Analysis on safety of albendazole in the treatment of echinococcosis

doi:10.12140/j.issn.1000-7423.2020.03.015

Abstract

Abstract:

This study aimed to investigate the probability of adverse effects of albendazole in the treatment of echinococcosis and assess the drug safety, providing reference for its safe medication in clinical practice. Literature search was performed in PubMed, EMBase, China Biology Medicine disc(CBMdisc), China National Knowledge Infrastructure(CNKI) and Wanfang Databases to obtain studies on the use of albendazole in the treatment of echinococcosis. Eligible studies were included according to the inclusion and exclusion criteria, and the reported adverse effects of albendazole were statistically analyzed. This review analyzed 26 eligible studies included, and found that the studies were mostly performed in Xinjiang, while considerably fewer performed in Tibet. According to the literature available, the occurrence rate of severe adverse effects was not high, and the adverse effects often involved digestive system, skin rash, and blood system, with transient presentation in most cases. The data indicates that the studies on the adverse side effects of albendazole is apparently limited. Although the current study results currently available suggest that albendazole is rather safe in clinical use, scale-up clinical trials remain imperative to verify this safety and address the drug safety.

Key words: Echinococcosis, Albendazol, Adverse drug reaction

CLC Number:

R532.32

LIU Ke-xin, ZHANG Wei, JIN Zhao-hui, QIN Zhou, ZHAXI Qun-zong, XU Ting. Analysis on safety of albendazole in the treatment of echinococcosis[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2020, 38(3): 354-359.

Figures/Tables 3

纳入研究	年份	地区/国家	研究类型	棘球蚴病部位	总例数	男性患者人数	女性患者人数	年龄/中位年龄
张超威^[12]	1990	N	临床观察	棘球蚴（肝、肺、腹膜、其他）	253	N	N	N
李明^[13]	1991	宁夏	对照实验	肝多房棘球蚴	80	20	60	17~71
Khuroo^[14]	1993	印度	随机对照	肝棘球蚴	20	7	13	12~64
Gil-Grande^[15]	1993	西班牙	随机对照	肝棘球蚴	37	22	15	N
李富荣^[16]	1996	兰州	临床观察	棘球蚴（肝、肺、腹膜、其他）	102	54	48	8~77
Franchi^[17]	1999	意大利	随机对照	肝棘球蚴	323	N	N	N
张贺玲^[18]	2000	新疆	临床观察	细粒棘球蚴	61	N	N	6~73
柴君杰^[19]	2001	新疆	临床观察	肝细粒棘球蚴	212	114	98	4~82
柯山^[20]	2002	新疆	对照实验	棘球蚴	53	27	26	N
亚德卡尔^[21]	2002	新疆	临床观察	肝细粒棘球蚴	71	37	34	7~70
李海涛^[22]	2004	新疆	临床观察	棘球蚴	66	35	31	8~76
Chai^[23]	2004	新疆	对照实验	肝棘球蚴	264	138	126	4~82
Bildik^[24]	2007	土耳其	随机对照	肝棘球蚴	63	N	N	N
李海涛^[25]	2010	新疆	临床观察	肝多房棘球蚴	26	10	16	14~67
朱兵^[26]	2010	新疆	临床观察	肝棘球蚴	24	15	9	15~60
Salinas^[27]	2011	秘鲁	回顾性	肝棘球蚴	27	7	20	51 ± 14
Shams^[28]	2011	印度	随机对照	肝棘球蚴	36	20	16	37 ± 12
古丽拜尔^[29]	2012	新疆	临床观察	肝细粒棘球蚴	116	54	52	N
王立英^[30]	2014	青海	临床观察	棘球蚴	160	70	110	6-16
Karabulut^[31]	2014	土耳其	回顾性	肝棘球蚴	101	38	62	47 ± 16
陈辉^[32]	2015	西藏	回顾性	脑棘球蚴 + 脑囊虫	22	15	7	26~58
Moroni^[33]	2016	美国	回顾性	棘球蚴	28	12	16	9 ± 4
Saidi^[34]	2018	伊朗	回顾性	肝棘球蚴	127	N	N	N
Fattahi^[35]	2018	伊朗	回顾性	多房棘球蚴	119	44	75	38
陈文君^[36]	2019	青海	临床观察	脑多房棘球蚴	18	10	8	21~59
Shankar^[37]	2019	印度	回顾性	棘球蚴（肝、肺）	22	15	7	13

