Efficacy and safety of ivermectin-albendazole combination versus ivermectin or albendazole monotherapy in soil-transmitted helminthiasis: A systematic review and meta-analysis.

BACKGROUND

Soil-transmitted helminthiasis remains a daunting challenge to global health, exerting its greatest toll on resource-limited regions of the world. A dual drug approach using the co-administration of ivermectin and albendazole has shown promising results in comparison to the traditional monotherapy strategy. In light of this, a systematic review and meta-analysis of randomized controlled trials was conducted.

METHODS

Several electronic databases including PubMed, Cochrane Central, Google Scholar, and Embase were explored to search for relevant studies from inception to September 2023. The Cochrane Risk of Bias Tool for Randomized Controlled Studies was utilized to evaluate the quality of studies.

RESULTS

A total of 8 randomized controlled trials, reporting 10 patient populations, were included. The treatment of trichuriasis significantly favored the dual therapy regimen of ivermectin-albendazole over albendazole-only monotherapy (risk ratio [RR]: 2.86; 95% confidence interval [CI]: 1.66-4.93; P = .0002), with no significant differences observed for ascariasis and hookworm. The treatment of trichuriasis and hookworm significantly favored the dual therapy regimen of ivermectin-albendazole over ivermectin-only monotherapy (RR: 1.86; 95% CI: 1.56-2.21; P < .00001 and RR: 2.31; 95% CI: 1.23-4.31; P = .009, respectively). There were no statistically significant differences between dual therapy and monotherapy in terms of adverse effects.

CONCLUSION

These findings highlight the nuanced effectiveness of combined therapy specific to certain helminth types, in addition to their comparable safety profiles, thereby providing pivotal insights that contribute to the evolving landscape of soil-transmitted helminth treatment strategies.