Comparative Efficacy Of Albendazole Versus Placebo, Corticosteroids, Praziquantel And Antiepileptics In Treating Neurocysticercosis: A Meta-Analysis

Introduction: Neurocysticercosis (NCC), caused by Taenia solium, is a significant public health concern in areas with poor sanitation, presenting with symptoms like seizures and intracranial lesions. This study assesses albendazole's efficacy in resolving seizures and neuroimaging abnormalities compared to other treatments. Methods: A systematic review and meta-analysis were conducted using studies from PubMed, Cochrane, ResearchGate, Google Scholar, Medline, Scopus, Embase, CINAHL, EBSCO, Elsevier, and reference lists. Inclusion criteria involved NCC patients of all ages and genders receiving albendazole monotherapy or placebo, adhering to CONSORT guidelines. Exclusions included combination therapy, lack of control groups, non-randomized studies, and insufficient outcome details. Data on study design, treatments, demographics, and outcomes were extracted. Statistical analyses used fixed- or random-effects models to calculate odds ratios (OR) with 95% confidence intervals (CI), assessing heterogeneity and publication bias. Results: The analysis included 22 randomized controlled trials (2,008 patients). Albendazole significantly reduced seizures and neuroimaging abnormalities compared to placebo and other treatments. Of 608 papers, 551 were excluded, leaving 57; after exclusions, 22 trials were analyzed. Nine compared albendazole to placebo, one to corticosteroids plus antiepileptics, one to a control group, six to praziquantel, and four to antiepileptics alone. Albendazole effectively resolved CT lesions/cysts (OR = 2.726, 95% CI: 2.346-3.166, p < 0.001) and showed potential for seizure resolution (random effects OR = 1.453, 95% CI: 0.942-2.242, p = 0.091). Conclusion: Albendazole is highly effective in resolving CT lesions in NCC patients, though its seizure control benefits remain uncertain. Significant heterogeneity and potential publication bias underscore the need for larger, more rigorous studies to confirm efficacy and address treatment variability.