References 40

[1]	Wang GQ. Epidemiological survey on echinococcosis in China[M]. Shanghai: Shanghai Scientific & Technical Publishers, 2016. (in Chinese)
[1]	( 王国强. 全国包虫病流行情况调查报告[M]. 上海: 上海科学技术出版社, 2016.)
[2]	Wang TP, Cao ZG. Current status of echinococcosis control in China and the existing challenges[J]. Chin J Parasitol Parasit Dis, 2018,36(3):291-296. (in Chinese)
[2]	( 汪天平, 操治国. 中国棘球蚴病防控进展及其存在的问题[J]. 中国寄生虫学与寄生虫病杂志, 2018,36(3):291-296.)
[3]	Wu WP, Wang H, Wang Q, et al. A nationwide sampling survey on echinococcosis in China during 2012-2016[J]. Chin J Parasitol Parasit Dis, 2018,36(1):1-14. (in Chinese)
[3]	( 伍卫平, 王虎, 王谦, 等. 2012-2016年中国棘球蚴病抽样调查分析[J]. 中国寄生虫学与寄生虫病杂志, 2018,36(1):1-14.)
[4]	Bai M, Han S, He RF, et al. Prevalence of hydatid disease in regions of four production types in Tibet Autonomous Region[J]. Chin J Parasitol Parasit Dis, 2018,36(1):26-29, 34. (in Chinese)
[4]	( 白玛央金, 韩帅, 何瑞峰, 等. 西藏自治区4种生产类型地区人群棘球蚴病流行情况[J]. 中国寄生虫学与寄生虫病杂志, 2018,36(1):26-29, 34.)
[5]	Li XT, Zhou XZ, Li B, et al. Reviewed on research of albendazole[J]. J Tradit Chin Vet Med, 2019,38(3):26-29. (in Chinese)
[5]	( 李晓婷, 周绪正, 李冰, 等. 广谱抗蠕虫药阿苯达唑研究进展[J]. 中兽医医药杂志, 2019,38(3):26-29.)
[6]	Davis A, Dixon H, Pawlowski ZS. Multicentre clinical trials of benzimidazole-carbamates in human cystic echinococcosis (phase 2)[J]. Bull World Health Organ, 1989,67(5):503-508.
[7]	Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis[J]. Bull World Health Organ, 1996,74(3):231-242.
[8]	National Health and Family Planning Commission of China. Diagnosis and treatment of hydatidosis (2017 edition) [EB/OL]. http://www. nhc. gov. cn/yzygj/s3594q/201706/242fa472d0a243d7a72bf0560c0fd316.(2017- 06- 02)[2019-09-10]. (in Chinese)
[8]	( 中华人民共和国国家卫生和计划生育委员会. 包虫病诊治方案(2017版). [EB/OL]( 2017- 06- 02)[2019-09-10]. http://www. nhc.gov.cn/yzygj/s3594q/201706/242fa472d0a243d7a72bf0560c0fd316.)
[9]	Chinese College of Surgeons (CCS) Chinese Committee. Expert consensus on the diagnosis and treatment of hepatic cystic and alveolar echinococcosis (2019 edition)[J]. Chin J Dig Surg, 2019. 18(8):711-721. (in Chinese)
[9]	( 中国医师协会外科医师分会包虫病外壳专业委员会. 肝两型包虫病诊断与治疗专家共识2019版[J]. 中华消化外科杂志, 2019. 18(8):711-721. )
[10]	Expert group of diagnosis and treatment of hydatid disease in sichuan province. Standard for diagnosis and treatment of hepatic echinococcosis in sichuan province[J]. Chin J Base and Clin Gen Surg, 2017. 24(7):798-803. (in Chinese)
[10]	( 四川省包虫病诊疗专家组. 四川省肝包虫病诊治规范[J]. 中国普外基础与临床杂志, 2017,24(7):798-803.)
[11]	Zhao SD, Wang H, Liu CL. Literature analysis on adverse reactions of albendazole[J]. Chin J Pharmacovigil, 2013,10(5):299-302, 305. (in Chinese)
[11]	( 赵世丹, 王慧, 刘翠丽. 阿苯达唑不良反应的文献分析[J]. 中国药物警戒, 2013,10(5):299-302, 305.)
[12]	Zhang CW. Treatment of human echinococcosis with albendazole[J]. Inter J Med Para Dise, 1990,17(1):36-37. (in Chinese)
[12]	( 张超威. 用阿苯达唑治疗人的棘球蚴感染[J]. 国外医学寄生虫病分册, 1990,17(1):36-37.)
[13]	Li M, Li WX, Liu XZ, et al. Eighty cases of alveolar hydatid disease treated with albeisdazole[J]. Chin J Parasitol Parasit Dis, 1991,9(2):62-64. (in Chinese)
