A randomized controlled pilot study of artesunate versus triclabendazole for human fascioliasis in central Vietnam
A randomized controlled pilot study of artesunate versus triclabendazole for human fascioliasis in central Vietnam
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DOI：
10.4269/ajtmh.2008.78.388
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发表时间：
2008-03-01
影响因子：
3.3
通讯作者：
Day, Jeremy N.
中科院分区：
文献类型：
--
作者：
Hien, Tran Tinh;Truong, Ng Thanh;Day, Jeremy N.
由肝片吸虫或大片吸虫引起的人类肝片吸虫病是一个日益严重的全球性问题。目前治疗的主要药物是三氯苯咪唑，但已经描述了动物的抗药性，而且在许多国家没有这种药物。抗疟疾青蒿琥酯具有极好的安全性，越来越多的证据表明，它在体外和体内都对其他寄生虫有效。我们进行了一项研究，以调查青蒿琥酯对有症状的人类肝片吸虫病的有效性；纳入了100名患者。接受青蒿琥酯治疗的患者在出院时无腹痛的可能性显著高于接受青蒿琥酯治疗的患者(50/50比44/50，P=0.027，相对危险度1.14，95%可信区间1.03~1.26)，但3个月的完全缓解率低于接受三氯苯达唑治疗的患者(38/50比46/50，P=0.05，RR0.83，95%CI0.69~0.98，青蒿琥酯与三氯苯达唑比较)。青蒿琥酯可能在肝片吸虫病中起作用。
Human fascioliasis caused by Fasciola hepatica or Fasciola gigantica is an increasing global problem. The mainstay of current treatment is triclabendazole, but resistance in animals has been described, and it is not available in many countries. The antimalarial artesunate has an excellent safety profile, and there is increasing evidence of its efficacy against other parasites both in vitro and in vivo. We performed a study to investigate the usefulness of artesunate in symptomatic human fascioliasis; 100 patients were enrolled. Patients treated with artesunate were significantly more likely to be free of abdominal pain at hospital discharge (50/50 versus 44/50, P = 0.027, relative risk 1.14, 95% confidence interval 1.03-1.26), but the complete response rate at 3 months was lower than for patients treated with triclabendazole (38/50 versus 46/50, P = 0.05, RR 0.83, 95% CI 0.69-0.98, artesunate versus triclabendazole). There may be a role for artesunate in fascioliasis.