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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Doxycycline Improves Filarial Lymphedema Independent of Active Filarial Infection: A Randomized Controlled Trial</title><author><name sortKey="Mand, Sabine" sort="Mand, Sabine" uniqKey="Mand S" first="Sabine" last="Mand">Sabine Mand</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Debrah, Alexander Yaw" sort="Debrah, Alexander Yaw" uniqKey="Debrah A" first="Alexander Yaw" last="Debrah">Alexander Yaw Debrah</name><affiliation><nlm:aff id="af3"><addr-line>Faculty of Allied Health Sciences</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Klarmann, Ute" sort="Klarmann, Ute" uniqKey="Klarmann U" first="Ute" last="Klarmann">Ute Klarmann</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af2"><addr-line>Institute for Medical Biometry, Informatics and Epidemiology</addr-line>,<institution>University Hospital Bonn</institution>,<country>Germany</country></nlm:aff></affiliation></author><author><name sortKey="Batsa, Linda" sort="Batsa, Linda" uniqKey="Batsa L" first="Linda" last="Batsa">Linda Batsa</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Marfo Debrekyei, Yeboah" sort="Marfo Debrekyei, Yeboah" uniqKey="Marfo Debrekyei Y" first="Yeboah" last="Marfo-Debrekyei">Yeboah Marfo-Debrekyei</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Kwarteng, Alexander" sort="Kwarteng, Alexander" uniqKey="Kwarteng A" first="Alexander" last="Kwarteng">Alexander Kwarteng</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Specht, Sabine" sort="Specht, Sabine" uniqKey="Specht S" first="Sabine" last="Specht">Sabine Specht</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Belda Domene, Aurea" sort="Belda Domene, Aurea" uniqKey="Belda Domene A" first="Aurea" last="Belda-Domene">Aurea Belda-Domene</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Fimmers, Rolf" sort="Fimmers, Rolf" uniqKey="Fimmers R" first="Rolf" last="Fimmers">Rolf Fimmers</name><affiliation><nlm:aff id="af2"><addr-line>Institute for Medical Biometry, Informatics and Epidemiology</addr-line>,<institution>University Hospital Bonn</institution>,<country>Germany</country></nlm:aff></affiliation></author><author><name sortKey="Taylor, Mark" sort="Taylor, Mark" uniqKey="Taylor M" first="Mark" last="Taylor">Mark Taylor</name><affiliation><nlm:aff id="af6"><addr-line>Liverpool School of Tropical Medicine</addr-line>,<country>United Kingdom</country></nlm:aff></affiliation></author><author><name sortKey="Adjei, Ohene" sort="Adjei, Ohene" uniqKey="Adjei O" first="Ohene" last="Adjei">Ohene Adjei</name><affiliation><nlm:aff id="af4"><addr-line>Komfo Anokye Teaching Hospital, School of Medical Sciences</addr-line>,<institution>Kwame Nkrumah University of Science and Technology</institution></nlm:aff></affiliation></author><author><name sortKey="Hoerauf, Achim" sort="Hoerauf, Achim" uniqKey="Hoerauf A" first="Achim" last="Hoerauf">Achim Hoerauf</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22610930</idno><idno type="pmc">3412691</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412691</idno><idno type="RBID">PMC:3412691</idno><idno type="doi">10.1093/cid/cis486</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002D55</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D55</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Doxycycline Improves Filarial Lymphedema Independent of Active Filarial Infection: A Randomized Controlled Trial</title><author><name sortKey="Mand, Sabine" sort="Mand, Sabine" uniqKey="Mand S" first="Sabine" last="Mand">Sabine Mand</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Debrah, Alexander Yaw" sort="Debrah, Alexander Yaw" uniqKey="Debrah A" first="Alexander Yaw" last="Debrah">Alexander Yaw Debrah</name><affiliation><nlm:aff id="af3"><addr-line>Faculty of Allied Health Sciences</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Klarmann, Ute" sort="Klarmann, Ute" uniqKey="Klarmann U" first="Ute" last="Klarmann">Ute Klarmann</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af2"><addr-line>Institute for Medical Biometry, Informatics and Epidemiology</addr-line>,<institution>University Hospital Bonn</institution>,<country>Germany</country></nlm:aff></affiliation></author><author><name sortKey="Batsa, Linda" sort="Batsa, Linda" uniqKey="Batsa L" first="Linda" last="Batsa">Linda Batsa</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Marfo Debrekyei, Yeboah" sort="Marfo Debrekyei, Yeboah" uniqKey="Marfo Debrekyei