AUTHOR=Zou Yuanyuan , Tuo Fei , Zhang Zhiqi , Guo Jiawen , Yuan Yueming , Zhang Hongying , Xu Zhiyong , Pan Ziyi , Tang Yexiao , Deng Changsheng , Julie Nadia , Wu Wanting , Guo Wenfeng , Li Changqing , Huang Xinan , Xu Qin , Song Jianping , Wang Qi 

TITLE=Safety and Efficacy of Adjunctive Therapy With Artesunate in the Treatment of Severe Malaria: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 11 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.596697

DOI=10.3389/fphar.2020.596697

ISSN=1663-9812

ABSTRACT=Objective: The purpose of this meta-analysis of longitudinal studies is to determine the safety and efficacy and artesunate combined with other forms of adjuvant therapies for severe malaria.
Methods: Following the Prisma guidelines, we searched multiple databases with the search terms: “artesunate” and “adjunctive therapy” and “severe malaria” in July 2020. If the search yielded either a prospective cohort study or a study reporting a randomized controlled trial (RCT), the study was included in this meta-analysis. The random-effects model was used to calculate the combined incidence rate and relative risk or risk difference.
Results: This meta-analysis included nine longitudinal studies with 725 participants. We found that the mortality rates in the artesunate monotherapy group and the artesunate+adjuvant therapy group are similar (RD= 0.02, 95%CI: 0.02-0.06). Artesunate, combined with adjuvant therapy, did not significantly improve the renal protection rate of patients with severe malaria (RD= 0.04, 95%CI: 0.03-0.11). The incidence of adverse reactions in the artesunate monotherapy group and the artesunate+adjuvant therapy group was also similar.
Conclusions: No significant differences in safety and efficacy were observed between the artesunate monotherapy group and the artesunate+adjuvant therapy group. Higher quality and rigorously designed randomized controlled studies are needed to validate our findings.