Punjab, India

Correspondence Address:
Pramil Tiwari
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, S.A.S. Nagar Mohali, 160062, Punjab
India

Objective: To compare the efficacy and safety outcomes of different antileishmanial agents used in visceral leishmaniasis clinical trials. Methods: A systematic literature search in PubMed/MEDLINE, EMBASE, Cochrane, and Google Scholar was done using keywords “randomized controlled trials”, “antileishmanial” and “visceral leishmaniasis”. The outcomes included were cure rate, overall withdrawals, relapse rate, and treatment-emergent adverse events. Effect estimates through the frequentist network meta-analysis approach were presented as OR with 95% CI. Rankogram plots were used for identifying the “best intervention” based on p-scores obtained using the surface under the cumulative ranking. The risk of bias was evaluated by using Pedro Scale. Results: Seventeen randomized controlled trials with 5 143 visceral leishmaniasis patients who received different antileishmanial agents (amphotericin B, miltefosine, paromomycin, meglumine antimoniate, sodium stibogluconate, sitamaquine, and pentavalent antimonials) and met the inclusion criteria were included. For efficacy outcomes of the treatments, the rankogram of the network meta-analysis revealed that paromomycin (p-score=0.814 8) has the highest probability of being best in the pool, followed by sodium stibogluconate (OR 0.82, 95% CI 0.24-2.79, p-score=0.758 0), amphotericin B+miltefosine (OR 0.66, 95% CI 0.02-19.04, p-score=0.732 9) as compared to the remaining treatments; however, the most of the treatment-emergent adverse events were reported with sitamaquine. Conclusions: Paromomycin reported the highest cure rates, while the maximum treatment-emergent adverse events were seen with sitamaquine.


How to cite this article:
Bashir A, Sahu G, Rashid I, Tiwari P. Efficacy and safety of pharmacotherapeutic interventions used in visceral leishmaniasis clinical trials: A systematic review and network meta-analysis.Asian Pac J Trop Med 2022;15:343-353


How to cite this URL:
Bashir A, Sahu G, Rashid I, Tiwari P. Efficacy and safety of pharmacotherapeutic interventions used in visceral leishmaniasis clinical trials: A systematic review and network meta-analysis. Asian Pac J Trop Med [serial online] 2022 [cited 2022 Sep 26 ];15:343-353
Available from: https://www.apjtm.org/article.asp?issn=1995-7645;year=2022;volume=15;issue=8;spage=343;epage=353;aulast=Bashir;type=0