Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis
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| Format: | Artículo científico |
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Universidad del Valle
2015
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| author | Lina Marcela Zuluaga-Idarraga |
| author_facet | Lina Marcela Zuluaga-Idarraga |
| contents | Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis Lina Marcela Zuluaga-Idarraga María-Eulalia Tamayo Perez Daniel Camilo Aguirre-Acevedo Medicina Malaria primaquine recurrence Plasmodium vivax pharmacovigilance Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P.vivax of primaquine regimen 0.5 mg/kg/day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P.vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax. 2015 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28343295006 https://www.redalyc.org/journal/283/28343295006/ https://www.redalyc.org/journal/283/28343295006/html/ https://www.redalyc.org/journal/283/28343295006/28343295006.epub https://www.redalyc.org/journal/283/28343295006/movil en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.4 Vol.46 |
| format | Artículo científico |
| id | redalyc_28343295006 |
| institution | Redalyc |
| language | en |
| publishDate | 2015 |
| publisher | Universidad del Valle |
| spellingShingle | Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis Lina Marcela Zuluaga-Idarraga Medicina Malaria primaquine recurrence Plasmodium vivax pharmacovigilance Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis Lina Marcela Zuluaga-Idarraga María-Eulalia Tamayo Perez Daniel Camilo Aguirre-Acevedo Medicina Malaria primaquine recurrence Plasmodium vivax pharmacovigilance Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P.vivax of primaquine regimen 0.5 mg/kg/day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P.vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax. 2015 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28343295006 https://www.redalyc.org/journal/283/28343295006/ https://www.redalyc.org/journal/283/28343295006/html/ https://www.redalyc.org/journal/283/28343295006/28343295006.epub https://www.redalyc.org/journal/283/28343295006/movil en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.4 Vol.46 |
| title | Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis |
| topic | Medicina Malaria primaquine recurrence Plasmodium vivax pharmacovigilance |
| url | https://www.redalyc.org/articulo.oa?id=28343295006 https://www.redalyc.org/journal/283/28343295006/ https://www.redalyc.org/journal/283/28343295006/html/ https://www.redalyc.org/journal/283/28343295006/28343295006.epub https://www.redalyc.org/journal/283/28343295006/movil |