Y" first="Yeboah" last="Marfo-Debrekyei">Yeboah Marfo-Debrekyei</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Kwarteng, Alexander" sort="Kwarteng, Alexander" uniqKey="Kwarteng A" first="Alexander" last="Kwarteng">Alexander Kwarteng</name><affiliation><nlm:aff id="af5"><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></nlm:aff></affiliation></author><author><name sortKey="Specht, Sabine" sort="Specht, Sabine" uniqKey="Specht S" first="Sabine" last="Specht">Sabine Specht</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Belda Domene, Aurea" sort="Belda Domene, Aurea" uniqKey="Belda Domene A" first="Aurea" last="Belda-Domene">Aurea Belda-Domene</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Fimmers, Rolf" sort="Fimmers, Rolf" uniqKey="Fimmers R" first="Rolf" last="Fimmers">Rolf Fimmers</name><affiliation><nlm:aff id="af2"><addr-line>Institute for Medical Biometry, Informatics and Epidemiology</addr-line>,<institution>University Hospital Bonn</institution>,<country>Germany</country></nlm:aff></affiliation></author><author><name sortKey="Taylor, Mark" sort="Taylor, Mark" uniqKey="Taylor M" first="Mark" last="Taylor">Mark Taylor</name><affiliation><nlm:aff id="af6"><addr-line>Liverpool School of Tropical Medicine</addr-line>,<country>United Kingdom</country></nlm:aff></affiliation></author><author><name sortKey="Adjei, Ohene" sort="Adjei, Ohene" uniqKey="Adjei O" first="Ohene" last="Adjei">Ohene Adjei</name><affiliation><nlm:aff id="af4"><addr-line>Komfo Anokye Teaching Hospital, School of Medical Sciences</addr-line>,<institution>Kwame Nkrumah University of Science and Technology</institution></nlm:aff></affiliation></author><author><name sortKey="Hoerauf, Achim" sort="Hoerauf, Achim" uniqKey="Hoerauf A" first="Achim" last="Hoerauf">Achim Hoerauf</name><affiliation><nlm:aff id="af1"><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></nlm:aff></affiliation></author></analytic><series><title level="j">Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Treatment with doxycycline leads to improvement of filarial lymphedema independent of active infection (ie, patients positive or negative for circulating filarial antigen). Therefore, doxycycline (200 mg/d for 6 weeks) should be considered for patients with stage 1–3 lymphedema to improve morbidity management.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Clin. Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">cid</journal-id><journal-id journal-id-type="hwp">cid</journal-id><journal-title-group><journal-title>Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</journal-title></journal-title-group><issn pub-type="ppub">1058-4838</issn><issn pub-type="epub">1537-6591</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22610930</article-id><article-id pub-id-type="pmc">3412691</article-id><article-id pub-id-type="doi">10.1093/cid/cis486</article-id><article-id pub-id-type="publisher-id">cis486</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles and Commentaries</subject></subj-group><series-title>Editor's choice</series-title></article-categories><title-group><article-title>Doxycycline Improves Filarial Lymphedema Independent of Active Filarial Infection: A Randomized Controlled Trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Mand</surname><given-names>Sabine</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="author-notes" rid="FN1">a</xref></contrib><contrib contrib-type="author"><name><surname>Debrah</surname><given-names>Alexander Yaw</given-names></name><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af5">5</xref><xref ref-type="author-notes" rid="FN1">a</xref></contrib><contrib contrib-type="author"><name><surname>Klarmann</surname><given-names>Ute</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="author-notes" rid="FN1">a</xref></contrib><contrib contrib-type="author"><name><surname>Batsa</surname><given-names>Linda</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Marfo-Debrekyei</surname><given-names>Yeboah</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Kwarteng</surname><given-names>Alexander</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Specht</surname><given-names>Sabine</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Belda-Domene</surname><given-names>Aurea</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Fimmers</surname><given-names>Rolf</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Taylor</surname><given-names>Mark</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Adjei</surname><given-names>Ohene</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Hoerauf</surname><given-names>Achim</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Institute