Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.

Detalhes bibliográficos
Autor(a) principal: Brito, Nayara Castelano
Data de Publicação: 2017
Outros Autores: Rabello, Ana Lucia Teles, Cota, Gláucia Fernandes
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/25399
Resumo: Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias. Belo Horizonte, MG, Brazil
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spelling Brito, Nayara CastelanoRabello, Ana Lucia TelesCota, Gláucia Fernandes2018-03-19T17:13:14Z2018-03-19T17:13:14Z2017BRITO, Nayara Castelano; RABELLO, Lucia Teles Rabello; COTA, Gláucia Fernandes. Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review. PLoS One, v. 12, n. 9, art. e0184777, 20171932-6203https://www.arca.fiocruz.br/handle/icict/2539910.1371/journal.pone.0184777engPublic Library of SciencelesoesLeishmanioseLesionsLeishmaniasisAntimonyParasitic diseasesAnti-addiction drug therapyUlcersHIV diagnosis and managementTuberculosis diagnosis and managementEfficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto René Rachou. Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Instituto René Rachou. Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias. Belo Horizonte, MG, BrazilFundação Oswaldo Cruz. Instituto René Rachou. Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias. Belo Horizonte, MG, BrazilBackground: The mainstays of cutaneous leishmaniasis (CL) treatment, in several world regions, are pentavalent antimony (Sbv) compounds administered parenterally, despite their recognized toxicity, which requires frequent laboratory monitoring and complicates their use in areas with scarce infrastructure. As result of these drawbacks, the WHO Expert Committee on leishmaniasis has expanded the recommendations for the use of local therapies, including Sbvintralesional infiltration (IL-Sbv), as CL therapy alternatives even in the New World. However, the efficacy of these approaches has never been compiled. The aim of this study was to critically and systematically assess the efficacy of IL-Sbv for CL treatment. Methodology: The PRISMA guidelines for systematic reviews and the Cochrane manual were followed. The sources used were the MEDLINE and LILACS databases and the International Clinical Trials Registry Platform of the World Health Organization. The outcome of interest was a clinical cure, defined as complete re-epithelialization of all lesions. The IL-Sbv pooled cure rate was estimated for several subgroups and direct comparisons were performed when possible. Results: Thirty nine articles (40 studies) involving 5679 patients treated with IL-Sbv infiltration were included. In direct comparison, only three studies involving 229 patients compared IL-Sbvinfiltration versus placebo and no difference was observed (OR: 1,9; 95%IC 0,93 to 3,82) based on cure rate 69.6% (95%CI 17.6–96.1%) and 83,2% (95%CI 66–92.7%) for placebo and IL-Sbv, respectively. In an alternative and non-comparative analysis, gathering all study arms using the intervention, the pooled IL-Sbv efficacy rate was 75% (95%CI 68–81%). In the Old World, the observed overall IL-Sbv efficacy rate was 75% (95%CI 66–82%), and the cure rates were significantly higher with sodium stibogluconate (SSG) than with meglumine antimoniate (MA): 83% (95%CI 75–90%) versus 68% (95%CI 54–79%), p = 0.03. Studies directly comparing IL-Sbv with topical 15% paromomycin ointment, IL hypertonic saline, radiofrequency-induced heat therapy, topical trichloroacetic acid and cryotherapy showed no significant difference in efficacy between the interventions. The analyses suggested a higher efficacy of IL-Sbv combined with cryotherapy (81.8%, 95%IC 62.4–92.4%) when compared with IL-Sbv alone (53.3%, 95%IC 46.1–66%), OR: 3.14 (95%CI 1.1–8.9), p = 0.03. In the New World, the global IL-Sbv efficacy was 77%(95%CI 66–85%). In contrast with the Old World, a significant difference favoring MA in relation to SSG was observed: 61% (95%CI 49–73%) versus 82% (95%CI 70–89%).By comparing IL infiltration schedules, it was determined that patients submitted to IL-Sbv treatments longer than 14 days had higher cure rates. Conclusions: Despite the high heterogeneity and low methodological quality of studies, an indirect comparison shows that the antimony infiltration efficacy rate is similar to that reported for antimony systemic use. The evidence gathered thus far is insufficient to identify the ideal IL therapeutic regime or estimate the rates of adverse events and mucosal late complications.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83082https://www.arca.fiocruz.br/bitstream/icict/25399/1/license.txt9193a7c197bc67acd023525e72a03240MD51ORIGINALEfficacy of pentavalent antimoniate intralesional infiltration.pdfEfficacy of pentavalent antimoniate intralesional infiltration.pdfapplication/pdf3128329https://www.arca.fiocruz.br/bitstream/icict/25399/2/Efficacy%20of%20pentavalent%20antimoniate%20intralesional%20infiltration.pdf9615eed55beb2be9d4334f49adbc37acMD52TEXTEfficacy of pentavalent antimoniate intralesional infiltration.pdf.txtEfficacy of pentavalent antimoniate intralesional infiltration.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
title Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
spellingShingle Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
Brito, Nayara Castelano
lesoes
Leishmaniose
Lesions
Leishmaniasis
Antimony
Parasitic diseases
Anti-addiction drug therapy
Ulcers
HIV diagnosis and management
Tuberculosis diagnosis and management
title_short Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
title_full Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
title_fullStr Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
title_full_unstemmed Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
title_sort Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.
author Brito, Nayara Castelano
author_facet Brito, Nayara Castelano
Rabello, Ana Lucia Teles
Cota, Gláucia Fernandes
author_role author
author2 Rabello, Ana Lucia Teles
Cota, Gláucia Fernandes
author2_role author
author
dc.contributor.author.fl_str_mv Brito, Nayara Castelano
Rabello, Ana Lucia Teles
Cota, Gláucia Fernandes
dc.subject.other.pt_BR.fl_str_mv lesoes
Leishmaniose
topic lesoes
Leishmaniose
Lesions
Leishmaniasis
Antimony
Parasitic diseases
Anti-addiction drug therapy
Ulcers
HIV diagnosis and management
Tuberculosis diagnosis and management
dc.subject.en.pt_BR.fl_str_mv Lesions
Leishmaniasis
Antimony
Parasitic diseases
Anti-addiction drug therapy
Ulcers
HIV diagnosis and management
Tuberculosis diagnosis and management
description Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias. Belo Horizonte, MG, Brazil
publishDate 2017
dc.date.issued.fl_str_mv 2017
dc.date.accessioned.fl_str_mv 2018-03-19T17:13:14Z
dc.date.available.fl_str_mv 2018-03-19T17:13:14Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv BRITO, Nayara Castelano; RABELLO, Lucia Teles Rabello; COTA, Gláucia Fernandes. Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review. PLoS One, v. 12, n. 9, art. e0184777, 2017
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/25399
dc.identifier.issn.pt_BR.fl_str_mv 1932-6203
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pone.0184777
identifier_str_mv BRITO, Nayara Castelano; RABELLO, Lucia Teles Rabello; COTA, Gláucia Fernandes. Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review. PLoS One, v. 12, n. 9, art. e0184777, 2017
1932-6203
10.1371/journal.pone.0184777
url https://www.arca.fiocruz.br/handle/icict/25399
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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