Efficacy and safety of triple therapy versus dual therapy for lymphatic filariasis: A systematic review and meta‐analysis

Objective Lymphatic filariasis is a serious public health issue. Recent studies showed that a single dosage of triple therapy (Ivermectin, Diethylcarbamazepine, and Albendazole) is more effective than dual therapy (Ivermectin plus Albendazole or Diethylcarbamazepine plus Albendazole) for clearing mi...

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Published in:Tropical medicine & international health 2022-03, Vol.27 (3), p.226-235
Main Authors: Abuelazm, Mohamed T., Abdelazeem, Basel, Badr, Helmy, Gamal, Mohamed, Ashraf, Mohamed, Abd‐elsalam, Sherief
Format: Article
Language:English
Subjects:
Albendazole
Albendazole - adverse effects
Animals
Antigens
Blood
Blood circulation
Clinical trials
diethylcarbamazine
Diethylcarbamazine - adverse effects
Drug Therapy, Combination
dual therapy
Elephantiasis, Filarial - drug therapy
Filariasis
Filaricides - adverse effects
Humans
Ivermectin
Ivermectin - therapeutic use
lymphatic filariasis
Meta-analysis
Microfilariae
Public health
Safety
Systematic review
Therapy
triple therapy
Vector-borne diseases
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Summary:Objective Lymphatic filariasis is a serious public health issue. Recent studies showed that a single dosage of triple therapy (Ivermectin, Diethylcarbamazepine, and Albendazole) is more effective than dual therapy (Ivermectin plus Albendazole or Diethylcarbamazepine plus Albendazole) for clearing microfilaria from the blood. We aimed to evaluate the efficacy and safety of triple therapy versus dual therapy in patients infected with microfilaria and communities endemic to lymphatic filariasis. Methods For this systematic review and meta‐analysis, we searched MEDLINE, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials, and Web of Science until 24th June 2021. We included randomized control trials that compared triple with dual therapy given to patients with lymphatic filariasis or endemic communities. This study was registered with PROSPERO (CRD42021266724). Results We included eight articles after the screening process. Triple therapy caused more clearance of microfilaria in the blood (RR: 1.52; 95% CI: 1.15, 2.02; p = 0.003), while dual therapy caused more clearance of the circulating filariae antigen in the blood (RR: 0.76; 95% CI: 0.65, 0.88; p = 0.0003), both 12 months after drug administration. The triple therapy had a similar adverse effect compared with the dual therapy group. Conclusion Based on the greater efficacy in the clearance of microfilaria and the safety of triple therapy, it constitutes a better strategy for the eradication programs of lymphatic filariasis in endemic regions. However, further studies are needed to confirm our results.
ISSN:1360-2276
1365-3156
DOI:10.1111/tmi.13727