[13]	( 李明, 李维新, 刘雄洲, 等. 阿苯达唑治疗肝泡球蚴病80例临床观察[J]. 中国寄生虫学与寄生虫病杂志, 1991,9(2):62-64.)
[14]	Khuroo MS, Dar MY, Yattoo GN, et al. Percutaneous drainage versus albendazole therapy in hepatic hydatidosis: a prospective, randomized study[J]. Gastroenterology, 1993,104(5):1452-1459.
[15]	Gil-Grande LA, Rodriguez-Caabeiro F, Prieto JG, et al. Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease[J]. Lancet, 1993,342(8882):1269-1272.
[16]	Li FR, Fu XY. A clinical observation on the treatment of human hydatidosis with albendazole[J]. J Pract Parasit Dis, 1996(4):160-161. (in Chinese)
[16]	( 李富荣, 付宣英. 阿苯达唑治疗102例包虫病的临床观察[J]. 实用寄生虫病杂志, 1996(4):160-161.)
[17]	Franchi C, Di VB, Teggi A. Long-term evaluation of patients with hydatidosis treated with benzimidazole carbamates[J]. Clin Infect Dis, 1999,29(2):304-309.
[18]	Zhang HL, Gu ZL, Zhu QY, et al. Efficacy of albendazole in the treatment of cystic hydatidosis[J]. Endem Dis Bull China, 2000,15(4):84-85. (in Chinese)
[18]	( 张贺玲, 顾再芦, 朱其银, 等. 新剂型阿苯达唑治疗囊型包虫病的疗效观察[J]. 地方病通报, 2000,15(4):84-85.)
[19]	Chai JJ, Menghe B, Jiao W, et al. Clinical efficacy of albendazole emulsion in treatment of 212 cases of liver cystic hydatidosis[J]. Chin J Parasitol Parasit Dis, 2001,19(3):129-134. (in Chinese)
[19]	( 柴君杰, 孟贺巴特, 焦伟, 等. 阿苯达唑乳剂治疗肝囊型包虫病212例临床疗效观察[J]. 中国寄生虫学与寄生虫病杂志, 2001,19(3):129-134.)
[20]	Ke S, Li HT, Wen H, et al. Initial clinical trial against human echinococcosis with liposomal albendazole[J]. J Xinjiang Med Univ, 2002,25(4):365-367. (in Chinese)
[20]	( 柯山, 李海涛, 温浩, 等. 阿苯达唑脂质体治疗包虫病的初期临床观察[J]. 新疆医科大学学报, 2002,25(4):365-367.)
[21]	Yadekaer. T, Aili, Tilahemaiti, et al. Clinical efficacy of albendazole emulsion in the treatment of 71 cases of hepatic cystic hydatidosis[J]. Ende Dis Bull, 2002,17(1):72-74. (in Chinese)
[21]	( 亚德卡尔·吐尔逊, 艾力, 提拉合买提, 等. 阿苯达唑乳剂治疗肝囊型包虫病71例临床疗效观察[J]. 地方病通报, 2002,17(1):72-74.)
[22]	Li HT, Ke S, Shao YM, et al. Clinical observation of efficacy on liposomal albendazole on Echinococcus infections in 66 cases[J]. Endem Dis Bull, 2004,19(1):16-19, 96. (in Chinese)
[22]	( 李海涛, 柯山, 邵英梅, 等. 阿苯达唑脂质体治疗66例人体包虫病的疗效观察[J]. 地方病通报, 2004,19(1):16-19, 96.)
[23]	Chai JJ, Menghebat, Jiao W, et al. Observations on clinical efficacy of albendazole emulsion in 264 cases of hepatic cystic echinococcosis[J]. Parasitol Int, 2004,53(1):3-10.
[24]	Bildik N, Cevik A, Altinta M, et al. Efficacy of preoperative albendazole use according to months in hydatid cyst of the liver[J]. J Clin Gastroenterol, 2007,41(3):312-316.
[25]	Li HT, Bai L, Zhao JM, et al. Clinical observation of liposmal albendazole for treating complex liver alveolar echinococcosis[J]. J Xinjiang Med Univ, 2010,33(9):1089-1092. (in Chinese)
[25]	( 李海涛, 白磊, 赵晋明, 等. 阿苯达唑脂质体治疗复杂肝泡型包虫病的初期临床观察[J]. 新疆医科大学学报, 2010,33(9):1089-1092.)
[26]	Zhu B, Yimamu A, Wang WL. Effects of albendazole chemotherapy on liver function and peripheral blood leukocytes in 24 patients with hepatic hydatid[J]. Chin J Misdiagn, 2010,10(18):4478. (in Chinese)
