Efficacy and Safety of Artemisinin-Piperaquine for the Treatment of Uncomplicated Malaria: A Systematic Review

作者：Qi Wang, Yuanyuan Zou, Ziyi Pan, Hongying Zhang, Changsheng Deng, Yueming Yuan, Jia–Wen Guo, Yexiao Tang, Nadia Julie, Wanting Wu, Guoming Li, Mingqiang Li, Ruixiang Tan, Xinan Huang, Wenfeng Guo, Changqing Li, Qin Xu, Jianping Song · 发表于：Frontiers in Pharmacology · 年份：2020 · DOI：10.3389/fphar.2020.562363 · 被引用次数：9 · 研究领域：Malaria Research and Control、Diverse Scientific Research Studies、Historical Medical Research and Treatments

OBJECTIVE: The World Health Organization recommends artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated malaria to improve the therapeutic efficacy and limit the choice of drug-resistant parasites. This systematic review and meta-analysis aimed to evaluate the comparative efficacy and safety of artemisinin-piperaquine (AP) in the treatment of uncomplicated malaria relative to other commonly used ACTs. METHODS: As per the PRISMA guidelines, the EMBASE, MEDLINE, the Google Scholar Library, and Cochrane library databases were systematically searched from inception until July 2020 with the following terms: "artemisinin-piperaquine" or "AP." Only randomized controlled trials (RCTs) were included. The competing interventions included dihydroartemisinin-piperaquine (DHA-PPQ), artemether-lumefantrine (AL, Coartem), artesunate-melfloquine (ASAM) and artesunate-amodiaquine (ASAQ, Artekin). Single-arm clinical trial on AP was also assessed. The reported outcomes, including the overall response, cure rate, fever and parasite clearance time, hematology, biochemistry, electrocardiogram (ECG), adverse events, recurrence rate, and sensitivity analyses, were systematically investigated. All data were analyzed using the Review Manager 5.3. RESULTS: A total of seven studies were reviewed, including five RCTs and two single-arm studies. A pooled analysis of 5 RCTs (n = 772) revealed a comparable efficacy on polymerase chain reaction (PCR)-confirmed cure rate between...