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静脉注射脂质体两性霉素 B 治疗皮肤和黏膜利什曼病的疗效和安全性:系统评价和荟萃分析方案。

Intravenous liposomal amphotericin B efficacy and safety for cutaneous and mucosal leishmaniasis: a systematic review and meta-analysis protocol.

机构信息

Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.

Pediatrics, McGill University Health Centre, Montreal, Québec, Canada.

出版信息

BMJ Open. 2021 Jun 16;11(6):e045707. doi: 10.1136/bmjopen-2020-045707.


DOI:10.1136/bmjopen-2020-045707
PMID:34135039
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8211079/
Abstract

INTRODUCTION: Treatment of cutaneous and mucosal leishmaniasis (CL and ML, respectively) must be individualised as there is no universal therapeutic approach. Intravenous liposomal amphotericin B (L-AmB) is an accessible and relatively safe treatment that has been increasingly used for the treatment of CL and ML. While several descriptive studies have been published on the efficacy and safety of L-AmB, there are no interventional studies. Moreover, the findings from published studies have not yet been integrated and synthesised. Therefore, we aim to evaluate and consolidate the descriptive evidence on the efficacy and the safety of Intravenous L-AmB treatment for CL and ML in both the New and Old World. METHODS AND ANALYSES: A systematic review of all relevant study types with no restriction on date or language of publication will be conducted. Online databases including MEDLINE, The Cochrane Library, EMBASE, EBSCO, Scopus, Ovid and WHO databases were searched on 3 April 2020. The search included all study types that assess Intravenous L-AmB treatment for CL and ML in humans. The Population, Intervention, Comparison, Outcome and Study Design strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be used to determine which studies will be selected for final inclusion. The quality of included case series and case reports will be assessed using modified quality assessment tools. A narrative synthesis of the findings will be provided and the primary outcome and secondary outcome of interest, response rate and adverse events rate, respectively, and the 95% CI will be ascertained. Estimates from individual studies will be pooled using random-effects model. ETHICS AND DISSEMINATION: This systematic review does not require formal ethical approval since no primary data will be collected. Findings will be disseminated through a peer-reviewed publication and relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020173440.

摘要

简介:皮肤和黏膜利什曼病(分别为 CL 和 ML)的治疗必须个体化,因为没有通用的治疗方法。静脉注射两性霉素 B 脂质体(L-AmB)是一种可及且相对安全的治疗方法,已越来越多地用于治疗 CL 和 ML。虽然已经发表了几项关于 L-AmB 的疗效和安全性的描述性研究,但没有干预性研究。此外,已发表研究的结果尚未进行整合和综合。因此,我们旨在评估和整合新老世界中静脉注射 L-AmB 治疗 CL 和 ML 的疗效和安全性的描述性证据。

方法和分析:将对所有相关研究类型进行系统评价,不限制发表日期或语言。于 2020 年 4 月 3 日在 MEDLINE、The Cochrane Library、EMBASE、EBSCO、Scopus、Ovid 和世界卫生组织数据库等在线数据库中进行搜索。该搜索包括所有评估人类 CL 和 ML 中静脉注射 L-AmB 治疗的研究类型。将使用人群、干预、比较、结局和研究设计策略以及系统评价和荟萃分析的首选报告项目指南来确定哪些研究将被选中最终纳入。将使用改良的质量评估工具评估病例系列和病例报告的质量。将提供发现的叙述性综合,确定主要结局和次要结局(分别为反应率和不良事件发生率),并确定 95%置信区间。将使用随机效应模型对来自个别研究的估计值进行汇总。

伦理和传播:由于不会收集原始数据,因此本系统评价不需要正式的伦理批准。研究结果将通过同行评审的出版物和相关会议进行传播。

PROSPERO 注册号:CRD42020173440。

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引用本文的文献

[1]
Intravenous Liposomal Amphotericin B Efficacy and Safety for Cutaneous and Mucosal Leishmaniasis: A Systematic Review and Meta-analysis.

Open Forum Infect Dis. 2023-7-11

[2]
How I Approach Leishmaniasis: Diagnosis and Treatment in the United States.

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[3]
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本文引用的文献

[1]
Cutaneous leishmaniasis in travellers and migrants: a 10-year case series in a Canadian reference centre for tropical diseases.

CMAJ Open. 2022

[2]
American cutaneous leishmaniasis in French Guiana: a retrospective comparison between liposomal amphotericin B and meglumine antimoniate.

Br J Dermatol. 2020-8

[3]
Effectiveness and Safety of Amphotericin B Deoxycholate, Amphotericin B Colloidal Dispersion, and Liposomal Amphotericin B as Third-Line Treatments for Cutaneous and Mucocutaneous Leishmaniasis: A Retrospective Study.

Am J Trop Med Hyg. 2020-2

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Cutaneous leishmaniasis in the 21st century: from the laboratory to the bedside.

Curr Opin Infect Dis. 2019-10

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Infect Dis Clin North Am. 2019-3

[6]
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Acta Trop. 2018-6

[7]
Liposomal amphotericin B in travelers with cutaneous and muco-cutaneous leishmaniasis: Not a panacea.

PLoS Negl Trop Dis. 2017-11-20

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Clin Infect Dis. 2016-12-15

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