Corticosteroids for neurocysticercosis: A systematic review and meta-analysis of randomized controlled trials

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dc.creatorCARLOS ALBERTO CUELLO GARCIA;201717
dc.creatorGIORDANO PEREZ GAXIOLA;227245
dc.creatorCARLOS ALBERTO CUELLO GARCIA;201717es
dc.creatorGIORDANO PEREZ GAXIOLA;227245es
dc.date2013
dc.date.accessioned2018-10-18T20:34:47Z
dc.date.available2018-10-18T20:34:47Z
dc.descriptionBackground: Neurocysticercosis is an infection of the central nervous system by the larval stage of Taenia solium. It is a major cause of epileptic seizures in low- and middle-income countries. Corticosteroids are frequently used to reduce inflammation and perilesional edema. We aimed to evaluate their efficacy for reducing the rate of seizures and lesion persistence in imaging studies. Methods: We searched randomized controlled trials in Medline, Central, EMBASE, LILACS, and the gray literature without language restrictions. We assessed eligibility, extracted data, and assessed the risk of bias in the included studies. The main outcomes included seizure recurrence and lesion persistence on imaging studies at 6-12 months of follow-up. Risk ratios (RR) were used for evaluating the main outcomes. Results: Thirteen studies involving 1373 participants were included. The quality of the evidence was deemed low to very low. Corticosteroids alone versus placebo/no drug (five trials) reduced the rate of seizure recurrence at 6-12 months (RR 0.46, 95% confidence interval (CI) 0.27-0.77; 426 participants) and the persistence of lesions in imaging studies (RR 0.63, 95% CI 0.43-0.92; 417 participants). No differences were noted in other comparisons, including the use of corticosteroids and albendazole combined. Corticosteroids plus albendazole increased the risk of abdominal pain, rash, and headaches (odds ratio 8.73, 95% CI 2.09-36.5; 116 participants, one trial). Conclusions: Although the evidence suggest corticosteroids can reduce the rate of seizure recurrence and speed up resolution of lesions at 6-12 months of follow-up, there remains uncertainty on the effect estimate due to a high risk of methodological and publication bias. More adequately performed randomized trials that evaluate the use of anthelmintics, corticosteroids, and both combined against placebo are needed. © 2013 International Society for Infectious Diseases.
dc.identifier.doi10.1016/j.ijid.2012.12.010
dc.identifier.endpagee592
dc.identifier.issn12019712
dc.identifier.issue8
dc.identifier.startpagee583
dc.identifier.urihttp://hdl.handle.net/11285/630360
dc.identifier.volume17
dc.languageeng
dc.relationhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84891371208&doi=10.1016%2fj.ijid.2012.12.010&partnerID=40&md5=b093caebcdaa0b41787225cc2e93cda9
dc.relationInvestigadores
dc.relationEstudiantes
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0
dc.sourceInternational Journal of Infectious Diseases
dc.subjectalbendazole
dc.subjectcorticosteroid
dc.subjectdexamethasone
dc.subjectplacebo
dc.subjectpraziquantel
dc.subjectprednisolone
dc.subjectabdominal pain
dc.subjectarticle
dc.subjectdrug efficacy
dc.subjectfollow up
dc.subjectheadache
dc.subjecthuman
dc.subjectneurocysticercosis
dc.subjectrash
dc.subjectrecurrent disease
dc.subjectseizure
dc.subjectAdrenal Cortex Hormones
dc.subjectAdult
dc.subjectAlbendazole
dc.subjectChild
dc.subjectDrug Combinations
dc.subjectHumans
dc.subjectMagnetic Resonance Imaging
dc.subjectNeurocysticercosis
dc.subjectRandomized Controlled Trials as Topic
dc.subjectSeizures
dc.subjectTomography, X-Ray Computed
dc.subjectTreatment Outcome
dc.subject.classification7 INGENIERÍA Y TECNOLOGÍA
dc.titleCorticosteroids for neurocysticercosis: A systematic review and meta-analysis of randomized controlled trials
dc.typeArtículo
refterms.dateFOA2018-10-18T20:34:47Z

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