Efficacy and safety of co-administered ivermectin plus albendazole for treating soil-transmitted helminths: A systematic review, meta-analysis and individual patient data analysis Marta S. Palmeirim Eveline Hürlimann Stefanie Knopp Benjamin Speich Vicente Belizario Jr. Serene A. Joseph Michel Vaillant Piero Olliaro Jennifer Keiser 10.1371/journal.pntd.0006458 https://plos.figshare.com/articles/dataset/Efficacy_and_safety_of_co-administered_ivermectin_plus_albendazole_for_treating_soil-transmitted_helminths_A_systematic_review_meta-analysis_and_individual_patient_data_analysis/6196535 <div><p>Background</p><p>The soil-transmitted helminths (STH), <i>Ascaris lumbricoides</i>, <i>Trichuris trichiura</i> and hookworms, infect 1.5 billion people worldwide and cause an estimated burden of 3.3 million disability-adjusted life years (DALYs). Current control strategies focus on morbidity reduction through preventive chemotherapy (PC) but the most commonly used recommended drugs (albendazole and mebendazole) are particularly inefficacious against <i>T</i>. <i>trichiura</i>. This, together with the threat of emerging drug resistance, calls for new control strategies, including co-administration with other anthelminthics. Ivermectin plus albendazole is widely used against lymphatic filariasis, but its efficacy and safety against STH infections has not yet been fully understood.</p><p>Methods and findings</p><p>We conducted a systematic literature review and meta-analysis on the efficacy and safety of ivermectin-albendazole co-administration in five different databases (i.e. PubMed, ISI Web of Science, ScienceDirect, CENTRAL and clinicaltrials.gov) from 1960 to January 2018. Four studies reporting efficacy of ivermectin-albendazole against STH infections and five studies on its safety met the selection criteria and were included for quantitative analysis. Ivermectin-albendazole was significantly associated with lower risk (risk ratio (RR) = 0.44, 95% confidence interval (CI) = 0.31–0.62) for <i>T</i>. <i>trichiura</i> infection after treatment compared to albendazole alone. The co-administration revealed no or only a marginal benefit on cure and egg reduction rates over albendazole alone for <i>A</i>. <i>lumbricoides</i> and hookworm infections. Adverse events (AEs) occurring after ivermectin-albendazole co-administration were mostly mild and transient. Overall, the number of individuals reporting any AE was not different (RR = 1.09, 95% CI = 0.87–1.36) in co-treated and albendazole-treated patients. However, although not statistically significant, sub-group analysis showed a tendency for slightly more AEs in patients with filariasis treated with ivermectin-albendazole compared to those treated with albendazole alone (RR = 1.29, 95% CI = 0.81–2.05).</p><p>Conclusions</p><p>Our findings suggest a good tolerability and higher efficacy of ivermectin-albendazole against <i>T</i>. <i>trichiura</i> compared to the current standard single-dose albendazole treatment, which supports the use of this co-administration in PC programs. Large-scale definitive randomized controlled trials are required to confirm our results.</p></div> 2018-04-27 17:36:48 trichiura RR soil-transmitted helminths PC safety STH infections patient data analysis Background ISI CENTRAL efficacy Current control strategies focus CI ivermectin-albendazole co-administration DALY disability-adjusted life years AE egg reduction rates