To provide a continuous update on the safety and efficacy of artesunate-mefloquine (ASMQ) compared with other artemisinin combination therapy (ACT) schemes used in the treatment of uncomplicated malaria caused by Plasmodium falciparum, this study updated and expanded the results of the systematic literature review published in 2016. Only randomised controlled clinical trials published from 1 January 2001 to 12 June 2023 from five databases were included in this study. The results related to efficacy, expressed through RR, were summarized in meta-analyses, performed according to the compared ACTs and with the intention-to-treat and per-protocol analyses. The results related to safety were synthesized in a descriptive manner. Thirty-two studies were included, of which 24 had been analysed in the 2016 review and eight new ones were added. Although the methodological quality of most studies was considered moderate, the body of evidence gathered indicates that ASMQ continues to be safe and effective for the treatment of uncomplicated infections caused by P. falciparum compared with other ACTs. However, the inclusion of two new studies, which identified failure rates exceeding 10%, suggests a possible reduction in the efficacy of ASMQ in the analysed locations. The incidence of serious adverse effects, such as seizure, encephalopathy and cardiac arrhythmia, was infrequent in both the ASMQ group and the comparison groups. After including new evidence, ASMQ is still recommended as a first-line treatment of uncomplicated malaria caused by P. falciparum, although local aspects need to be considered.

中文翻译：

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青蒿琥酯-甲氟喹治疗无并发症的恶性疟原虫疟疾：最新的系统评价和疗效和安全性荟萃分析。

为了持续更新青蒿琥酯甲氟喹（ASMQ）与其他青蒿素联合疗法（ACT）方案相比用于治疗恶性疟原虫引起的单纯性疟疾的安全性和有效性，本研究更新并扩展了系统文献的结果2016年发表的综述。本研究仅纳入2001年1月1日至2023年6月12日发表的来自五个数据库的随机对照临床试验。通过 RR 表达的与疗效相关的结果在荟萃分析中进行总结，根据比较的 ACT 以及意向治疗和符合方案分析进行。以描述性方式综合了与安全性相关的结果。纳入了 32 项研究，其中 24 项已在 2016 年综述中进行了分析，并添加了 8 项新研究。尽管大多数研究的方法学质量被认为是中等的，但收集的证据表明，与其他 ACT 相比，ASMQ 对于治疗由恶性疟原虫引起的简单感染仍然是安全有效的。然而，两项新研究发现故障率超过 10%，这表明 ASMQ 在分析地点的功效可能会降低。ASMQ 组和对照组中癫痫、脑病和心律失常等严重不良反应的发生率均较低。在纳入新的证据后，ASMQ 仍被推荐作为恶性疟原虫引起的单纯性疟疾的一线治疗，尽管需要考虑局部因素。