SynthesisInfection2026
Efficacy and safety of praziquantel combined with artemisinin derivatives versus praziquantel monotherapy for schistosomiasis: a meta-analysis of randomized controlled trials.
Synthesis in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPraziquantel (PZQ) is the mainstay treatment for schistosomiasis, but its efficacy against juvenile schistosomes is limited, which can lead to treatment failure and reinfection. Artemisinin derivatives (ARTs) exhibit potent activity against juvenile worms, offering a complementary mechanism. However, the potential risk of accelerating artemisinin resistance, particularly in schistosomiasis-malaria co-endemic regions, warrants consideration when evaluating ART-based regimens. To find a more optimal regimen for the treatment of schistosomiasis, this meta-analysis evaluated the effectiveness of ARTs and PZQ in combination or as a single agent for the treatment of schistosomiasis. PURPOSE: To evaluate the efficacy and safety of PZQ combined with ARTs compared with praziquantel alone for the treatment of schistosomiasis through a meta-analysis of randomized controlled trials.
methodsRandomized controlled trials (RCTs) of artemisinin derivatives in combination with praziquantel in the treatment of schistosomiasis were selected from computerized searches of PubMed, Embase, Cochrane Library, and Web of Science, up to November 2025. The inclusion criteria were randomized controlled trials involving participants diagnosed with Schistosoma mansoni, S. haematobium, or S. japonicum, who were treated with PZQ combined with ARTs or PZQ alone, and reporting on efficacy and safety outcomes. The primary outcome indicator was cure rate (CR), and secondary outcome indicators were egg count reduction rate and number of adverse events. The meta-analysis was performed using a random-effects model. Subgroup analyses were conducted to explore the impact of different types of schistosomes.
resultsA total of eight studies, involving 1595 patients with schistosomiasis, explored the cure rate of PZQ combined with ARTs and PZQ alone. The pooled result showed that PZQ combined with ARTs had a significantly higher cure rate than PZQ alone (RR 1.12; 95% CI 1.01-1.24; P = 0.02). The corresponding subgroup analysis results showed that the CR of patients with S. mansoni treated with PZQ combined with ARTs was still higher than that of patients treated with PZQ alone (RR 1.16; 95% CI 1.01-1.34; P = 0.03). However, there was no statistically significant difference between PZQ combined with ARTs and PZQ for S. haematobium (RR 1.11; 95% CI 0.99-1.23; P = 0.06) or S. japonicum (RR 1.02; 95% CI 0.95-1.09; P = 0.60) in subgroup analyses. In addition, our study also found that there was no significant difference in egg count reduction between the PZQ-ARTs and PZQ-alone groups, either for S. mansoni (MD - 4.54, 95% CI - 17.67 to 8.58; P = 0.50) or for S. haematobium (MD - 13.74; 95% CI - 55.64 to 28.15; P = 0.52). Furthermore, the combination therapy was associated with a higher incidence of adverse events compared with PZQ alone (RR 1.41; 95% CI 1.01 to 1.96; P = 0.04).
conclusionsThe combination of PZQ and ARTs can significantly improve the CR for S. mansoni, but not for other schistosome species, at the cost of a higher incidence of adverse events, which were however manageable.
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