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=11

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=<p><bold>Objective:</bold> The purpose of this meta-analysis of longitudinal studies is to determine the safety and efficacy of artesunate combined with other forms of adjunctive therapies for severe malaria.</p><p><bold>Methods:</bold> 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 showed a randomized controlled trial, 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.</p><p><bold>Results:</bold> This meta-analysis included nine longitudinal studies with 724 participants. We found that the mortality rates in the artesunate monotherapy group and the artesunate + adjuvant therapy group are similar (RD = −0.02, 95% confidence interval: −0.06–0.02). The incidence of adverse reactions in the artesunate monotherapy group and the artesunate + adjuvant therapy group was also similar.</p><p><bold>Conclusion:</bold> 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.</p>