title: Albendazole and Corticosteroids for the Treatment of Solitary Cysticercus Granuloma: A Network Meta-analysis.
abstract: BACKGROUND
  Solitary cysticercus granuloma (SCG) is the commonest form of neurocysticercosis in the Indian subcontinent and in travelers. Several different treatment options exist for SCG. We conducted a Bayesian network meta-analysis of randomized clinical trials (RCTs) to identify the best treatment option to prevent seizure recurrence and promote lesion resolution for patients with SCG.
  
  
  RESULTS
  PubMed, EMBASE and the Cochrane Library databases (up to June 1, 2015) were searched for RCTs that compared any anthelmintics or corticosteroids, alone or in combination, with placebo or head to head and reported on seizure recurrence and lesion resolution in patients with SCG. A total of 14 RCTs (1277 patients) were included in the quantitative analysis focusing on four different treatment options. A Bayesian network model computing odds ratios (OR) with 95% credible intervals (CrI) and probability of being best (Pbest) was used to compare all interventions simultaneously. Albendazole and corticosteroids combination therapy was the only regimen that significantly decreased the risk of seizure recurrence compared with conservative treatment (OR 0.32, 95% CrI 0.10-0.93, Pbest 73.3%). Albendazole and corticosteroids alone or in combination were all efficacious in hastening granuloma resolution, but the combined therapy remained the best option based on probability analysis (OR 3.05, 95% CrI 1.24-7.95, Pbest 53.9%). The superiority of the combination therapy changed little in RCTs with different follow-up durations and in sensitivity analyses. The limitations of this study include high risk of bias and short follow-up duration in most studies.
  
  
  CONCLUSIONS
  Dual therapy of albendazole and corticosteroids was the most efficacious regimen that could prevent seizure recurrence and promote lesion resolution in a follow-up period of around one year. It should be recommended for the management of SCG until more high-quality evidence is available.
authors: Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.|Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors: Bing-Cheng
authors: BC
authors: Zhao
authors: Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.|Key Laboratory for Tropical Disease Control, Sun Yat-sen University, Guangzhou, China.
authors: Hong-Ye
authors: HY
authors: Jiang
authors: Department of Anesthesiology, the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Wei-Ying
authors: WY
authors: Ma
authors: Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors: Da-Di
authors: DD
authors: Jin
authors: Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors: Hao-Miao
authors: HM
authors: Li
authors: Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors: Hai
authors: H
authors: Lu
authors: Department of Orthopedics and Rehabilitation Medicine, Fukui University of Medical Sciences, Fukui, Japan.
authors: Hideaki
authors: H
authors: Nakajima
authors: Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
authors: Tong-Yi
authors: TY
authors: Huang
authors: Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
authors: Kai-Yu
authors: KY
authors: Sun
authors: Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
authors: Shu-Ling
authors: SL
authors: Chen
authors: Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors: Ke-Bing
authors: KB
authors: Chen
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D003552:Cysticercus / Q000187:drug effects* / Q000254:growth & development; D004359:Drug Therapy, Combination; D005260:Female; D006099:Granuloma / Q000188:drug therapy* / Q000469:parasitology; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000871:Anthelmintics; D015766:Albendazole