Cochrane · systematic review · CD004834
Interventions for American cutaneous and mucocutaneous leishmaniasis
Pinart, M, Rueda, J-R, Romero, GAS, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
16
No studies
5
Included studies
NR
No studies 5 · 23.8%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 14.3%Moderate 10 · 47.6%High 3 · 14.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Meglumine antimoniate (IMMA) (20 mg/kg/d for 20 days) compared to placebo (3 tablets/4 times a day for 28 d) in L. braziliensis and L. panamensis for American cutaneous and mucocutaneous leishmaniasis
Population: People with American cutaneous and mucocutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Meglumine antimoniate (IMMA) (20 mg/kg/d for 20 days) vs placebo (3 tablets/4 times a day | RR 4.23 [0.84, 21.38] | 2 studies · 157 participants | Moderate Downgraded: imprecision |
Adverse effects (number of participants who had at least one adverse effect) Meglumine antimoniate (IMMA) (20 mg/kg/d for 20 days) vs placebo (3 tablets/4 times a day | RR 1.51 [1.17, 1.96] | 1 study · 134 participants | Moderate Downgraded: imprecision |
Recurrence Meglumine antimoniate (IMMA) (20 mg/kg/d for 20 days) vs placebo (3 tablets/4 times a day | RR 1.79 [0.17, 19.26] | 1 study · 127 participants | Low Downgraded: imprecision |
Oral miltefosine (50 mg for 28 days) compared to placebo (same regimen) in L.mexicana, L.panamensis and L.braziliensis for American cutaneous leishmaniasis
Population: People with American cutaneous and mucocutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Oral miltefosine (50 mg for 28 days) vs placebo (same regimen) | RR 2.25 [1.42, 3.38] | 1 study · 133 participants | Moderate Downgraded: imprecision |
Adverse effects (number of participants who had the event) Oral miltefosine (50 mg for 28 days) vs placebo (same regimen) | RR 3.96 [1.49, 10.48] | 1 study · 133 participants | Moderate Downgraded: imprecision |
Recurrence Oral miltefosine (50 mg for 28 days) vs placebo (same regimen) | RR 2.97 [0.37, 23.89] | 1 study · 133 participants | Low Downgraded: imprecision |
Oral miltefosine (1.2 to 3.3 mg/kg/d 28 days) compared to meglumine antimoniate (20 mg/kg 20 days) in L. braziliensis, L. panamensis,L. guyanensis and L. amazonensis for American cutaneous and mucocutaneous leishmaniasis
Population: People with American cutaneous and mucocutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Oral miltefosine (1.2 to 3.3 mg/kg/d 28 days) vs meglumine antimoniate (20 mg/kg 20 days) | RR 1.05 [0.9, 1.23] | 7 studies · 676 participants | Low Downgraded: risk of bias, inconsistency |
Adverse effects (number of participants who had the event) Oral miltefosine (1.2 to 3.3 mg/kg/d 28 days) vs meglumine antimoniate (20 mg/kg 20 days) | RR 2.45 [1.72, 3.49] | 3 studies · 464 participants | Moderate Downgraded: risk of bias |
Recurrence ‐ not measured Oral miltefosine (1.2 to 3.3 mg/kg/d 28 days) vs meglumine antimoniate (20 mg/kg 20 days) | no estimate extracted | NR | No studies |
Azithromycin (500 mg 20 ‐ 28 days) compared to meglumine antimoniate (15 ‐ 20 mg/kg/d for 20 ‐ 28 days) in L. braziliensis for American cutaneous and mucocutaneous leishmaniasis
Population: People with American cutaneous and mucocutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Azithromycin (500 mg 20 ‐ 28 days) vs meglumine antimoniate (15 ‐ 20 mg/kg/d | RR 0.51 [0.34, 0.76] | 2 studies · 93 participants | Moderate Downgraded: risk of bias |
Adverse effects Azithromycin (500 mg 20 ‐ 28 days) vs meglumine antimoniate (15 ‐ 20 mg/kg/d | no estimate extracted | 1 study · 45 participants | Moderate Downgraded: risk of bias |
Recurrence ‐ not measured Azithromycin (500 mg 20 ‐ 28 days) vs meglumine antimoniate (15 ‐ 20 mg/kg/d | no estimate extracted | NR | No studies |
Topical imiquimod 5% (3 times/week) + meglumine antimoniate (IVMA) (20 mg/kg/d for 20 days) compared to placebo + IVMA in L. braziliensis, L. guyanensis and L. peruviana for American cutaneous leishmaniasis
Population: People with American cutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Topical imiquimod 5% (3 times/week) + meglumine antimoniate (IVMA) (20 mg/kg/d for 20 days) vs placebo + IVMA | RR 1.3 [0.95, 1.8] | 1 study · 80 participants | Moderate Downgraded: imprecision |
Adverse effects (number of participants who had the event) Topical imiquimod 5% (3 times/week) + meglumine antimoniate (IVMA) (20 mg/kg/d for 20 days) vs placebo + IVMA | no estimate extracted | 1 study · 80 participants | High |
Recurrence ‐ not measured Topical imiquimod 5% (3 times/week) + meglumine antimoniate (IVMA) (20 mg/kg/d for 20 days) vs placebo + IVMA | no estimate extracted | NR | No studies |
Thermotherapy one session (at 50 ºC for 30 seconds) compared to meglumine antimoniate (20 mg Sb5/kg/day for 20 days) in L. panamensis and L. braziliensis for American cutaneous leishmaniasis
Population: People with American cutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Thermotherapy one session (at 50 ºC for 30 seconds) vs meglumine antimoniate (20 mg Sb5/kg/day | RR 0.8 [0.68, 0.95] | 1 study · 292 participants | High |
Adverse effects Thermotherapy one session (at 50 ºC for 30 seconds) vs meglumine antimoniate (20 mg Sb5/kg/day | no estimate extracted | 1 study · 292 participants | High |
Recurrence ‐ not measured Thermotherapy one session (at 50 ºC for 30 seconds) vs meglumine antimoniate (20 mg Sb5/kg/day | no estimate extracted | NR | No studies |
Pentoxifylline (oral 400 mg thrice daily) plus meglumine antimoniate (IMMA) (20 mg/ kg /day for 20 days) compared to IMMA plus placebo for American cutaneous and mucocutaneous leishmaniasis
Population: People with American cutaneous leishmaniasis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Complete cure, at least 3 months after the end of treatment Pentoxifylline (oral 400 mg thrice daily) plus meglumine antimoniate (IMMA) (20 mg/ kg /day for 20 days) vs IMMA plus placebo | RR 0.86 [0.63, 1.18] | 1 study · 70 participants | Moderate Downgraded: imprecision |
Adverse effects Pentoxifylline (oral 400 mg thrice daily) plus meglumine antimoniate (IMMA) (20 mg/ kg /day for 20 days) vs IMMA plus placebo | no estimate extracted | 1 study · 70 participants | Moderate Downgraded: imprecision |
Recurrence ‐ not measured Pentoxifylline (oral 400 mg thrice daily) plus meglumine antimoniate (IMMA) (20 mg/ kg /day for 20 days) vs IMMA plus placebo | no estimate extracted | NR | No studies |