[26]	( 朱兵, 依马木·阿不拉, 王龙文. 阿苯达唑化疗对24例肝包虫患者肝功能及外周血白细胞的影响[J]. 中国误诊学杂志, 2010,10(18):4478.)
[27]	Salinas JL, Vildozola GH, Astuvilca J, et al. Long-term albendazole effectiveness for hepatic cystic echinococcosis[J]. Am J Trop Med Hyg, 2011,85(6):1075-1079.
[28]	Shams UB, Arif SH, Malik AA, et al. Role of albendazole in the management of hydatid cyst liver[J]. Saudi J Gastroenterol, 2011,17(5):343-347.
[29]	Gulibaier K, Adili M, Duolikun M. The clinical efficacy of albendazole emulsion in treating 116 cases of cystic hydatidosis[J]. Xinjiang Med J, 2012; 42:30-32. (in Chinese)
[29]	( 古丽拜尔·卡哈尔, 阿地力·买买提, 多力坤·买买提. 阿苯达唑乳剂治疗囊型包虫病116例临床疗效观察[J]. 新疆医学, 2012,42(5):30-32.)
[30]	Wang LY, Wu WP, Cai HX, et al. Clinical observation of albendazole to treat echinococcosis in children[J]. J Pathog Biol, 2014,9(10):911-914. (in Chinese)
[30]	( 王立英, 伍卫平, 蔡辉霞, 等. 阿苯达唑治疗中小学生棘球蚴病的观察[J]. 中国病原生物学杂志, 2014,9(10):911-914.)
[31]	Karabulut K, Ozbalci GS, Kesicioglu T, et al. Long-term outcomes of intraoperative and perioperative albendazole treatment in hepatic hydatidosis: single center experience[J]. Ann Surg Treat Res, 2014,87(2):61-65.
[32]	Chen H, Zhuang JX, Jia YH. Therapeutic effects of albendazole tablets on cerebral echinococcosis complicated with cerebral cysticercosis[J]. Med J Natl Defending Forces Southwest China, 2015,25(9):975-976. (in Chinese)
[32]	( 陈辉, 庄进学, 贾映海. 阿苯达唑片治疗脑包虫病并发脑囊虫病的疗效分析[J]. 西南国防医药, 2015,25(9):975-976.)
[33]	Moroni S, Moscatelli G, Bournissen FG, et al. Abdominal cystic echinococcosis treated with albendazole. A pediatric cohort study[J]. PLoS One, 2016,11(9):e0160472.
[34]	Saidi F, Habibzadeh F. The non-operative management of asymptomatic liver hydatids: ending echinococcophobia[J]. J Gastrointest Surg, 2018,22(3):486-495.
[35]	Fattahi Masoom SH, Lari SM, Fattahi AS, et al. Albendazole therapy in human lung and liver hydatid cysts: a 13-year experience[J]. Clin Respir J, 2018,12(3):1076-1083.
[36]	Chen WJ, Bao HH. Effect and imaging changes of albendazole in the treatment of cerebral vesicular hydatidosis[J]. J Prev Med Chin PLA, 2019,37(2):80-81, 84. (in Chinese)
[36]	( 陈文君, 鲍海华. 阿苯达唑治疗脑泡型包虫病的疗效及影像学改变[J]. 解放军预防医学杂志, 2019,37(2):80-81, 84.)
[37]	Shankar G, Ramesh S, Srimurthy KR. Long-term outcome of minimal access surgery for hydatidosis in children: a single institutional experience[J]. J Ped Endosc Surg, 2019,1(3):113-117.
[38]	Xu S, Dang ZS, Zhang HB, et al. Research progress on drug treatment for hydatidosis[J]. Chin J Parasitol Parasit Dis, 2018,36(3):297-302. (in Chinese)
[38]	( 徐硕, 党志胜, 张皓冰, 等. 棘球蚴病药物治疗的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2018,36(3):297-302.)
[39]	Gong XH, Zhang XL. Albendazole causes hair loss and blood disorders[J]. Adverse Drug React J, 2003,5(1):49. (in Chinese)
[39]	( 龚学红, 张晓林. 阿苯达唑致脱发、血液系统障碍[J]. 药物不良反应杂志, 2003,5(1):49.)
[40]	Zheng DN, Gan XH. One case of albendazole-induced neutropenia with alopecia[J]. Central South Pharm, 2016,14(5):558-559. (in Chinese)
[40]	( 郑冬妮, 干小红. 阿苯达唑致中性粒细胞缺乏并脱发1例[J]. 中南药学, 2016,14(5):558-559.)