Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis
Efficacy of single dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis
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DOI：
10.1016/s0035-9203(98)90972-5
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发表时间：
1998-01-01
影响因子：
2.2
通讯作者：
Dissanaike, AS
中科院分区：
文献类型：
--
作者：
Ismail, MM;Jayakody, RL;Dissanaike, AS
在一项对 50 名患有班氏菌感染的男性无症状微丝蚴病受试者进行的“盲”试验中，单剂量阿苯达唑 (alb) 600 mg 单独或与伊维菌素肝) 400 μg/kg 或柠檬酸二乙基卡马嗪 (DEC) 6 mg/kg 的安全性、耐受性和杀丝虫功效与单剂量组合 DEC 6 进行了比较治疗后 15 个月期间，mg/kg 和肝脏 400 μg/kg。除一名受试者外，所有受试者的微丝蚴 (mf)/mL 为 67 个，治疗前计数 >100 mf/mL。所有 4 种治疗均显着降低了 mf 计数，但 alb/iver 是从夜间血液中清除 mf 的最有效方案：治疗 15 个月后，13 名受试者中有 9 名 (69%) 通过膜过滤出现微丝丝血症，而接受 alb、alb/DEC 和 DEC/iver 治疗组的分别为 12 名受试者中的 1 名 (8%)、11 名受试者中的 3 名 (27%) 和 10 名受试者中的 3 名 (30%)。丝虫抗原测试表明，所有 4 种治疗方法均对班氏丝虫成虫具有显着活性；根据该测试，alb/DEC 具有最大的活性，治疗后 15 个月抗原水平下降 77%。尽管所有治疗组均观察到轻微的自限性全身反应，但所有 4 种方案均具有良好的耐受性和临床安全性。这些结果表明，alb/iver 是抑制班克罗夫特丝虫病微丝蚴血症的安全有效的单剂量方案，可考虑用于控制计划。这种组合的其他好处是其对肠道蠕虫具有强效、广谱的活性，并且在非洲地区具有潜在的相对安全性，在这些地区，由于与盘尾丝虫病或罗阿虫病同时流行，DEC 无法用于丝虫病控制。
In a 'blind' trial on 50 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of a single dose of albendazole (alb) 600 mg alone or in combination with ivermectin liver) 400 mu g/kg or diethylcarbamazine citrate (DEC) 6 mg/kg was compared with a single dose of the combination DEC 6 mg/kg and iver 400 mu g/kg over a period of 15 months after treatment. All but one subject, with 67 microfilariae (mf)/mL, had pre-treatment counts >100 mf/mL. All 4 treatments significantly reduced mf counts, but alb/iver was the most effective regimen for clearing mf from night blood: 9 of 13 subjects (69%) were amicrofilaraemic by membrane filtration 15 months after treatment compared to one of 12 (8%), 3 of 11 (27%), and 3 of 10 (30%) in the groups treated with alb, alb/DEC, and DEC/iver, respectively. Filarial antigen tests suggested that all 4 treatments had significant activity against adult W. bancrofti; alb/DEC had the greatest activity according to this test, with antigen levels decreasing by 77% 15 months after therapy. All 4 regimens were well tolerated and clinically safe, although mild, self-limited systemic reactions were observed in all treatment groups. These results suggest that alb/iver is a safe and effective single dose regimen for suppression of microfilaraemia in bancroftian filariasis that could be considered for control programmes. Additional benefits of this combination are its potent, broad spectrum activity against intestinal helminths and potential relative safety in areas of Africa where DEC cannot be used for filariasis control because of co-endemicity with onchocerciasis or loiasis.