Efficacy and Safety of a Single Dose of Ivermectin, Diethylcarbamazine, and Albendazole for Treatment of Lymphatic Filariasis in Cote d'Ivoire: An Open-label Randomized Controlled Trial

被引:38
作者
Bjerum, Catherine M. [1 ]
Ouattara, Allassane F. [2 ,3 ]
Aboulaye, Meite [4 ]
Kouadio, Olivier [2 ]
Marius, Vanga K. [5 ]
Andersen, Britt J. [6 ]
Weil, Gary J. [6 ]
Koudou, Benjamin G. [2 ,3 ]
King, Christopher L. [1 ,7 ]
机构
[1] Case Western Reserve Univ, Sch Med, Ctr Global Hlth & Dis, Cleveland, OH 44106 USA
[2] Ctr Suisse Rech Sci Cote dIvoire, Abidjan, Cote Ivoire
[3] Univ Nangui Abrogoua, Abidjan, Cote Ivoire
[4] Programme Natl Lutte Schistosomiase Geohelminthia, Abidjan, Cote Ivoire
[5] Univ Alassane Ouattara, Ctr Hosp Univ Bouake, Bouake, Cote Ivoire
[6] Washington Univ, Sch Med, Dept Med, Div Infect Dis, St Louis, MO 63110 USA
[7] Cleveland Vet Affairs Med Ctr, Vet Affairs Res Serv, Cleveland, OH USA
基金
比尔及梅琳达.盖茨基金会;
关键词
lymphatic filariasis; ivermectin; diethylcarbamazine; albendazole; efficacy; WUCHERERIA-BANCROFTI; COMBINATION; INSIGHTS; CHILDREN; ANTIGEN;
D O I
10.1093/cid/ciz1050
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Improved drug regimens are needed to accelerate elimination of lymphatic filariasis in Africa. This study determined whether a single co-administered dose of ivermectin plus diethylcarbamazine plus albendazole [IDA] is noninferior to standard 3 annual doses of ivermectin plus albendazole (IA) used in many LF-endemic areas of Africa. Methods. Treatment-naive adults with Wuchereria bancrofti microfilaremia in Cbte d'Ivoire were randomized to receive a single dose of IDA (n = 43) or 3 annual doses of IA (n = 52) in an open-label, single-blinded trial. The primary endpoint was the proportion of participants who were microfilaria (Mf) negative at 36 months. Secondary endpoints were Mf clearance at 6,12, and 24 months; inactivation of adult worm nests; and safety. Results. At 36 months posttreatment with IDA, 18/33 (55%; 95% CI, 38-72%) cleared Mf versus 33/42 (79%; 67-91%) with IA (P = .045). At 6 and 12 months IDA was superior to IA in clearing Mf (89% [77-99%] and 71% [56-85%D, respectively, versus 34% (20-48%) and 26% (14-42%) (P < .001). IDA was equivalent to IA at 24 months (61% [45-77%] vs 54% [38-72%]; P = .53). IDA was superior to IA for inactivating adult worms at all time points. Both treatments were well tolerated, and there were no serious adverse events. Conclusions. A single dose of IDA was superior to 2 doses of IA in reducing the overall Mf burden by 24 months. Reinfection may have contributed to the lack of sustained clearance of Mf with IDA.
引用
收藏
页码:E68 / E75
页数:8
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