for Medical Microbiology, Immunology and Parasitology</addr-line></aff><aff id="af2"><label>2</label><addr-line>Institute for Medical Biometry, Informatics and Epidemiology</addr-line>,<institution>University Hospital Bonn</institution>,<country>Germany</country></aff><aff id="af3"><label>3</label><addr-line>Faculty of Allied Health Sciences</addr-line></aff><aff id="af4"><label>4</label><addr-line>Komfo Anokye Teaching Hospital, School of Medical Sciences</addr-line>,<institution>Kwame Nkrumah University of Science and Technology</institution></aff><aff id="af5"><label>5</label><addr-line>Kumasi Centre for Collaborative Research in Tropical Medicine</addr-line>,<country>Ghana</country></aff><aff id="af6"><label>6</label><addr-line>Liverpool School of Tropical Medicine</addr-line>,<country>United Kingdom</country></aff><author-notes><fn id="FN1"><label>a</label><p>S. M., A. Y. D., and U. K. contributed equally to this study.</p></fn><corresp>Correspondence: Ute Klarmann, MD, Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany (<email>ute.klarmann@ukb.uni-bonn.de</email>).</corresp></author-notes><pub-date pub-type="ppub"><day>1</day><month>9</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>18</day><month>5</month><year>2012</year></pub-date><volume>55</volume><issue>5</issue><fpage>621</fpage><lpage>630</lpage><history><date date-type="received"><day>29</day><month>12</month><year>2011</year></date><date date-type="accepted"><day>30</day><month>4</month><year>2012</year></date></history><permissions><copyright-statement>© The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.</copyright-statement><copyright-year>2012</copyright-year><license license-type="creative-commons"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/byc/3.0">http://creativecommons.org/licenses/byc/3.0</ext-link>), which permits unrestricted nonommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="cis486.pdf"></self-uri><abstract abstract-type="precis"><p>Treatment with doxycycline leads to improvement of filarial lymphedema independent of active infection (ie, patients positive or negative for circulating filarial antigen). Therefore, doxycycline (200 mg/d for 6 weeks) should be considered for patients with stage 1–3 lymphedema to improve morbidity management.</p></abstract><abstract><p><bold><italic>Background.</italic></bold> The aim of this study was to determine whether improvement of filarial lymphedema (LE) by doxycycline is restricted to patients with ongoing infection (positive for circulating filarial antigen [CFA]), or whether the majority of CFA-negative patients with LE would also show a reduction in LE severity.</p><p><bold><italic>Methods.</italic></bold> One hundred sixty-two Ghanaian participants with LE stage 1–5 (Dreyer) were randomized blockwise into 2 groups (CFA positive or negative) and allocated to 3 treatment arms of 6 weeks: (1) amoxicillin (1000 mg/d), (2) doxycycline (200 mg/d), or (3) placebo matching doxycycline. All groups received standard hygiene morbidity management. The primary outcome was reduction of LE stages. Secondary outcomes included frequency of acute attacks and ultrasonographic assessment of skin thickness at the ankles. Parameters were assessed before treatment and after 3, 12, and 24 months.</p><p><bold><italic>Results.</italic></bold> Doxycycline-treated patients with LE stage 2–3 showed significant reductions in LE severity after 12 and 24 months, regardless of CFA status. Improvement was observed in 43.9% of doxycycline-treated patients, compared with only 3.2% and 5.6% in the amoxicillin and placebo arms, respectively. Skin thickness was correlated with LE stage improvement. Both doxycycline and amoxicillin were able to reduce acute dermatolymphangioadenitis attacks.</p><p><bold><italic>Conclusions.</italic></bold> Doxycycline treatment improves mild to moderate LE independent of ongoing infection. This finding expands the benefits of doxycycline to the entire population of patients suffering from LE. Patients with LE stage 1–3 should benefit from a 6-week course of doxycycline every other year or yearly, which should be considered as an improved tool to manage morbidity in filarial LE.</p><p><bold><italic>Clinical Trials Registration.</italic></bold> ISRCTN 90861344.</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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