Publication:
A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?

Issued Date

2021-03-01

Resource Type

Article

ISSN

19352735
19352727

DOI

10.1371/journal.pntd.0009144

Other identifier(s)

2-s2.0-85103144168

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

PLoS Neglected Tropical Diseases. Vol.15, No.3 (2021)

Suggested Citation

Podjanee Jittamala, Wuelton Monteiro, Menno R. Smit, Belen Pedrique, Sabine Specht, Carlos J. Chaccour, Céline Dard, Pascal Del Giudice, Virak Khieu, Annabel Maruani, Virgilio E. Failoc-Rojas, Marimar Sáez-De-ocariz, Antoni Soriano-Arandes, Jaime Piquero-Casals, Anne Faisant, Marie Pierre Brenier-Pinchart, David Wimmersberger, Jean T. Coulibaly, Jennifer Keiser, Franck Boralevi, Oliver Sokana, Michael Marks, Daniel Engelman, Lucia Romani, Andrew C. Steer, Lorenz von Seidlein, Nicholas J. White, Eli Harriss, Kasia Stepniewska, Georgina S. Humphreys, Kalynn Kennon, Philippe J. Guerin, Kevin C. Kobylinski A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?. PLoS Neglected Tropical Diseases. Vol.15, No.3 (2021). doi:10.1371/journal.pntd.0009144 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78372

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Title

A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?

Author(s)

Podjanee Jittamala
 Wuelton Monteiro
 Menno R. Smit
 Belen Pedrique
 Sabine Specht
 Carlos J. Chaccour
 Céline Dard
 Pascal Del Giudice
 Virak Khieu
 Annabel Maruani
 Virgilio E. Failoc-Rojas
 Marimar Sáez-De-ocariz
 Antoni Soriano-Arandes
 Jaime Piquero-Casals
 Anne Faisant
 Marie Pierre Brenier-Pinchart
 David Wimmersberger
 Jean T. Coulibaly
 Jennifer Keiser
 Franck Boralevi
 Oliver Sokana
 Michael Marks
 Daniel Engelman
 Lucia Romani
 Andrew C. Steer
 Lorenz von Seidlein
 Nicholas J. White
 Eli Harriss
 Kasia Stepniewska
 Georgina S. Humphreys
 Kalynn Kennon
 Philippe J. Guerin
 Kevin C. Kobylinski

Other Contributor(s)

Faculty of Tropical Medicine, Mahidol University
 Hospital Regional Lambayeque
 Vall d'Hebron Institut de Recerca
 Universidad San Ignacio de Loyola
 Université de Bordeaux
 Ministry of Health Cambodia
 University of Cocody
 Centre Suisse de Recherches Scientifiques Abidjan
 Ifakara Health Institute
 Emma Kinderziekenhuis
 Universidad de Navarra
 London School of Hygiene & Tropical Medicine
 Green Templeton College
 University of Oxford
 The Kirby Institute
 University of Melbourne
 Universitat Basel
 Hospital for Tropical Diseases
 Centre Hospitalier Universitaire de Bordeaux
 Liverpool School of Tropical Medicine
 Centre Hospitalier Regional et Universitaire de Tours
 Armed Forces Research Institute of Medical Sciences, Thailand
 Murdoch Children's Research Institute
 Nuffield Department of Medicine
 Centre Hospitalier Universitaire de Grenoble
 Instituto Nacional de Pediatría
 Universiteit van Amsterdam
 Universidade do Estado do Amazonas
 Universitat de Barcelona
 Centre Hospitalier de Basse-Terre
 Drugs for Neglected Diseases initiative (DNDi)
 Infectious Diseases Data Observatory (IDDO)
 Solomon Islands Ministry of Health and Medical Services
 Dermik
 Centre Hospitalier Intercommunal de Fréjus-Saint-Raphaël
 Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
 WorldWide Antimalarial Resistance Network (WWARN)
 Centro de Investigação em Saúde de Manhiça

Abstract

Background Oral ivermectin is a safe broad spectrum anthelminthic used for treating several neglected tropical diseases (NTDs). Currently, ivermectin use is contraindicated in children weighing less than 15 kg, restricting access to this drug for the treatment of NTDs. Here we provide an updated systematic review of the literature and we conducted an individual-level patient data (IPD) meta-analysis describing the safety of ivermectin in children weighing less than 15 kg. Methodology/Principal findings A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for IPD guidelines by searching MEDLINE via PubMed, Web of Science, Ovid Embase, LILACS, Cochrane Database of Systematic Reviews, TOXLINE for all clinical trials, case series, case reports, and database entries for reports on the use of ivermectin in children weighing less than 15 kg that were published between 1 January 1980 to 25 October 2019. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017056515. A total of 3,730 publications were identified, 97 were selected for potential inclusion, but only 17 sources describing 15 studies met the minimum criteria which consisted of known weights of children less than 15 kg linked to possible adverse events, and provided comprehensive IPD. A total of 1,088 children weighing less than 15 kg were administered oral iver-mectin for one of the following indications: scabies, mass drug administration for scabies control, crusted scabies, cutaneous larva migrans, myiasis, pthiriasis, strongyloidiasis, tri-churiasis, and parasitic disease of unknown origin. Overall a total of 1.4% (15/1,088) of children experienced 18 adverse events all of which were mild and self-limiting. No serious adverse events were reported. Conclusions/Significance Existing limited data suggest that oral ivermectin in children weighing less than 15 kilograms is safe. Data from well-designed clinical trials are needed to provide further assurance.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/78372

Collections

Scopus 2021