Background

Many drugs have been used to treat scabies, but it is unclear which of them is the most efficacious.

Objective

To evaluate the comparative efficacy and safety of antiscabietic agents.

Methods

A systematic review of randomized controlled trials was conducted. Direct and network meta-analyses were applied to 13 antiscabietic agents on 3 outcomes (cure, persistent itching, and adverse events). Their probability of having highest efficacy and safety was estimated and ranked.

Results

A network meta-analysis of 52 trials including 9917 patients indicated that permethrin (the reference treatment) had a significantly higher cure rate than sulfur, malathion, lindane, crotamiton, and benzyl benzoate. Combination permethrin plus oral ivermectin had a nonsignificantly higher cure rate than permethrin. Combination permethrin plus oral ivermectin was ranked highest in terms of cure, topical ivermectin in terms of persistent itching, and synergized pyrethrins in terms of adverse events. On the basis of clustered ranking, permethrin, oral ivermectin, and synergized pyrethrins seemed to retain balance between cure and adverse events.

Limitations

There are small numbers of trials and patients in some comparisons and a high risk of bias in some trials.

Conclusion

There is no 1 treatment that ranked highest in all aspects. Physicians should consider the drug's efficacy and safety profiles, along with ease of administration.

中文翻译：

---

抗sc剂的疗效和安全性：随机对照试验的系统评价和网络荟萃分析

背景

许多药物已用于治疗sc疮，但尚不清楚哪种药物最有效。

客观的

评估抗sc剂的比较疗效和安全性。

方法

对随机对照试验进行了系统评价。将直接和网络荟萃分析应用于3种结局（治愈，持续瘙痒和不良事件）的13种抗anti剂。对他们具有最高疗效和安全性的可能性进行了评估和排名。

结果

对包括9917名患者的52个试验进行的网络荟萃分析表明，氯菊酯（参考治疗）的治愈率显着高于硫磺，马拉硫磷，林丹，克罗米通和苯甲酸苄酯。苄氯菊酯加伊维菌素联合用药的治愈率比苄氯菊酯高得多。苄氯菊酯加口服伊维菌素的组合在治愈率方面最高，局部伊维菌素在持续瘙痒方面名列前茅，而除虫菊酯在不良事件方面则增效。根据聚类排名，苄氯菊酯，口服伊维菌素和增效除虫菊酯似乎在治愈和不良事件之间保持平衡。

局限性

在某些比较中，试验和患者的数量很少，而在某些试验中，存在偏见的风险很高。

结论

没有哪一种治疗方法在所有方面都排名最高。医师应考虑药物的功效和安全性，以及易于给药。