Salinas R, Prasad K
Instituto de Salud Pública de Chile (ISP), Avenida Marathón 1000, Nuñoa, Santiago 52310, Chile.
Cochrane Database Syst Rev. 2007 Jul 18(4):CD000215. doi: 10.1002/14651858.CD000215.pub2.
Anthelminthic drugs may shrink brain cysts in neurocysticercosis, but can also cause severe adverse effects.
The objective of this review was to assess the effects of drug treatment in human neurocysticercosis in relation to survival, cyst persistence, subsequent seizures and hydrocephalus.
We searched the Cochrane Infectious Diseases Group specialized trials register (September 2002), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2002), MEDLINE (1966 to September 2002), EMBASE (1980 to August 2002), LILACS (September 2002). We contacted researchers and experts in the field, and pharmaceutical companies.
Randomised or quasi-randomised trials comparing a cysticidal drug with a placebo or a control group receiving symptomatic therapy, in patients with neurocystercosis.
Assessment of trial quality and data extraction was done independently by two reviewers.
Four studies involving 305 people met the inclusion criteria. None reported on withdrawal of anticonvulsant therapy, headache relief, disability or death as outcomes. A difference just approaching significance was detected between cysticidal therapy and placebo in relation to cyst persistence up to six months (relative risk 0.83, 95% confidence interval 0.70 to 0.99). Two trials reported on seizures after one to two years follow-up and found no difference (relative risk 0.95, 95% 0.59 to 1.51). There was no difference detected for hydrocephalus (relative risk 2.19, 95% confidence interval 0.29 to 16.55).
AUTHORS' CONCLUSIONS: There is insufficient evidence to assess whether cysticidal therapy in neurocysticerosis is associated with beneficial effects.
