The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review.
Background Mucosal or mucocutaneous leishmaniasis is the most severe form of tegumentary leishmaniasis due to its destructive character and potential damage to respiratory and digestive tracts. The current treatment recommendations are based on low or very low-quality evidence, and pentavalent antim...
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ftdoajarticles:oai:doaj.org/article:e60ab1a3b6a84fbfa7c33e963c32cf07 2023-09-26T15:15:19+02:00 The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. Janaína de Pina Carvalho Sarah Nascimento Silva Mariana Lourenço Freire Líndicy Leidicy Alves Carolina Senra Alves de Souza Gláucia Cota 2022-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010931 https://doaj.org/article/e60ab1a3b6a84fbfa7c33e963c32cf07 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010931 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010931 https://doaj.org/article/e60ab1a3b6a84fbfa7c33e963c32cf07 PLoS Neglected Tropical Diseases, Vol 16, Iss 11, p e0010931 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010931 2023-08-27T00:36:33Z Background Mucosal or mucocutaneous leishmaniasis is the most severe form of tegumentary leishmaniasis due to its destructive character and potential damage to respiratory and digestive tracts. The current treatment recommendations are based on low or very low-quality evidence, and pentavalent antimonial derivatives remain strongly recommended. The aim of this review was to update the evidence and estimate the cure rate and safety profile of the therapeutic options available for mucosal leishmaniasis (ML) in the Americas. Methodology A systematic review was conducted in four different databases and by different reviewers, independently, to evaluate the therapeutic efficacy and toxicity associated with different treatments for ML. All original studies reporting cure rates in more than 10 patients from American regions were included, without restriction of design, language, or publication date. The risk of bias was assessed by two reviewers, using different tools according to the study design. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping all study arms addressing the same intervention. The protocol for this review was registered at the International Prospective Register of Systematic Reviews, PROSPERO: CRD42019130708. Principal findings Twenty-seven original studies from four databases fulfilled the selection criteria. A total of 1,666 patients with ML were treated predominantly with pentavalent antimonials in Brazil. Other interventions, such as pentamidine, miltefosine, imidazoles, aminosidine sulfate, deoxycholate and lipidic formulations of amphotericin B (liposomal, lipid complex, colloidal dispersion), in addition to combinations with pentoxifylline, allopurinol or sulfa were also considered. In general, at least one domain with a high risk of bias was identified in the included studies, suggesting low methodological quality. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 11 e0010931 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Janaína de Pina Carvalho Sarah Nascimento Silva Mariana Lourenço Freire Líndicy Leidicy Alves Carolina Senra Alves de Souza Gláucia Cota The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Mucosal or mucocutaneous leishmaniasis is the most severe form of tegumentary leishmaniasis due to its destructive character and potential damage to respiratory and digestive tracts. The current treatment recommendations are based on low or very low-quality evidence, and pentavalent antimonial derivatives remain strongly recommended. The aim of this review was to update the evidence and estimate the cure rate and safety profile of the therapeutic options available for mucosal leishmaniasis (ML) in the Americas. Methodology A systematic review was conducted in four different databases and by different reviewers, independently, to evaluate the therapeutic efficacy and toxicity associated with different treatments for ML. All original studies reporting cure rates in more than 10 patients from American regions were included, without restriction of design, language, or publication date. The risk of bias was assessed by two reviewers, using different tools according to the study design. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping all study arms addressing the same intervention. The protocol for this review was registered at the International Prospective Register of Systematic Reviews, PROSPERO: CRD42019130708. Principal findings Twenty-seven original studies from four databases fulfilled the selection criteria. A total of 1,666 patients with ML were treated predominantly with pentavalent antimonials in Brazil. Other interventions, such as pentamidine, miltefosine, imidazoles, aminosidine sulfate, deoxycholate and lipidic formulations of amphotericin B (liposomal, lipid complex, colloidal dispersion), in addition to combinations with pentoxifylline, allopurinol or sulfa were also considered. In general, at least one domain with a high risk of bias was identified in the included studies, suggesting low methodological quality. The pooled cure rate based on the latest cure assessment reported in the original studies was calculated grouping ... |
format |
Article in Journal/Newspaper |
author |
Janaína de Pina Carvalho Sarah Nascimento Silva Mariana Lourenço Freire Líndicy Leidicy Alves Carolina Senra Alves de Souza Gláucia Cota |
author_facet |
Janaína de Pina Carvalho Sarah Nascimento Silva Mariana Lourenço Freire Líndicy Leidicy Alves Carolina Senra Alves de Souza Gláucia Cota |
author_sort |
Janaína de Pina Carvalho |
title |
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
title_short |
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
title_full |
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
title_fullStr |
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
title_full_unstemmed |
The cure rate after different treatments for mucosal leishmaniasis in the Americas: A systematic review. |
title_sort |
cure rate after different treatments for mucosal leishmaniasis in the americas: a systematic review. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010931 https://doaj.org/article/e60ab1a3b6a84fbfa7c33e963c32cf07 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 11, p e0010931 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010931 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010931 https://doaj.org/article/e60ab1a3b6a84fbfa7c33e963c32cf07 |
op_doi |
https://doi.org/10.1371/journal.pntd.0010931 |
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PLOS Neglected Tropical Diseases |
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11 |
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