Mebendazole 100mg/5ml oral suspension

Soil-transmitted helminthic (STH) infections are the leading cause of stunting among children. To lessen the burden, the World Health Organization (WHO) recommended a periodic deworming program through the use of single-dose therapy in the endemic regions. Therefore, the purpose of this study was to synthesize evidence about the efficacy of anthelminthic drugs against STH infections among preschool and school-age children. The Preferred Reposting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed in this study. Relevant electronic databases, including PubMed, Scopus, Embase, DOAJ, Science Direct, the WHO Clinical Trials.gov library, Google Scholar, and AJOL databases, were searched for relevant publications. Randomized controlled trials (RCTs) and non-randomized interventional studies focused on the efficacy of albendazole and mebendazole against STHs in children were included in the study. Review Manager was used to analyze the data. A random effects model was used to obtain the pooled estimated efficacy. To evaluate heterogeneity, the I2 test and Cochrane Q (χ2) were employed. The risk of publication bias was investigated using Egger’s test and the funnel plot. The protocol of this review was registered at the PROSPERO international prospective register of systematic reviews (CRD42023401196). Of the 69 publications selected for the systematic review, 66 with complete data were included in the meta-analysis. Single doses of albendazole and mebendazole have shown satisfactory efficacy [egg reduction rate (ERR)] against Ascaris lumbricoides [95.54% (95% CI: 88.75–102.34%) and 98.69% (95% CI: 97.68–99.65%), respectively. The effectiveness of these two drugs against Trichuris trichiura and hookworms was comparatively low (< 80% ERR), except for albendazole, which showed high ERRs [93.44% (95%CI: 92.39–94.49%)] against hookworms. The cure rate (CR) of albendazole against T. trichiura, A. lumbricoides, and hookworms were 50.8%, 91.3%, and 78.32%, respectively. Likewise, mebendazole showed CRs of 48.15%, 92.8%, and 49.32% against T. trichiura, A. lumbricoides, and hookworms, respectively. Subgroups such as studies conducted after 2000, diagnostic type (McMaster), and longer follow-up weeks significantly reduced the efficacy of the two drugs against T. trichura. While the combination of albendazole or mebendazole with other drugs and RCT showed significantly improved efficacy against T. trichura. The count of eggs per gram of stool (EPG) was identified as one of the variables that negatively and significantly influenced the efficacy of albendazole or mebendazole against A. lumbricoides. Despite the wide range of ERRs and CR reported in the different articles included in this review, the pooled estimated efficacy of albendazole and mebendazole against STHs falls in the satisfactory category of WHO recommendations. Further evaluation of the combination of anthelminthic drugs as a preventive chemotherapy option and routine drug efficacy testing are necessary to prevent the emergence and widespread use of drug-resistant STHs.

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AimMebendazole (MBZ), a benzimidazole anthelmintic with established clinical use, has emerged as a repurposing candidate for primary brain tumours due to its multimodal anticancer actions and central nervous system penetrance. This systematic review synthesizes preclinical and clinical evidence evaluating MBZ's efficacy, mechanisms of action and translational relevance.MethodsThis systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology. Systematic searches were performed in PubMed, EMBASE, SCOPUS and Web of Science using predefined eligibility criteria. A total of 22 studies were included (17 preclinical and five clinical/population).ResultsPreclinical work across glioblastoma, diffuse midline glioma, medulloblastoma and meningioma demonstrates consistent tumour growth suppression and survival extension via microtubule depolymerization, kinase inhibition, angiogenesis blockade, Hedgehog pathway interference, apoptosis/pyroptosis induction and impairment of DNA repair. MBZ also potentiates standard therapies, enhancing the effects of alkylators, radiotherapy and autophagy inhibitors. Efficacy was influenced by formulation, with polymorph C demonstrating superior brain penetration and tolerability. Additional delivery strategies, including efflux inhibition, intranasal microemulsions and nanosuspensions, further improved exposure. Clinically, MBZ was generally tolerable at high oral doses in early-phase studies, but evidence of efficacy remained modest, inconsistent and inconclusive.ConclusionMBZ shows broad preclinical anticancer activity and acceptable tolerability in early human studies, but current clinical evidence does not demonstrate meaningful efficacy in brain tumour patients. Further well-designed comparative trials with clear formulation reporting and integrated pharmacokinetic and biomarker analyses are needed.

Abstract licence: CC BY-NC