Table 4 Main therapeutic findings and conclusions of randomized controlled trials included in the quantitative analysis (meta-analysis)

Bildik N, et al....... 2007 [33]

Liver

Non-registered information

G-I: ABZ (10 mg/kg/day 1 month before surgery)

G-II: ABZ (10 mg/kg/day 2 months before surgery)

G-III: ABZ (10 mg/kg/day 3 months before surgery)

G-IV (control gr.): surgery (no preoperative therapy)

Viability of the scoleces

Intact

Dead

G-I

G-II

G-III

G-IV

10

7

2

17

11

14

19

4

Cobo F, et al. 1998 [9]

Liver

Non-registered information

G-I: ABZ (10 mg/kg/day 1 month before surgery)

G-II: ABZ (20 mg/kg/day 1 months before surgery)

G-III: ABZ (10 mg/kg/day) + PZQ (25 mg/kg/day 1 month before surgery)

Protoscolex viability. ABZ sulphoxide levels in serum and cyst fluid

p = 0.004

p = 0.030

p = 0.016

p = 0.034

Davis A, et al. 1986 [34]

Liver, lung, other organs

Non-registered information

MBZ (13 to 136.4 mg/kg/day)

FBZ (37.5 to 54.5 mg/kg/day)

ABZ (9.8 to 15.4 mg/kg/day)

Results:

-success

-partial success

-improvement

-no success

MBZ

FBZ

ABZ

8 (9.4)

4 (4.7)

40 (47.1)

33 (38.8)

1

-

-

5

5 (16.7)

4 (13.3)

14 (46.7)

7 (23.3)

Davis A, et al. 1989 [35]

Liver, lung, other organs

Non-registered information

ABZ (10 mg/kg/day 1 month)

MBZ (1.5 to 4.5 g/kg/day, children half of the adult dose)

Results:

-success

-favourable effect

-no success

Follow-up

ABZ

MBZ

< 12 months:

-success

-favourable effect

-no success

no evaluation

> 12 months:

-success

-favourable effect

-no success

21 (100)

-

13 (62)

5 (24)

3 (14)

46 (100)

18 (39)

18 (39)

10 (22)

23 (100)

-

6 (26)

13 (57)

4 (17)

22 (100)

3 (14)

14 (64)

5 (23)

Franchi C, et al. 1999 [36]

Liver, abdomen, lung

Non-registered information

G-I: MBZ (50 mg/kg/day)

G-II: ABZ (10–12 mg/kg/day)

Both drugs in continuous 3- to 6-months cycles

Chest radiographic, ultrasonography, morphological changes and sonographic classification by Caremani et al

Cysts

G-I

G-II

Treated

Evaluated

Changed

Further deg.

Relapse

289

271

152

34

37

640

611

502

110

134

Gil-Grande LA, et al. 1993 [37]

Liver or abdominal

G-A: 10.4 ± 4.1

G-B: 8.9 ± 4.3

G-C: 10.5 ± 5.1

G-A: ABZ (10 mg/kg/day 1 month before surgery)

G-B: ABZ (10 mg/kg/day 3 months before surgery)

G-C (control group): surgery (no ABZ treatment)

Protoscolex and cyst viability (patients/mice). Echographic changes

Keshmiri M, et al. 1999 [38]

Lung

E.gr: cm³ ± SD,

29.6 ± 50.5^All

27.1 ± 45.8^Treat.

C.gr: cm³ ± SD,

18.3 ± 49.5^All

25.1 ± 63.3^Treat.

Experimental group: ABZ (10–15 mg/kg/day 6 months)

Control group: placebo

Radiological or ultrasonic findings. Response to treatment was classified:

-Cured

-Improved

-No change

-Worsened

(Caremani et al)

ABZ

Placebo

No. cysts

Worse

No change

124

9 (7)

32 (26)

26

10 (39)

13 (50)

> 25% (p < 0.001)

> 50% (p < 0.001)

> 75% (p = 0.067)

Disappeared (p = 0.075)

83 (67)

60 (48)

36 (29)

16 (13)

3 (12)

1 (4)

1 (4)

0 (0)

Keshmiri M, et al. 2001 [39]

Lung, abdomen (including liver)

E.gr: cm³ ± SD,

Lung, 29.6 ± 50.5^All

27.1 ± 45.8^Treat.

Abdomen (liver),

198.1 ± 403.7^All

212.7 ± 426.2^Treat.

C.gr: cm³ ± SD,

Lung,

18.3 ± 49.5^All

25.1 ± 63.3^Treat.

Abdomen (liver),

74.0 ± 130.8^All

91.9 ± 155.4^Treat.

Experimental group: ABZ (400 mg twice a day, in 3 cycles of 6 weeks with 2 weeks between cycles)

Control group: placebo

Volume. Ultrasonography and Computed tomography changes: 7 types, T1-T7.

Response to treatment was classified:

-Cured

-Improved

-No change

-Worsened

(Caremani et al)

ABZ

Placebo

No. cysts

Worse (p < 0.001)

No change

Improved (p < 0.001)

Cure (p = 0.081)

172

15 (8.7)

23 (13.4)

117 (68)

17 (9.9)

31

11 (35.5)

16 (51.6)

4 (12.9)

0 (0.0)

Khuroo MS, et al. 1993 [40]

Liver

cm / cm³, mean ± SD

At entry into the study vs the end of study

PD,

9.2 ± 4.4 vs 5.1 ± 3.9

686 ± 651 vs 297 ± 515

ALB-PD,

10.8 ± 3.0 vs 4.8 ± 3.4

835 ± 528 vs 260 ± 389

ALB,

8.8 ± 4.5 vs 8.0 ± 5.0

642 ± 717 vs 606 ± 741

G-I: PD

G-II: ABZ (10 mg.kg-1.day-1 for 8 weeks) plus PD

G-III: ABZ alone

At entry into the study vs the end of study:

-Clinical response

-Cyst size

-Cyst echopattern

-Hydatid serology

-Complications

p-value

< 0.001

< 0.005

< 0.05

< 0.01

< 0.01

NS

Mohamed AE, et al. 1998 [8]

1st, Liver(18), lung(1), multiple cyst(3).

2nd, Liver(13), lung(2), others:pelvis, mediastinum, kidney, spinal(4)

Non-registered information

1st, ABZ (400 mg twice day four weeks/two-week drug free period)

2nd, ABZ (400 mg twice a day) + PZQ (50 mg/kg)

Ultrasound and computed tomography changes, magnetic resonance, hydatid serology and chest-X-ray.

Complete cure rates

ABZ

ABZ + PZQ

No. patients

22

19

Disappearance

8 (36.4)

9 (47.4)

Liver

7/13

Lung

2/2

Reduction

5 (22.7)

9 (47.4)

Liver

5/13

Others

4/4

No change

2 (9.1)

1 (5.2)

Increase

0

0

Shams-UI-Bari, et al. 2011 [41]

Liver

Non-registered information

Group A: surgery.

Group B: ABZ (10 mg/kg/day 12 weeks) + surgery + ABZ (10 mg/kg/day 12 weeks)

Viability, motility of the scolices and their ability to exclude 5% eosin, under immediate microscopy.

Recurrence.

G-A

G-B

Type I

Type II

Type III

Type IV

Viable

Non-viable, p < 0.01

Recurrence, p < 0.05

12 (33.3)

10 (27.2)

8 (22.2)

6 (16.6)

36 (100)

0 (0)

6 (16.6)

11 (30.5)

11 (30.5)

10 (27.7)

4 (11.1)

2 (5.5)

34 (94.5)

0 (0)