ArticlePathogens (Basel, Switzerland)2022
Salvage Therapy for Alveolar Echinococcosis-A Case Series.
Article in Pathogens (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Alveolar Echinococcosis in the Early 2020s: A Systematic Review.Pathogens (Basel, Switzerland) · 2026Pooled it
- Hepatobiliary alveolar echinococcosis treated with delayed resection following percutaneous drainage.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Drug repurposing for hard-to-treat human alveolar echinococcosis: pyronaridine and beyond.Parasitology · 2024Article
- Chemotherapy for the treatment of alveolar echinococcosis: Where are we?Parasite (Paris, France) · 2024Review
- Alveolar Echinococcus in a 70-year-old man in Ontario.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Investigation of the mechanism of action of mefloquine and derivatives against the parasite Echinococcus multilocularis.International journal for parasitology. Drugs and drug resistance · 2023Article
- Case Report: Amphotericin B and Mefloquine as a Salvage Treatment of Alveolar Echinococcosis.The American journal of tropical medicine and hygiene · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Benzimidazoles are the only approved drugs for the treatment of inoperable human alveolar echinococcosis but may be limited due to intolerance or, rarely, ineffectiveness. A medical second-line or salvage therapy is not available, though it is urgently needed. We report long-term follow-up data from 14 patients who underwent salvage therapy with repurposed drugs with cumulatively 53.25 patient-years. Treatment response was evaluated by both clinical outcome and image studies, preferably PET/CT. Eleven patients received amphotericin B, and 70% of evaluable cases showed some positive treatment response, but side effects often limited therapy. Five patients received nitazoxanide, of which two showed clear progression but one achieved a lasting stable disease. One patient was treated with mefloquine combination therapy in advanced disease, and overall, a positive treatment response could not be assessed. Furthermore, we report on one patient receiving pembrolizumab for a concomitant malignancy, which did not result in a reduction of echinococcal manifestation. In summary, current options of salvage therapy can sometimes induce persistent disease control, although with potentially significant side effects and high treatment costs, and mortality remains high. No clear recommendation for a salvage therapy can be given; treatment remains highly experimental, and non-pharmaceutical interventions have to be considered.
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