Comparison of high dose ivermectin and diethylcarbamazine for activity against bancroftian filariasis in Haiti.
Identifieur interne : 005C07 ( PubMed/Corpus ); précédent : 005C06; suivant : 005C08Comparison of high dose ivermectin and diethylcarbamazine for activity against bancroftian filariasis in Haiti.
Auteurs : F O Richards ; M L Eberhard ; R T Bryan ; D F Mcneeley ; P J Lammie ; M B Mcneeley ; Y. Bernard ; A W Hightower ; H C SpencerSource :
- The American journal of tropical medicine and hygiene [ 0002-9637 ] ; 1991.
English descriptors
- KwdEn :
- Adolescent, Adult, Animals, Diethylcarbamazine (therapeutic use), Double-Blind Method, Drug Tolerance, Elephantiasis, Filarial (blood), Elephantiasis, Filarial (drug therapy), Female, Follow-Up Studies, Haiti, Humans, Ivermectin (therapeutic use), Male, Microfilariae (drug effects), Microfilariae (growth & development), Middle Aged, Wuchereria bancrofti (drug effects), Wuchereria bancrofti (growth & development).
- MESH :
- chemical , therapeutic use : Diethylcarbamazine, Ivermectin.
- blood : Elephantiasis, Filarial.
- drug effects : Microfilariae, Wuchereria bancrofti.
- drug therapy : Elephantiasis, Filarial.
- growth & development : Microfilariae, Wuchereria bancrofti.
- Adolescent, Adult, Animals, Double-Blind Method, Drug Tolerance, Female, Follow-Up Studies, Haiti, Humans, Male, Middle Aged.
Abstract
This three-phase study was designed to compare high dose ivermectin with a standard diethylcarbamazine (DEC) regimen for patient tolerability, potential to kill adult filaria, and duration of microfilarial suppression in 30 Haitian subjects with Wuchereria bancrofti microfilaremia. All were first given a 1-mg oral dose of ivermectin (phase 1) to reduce microfilaria densities. Participants were randomized into three groups: Group 1 received DEC (6mg/kg per day for 12 days), Group 2 received 200 mcg/kg of ivermectin, and Group 3 received 400 mcg/kg of ivermectin (200 mcg/kg per day for 2 days). All drug regimens were well tolerated with few adverse reactions. Most reactions occurred during phase I and consisted primarily of headache, fever, and myalgia. At the end of phase 1, 27 of 30 (90%) patients were microfilaria negative. During phase 2, four of the six men receiving DEC developed scrotal reactions suggesting killing adult worms; no such reactions were noted in 10 men receiving ivermectin (p less than 0.05). At one-year follow up (phase 3), all treatment groups had less than 10% return to pretreatment microfilaria levels. The mean percent of baseline microfilaria counts were for Group 1, 0.9% (range 0-5%); Group 2, 8.2% (range 0-31%); and Group 3, 3.8% (range 0-25%). Seven individuals in Group 1 were microfilaria-negative, while only one and three individuals were microfilaria-negative in Groups 2 and 3, respectively. These results suggest that DEC causes more damage to the adult worms and greater reduction in microfilaria densities than ivermectin, but that high doses of ivermectin may suppress microfilaremia in lymphatic filariasis for periods much longer than previously reported.
PubMed: 1996738
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pubmed:1996738Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of high dose ivermectin and diethylcarbamazine for activity against bancroftian filariasis in Haiti.</title>
<author><name sortKey="Richards, F O" sort="Richards, F O" uniqKey="Richards F" first="F O" last="Richards">F O Richards</name>
<affiliation><nlm:affiliation>Division of Parasitic Diseases, Centers for Disease Control, US Department of Health and Human Services, Atlanta, GA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Eberhard, M L" sort="Eberhard, M L" uniqKey="Eberhard M" first="M L" last="Eberhard">M L Eberhard</name>
</author>
<author><name sortKey="Bryan, R T" sort="Bryan, R T" uniqKey="Bryan R" first="R T" last="Bryan">R T Bryan</name>
</author>
<author><name sortKey="Mcneeley, D F" sort="Mcneeley, D F" uniqKey="Mcneeley D" first="D F" last="Mcneeley">D F Mcneeley</name>
</author>
<author><name sortKey="Lammie, P J" sort="Lammie, P J" uniqKey="Lammie P" first="P J" last="Lammie">P J Lammie</name>
</author>
<author><name sortKey="Mcneeley, M B" sort="Mcneeley, M B" uniqKey="Mcneeley M" first="M B" last="Mcneeley">M B Mcneeley</name>
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<author><name sortKey="Bernard, Y" sort="Bernard, Y" uniqKey="Bernard Y" first="Y" last="Bernard">Y. Bernard</name>
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<author><name sortKey="Hightower, A W" sort="Hightower, A W" uniqKey="Hightower A" first="A W" last="Hightower">A W Hightower</name>
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<author><name sortKey="Spencer, H C" sort="Spencer, H C" uniqKey="Spencer H" first="H C" last="Spencer">H C Spencer</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Comparison of high dose ivermectin and diethylcarbamazine for activity against bancroftian filariasis in Haiti.</title>
<author><name sortKey="Richards, F O" sort="Richards, F O" uniqKey="Richards F" first="F O" last="Richards">F O Richards</name>
<affiliation><nlm:affiliation>Division of Parasitic Diseases, Centers for Disease Control, US Department of Health and Human Services, Atlanta, GA.</nlm:affiliation>
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<author><name sortKey="Eberhard, M L" sort="Eberhard, M L" uniqKey="Eberhard M" first="M L" last="Eberhard">M L Eberhard</name>
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<author><name sortKey="Bryan, R T" sort="Bryan, R T" uniqKey="Bryan R" first="R T" last="Bryan">R T Bryan</name>
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<author><name sortKey="Mcneeley, D F" sort="Mcneeley, D F" uniqKey="Mcneeley D" first="D F" last="Mcneeley">D F Mcneeley</name>
</author>
<author><name sortKey="Lammie, P J" sort="Lammie, P J" uniqKey="Lammie P" first="P J" last="Lammie">P J Lammie</name>
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<author><name sortKey="Mcneeley, M B" sort="Mcneeley, M B" uniqKey="Mcneeley M" first="M B" last="Mcneeley">M B Mcneeley</name>
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<author><name sortKey="Bernard, Y" sort="Bernard, Y" uniqKey="Bernard Y" first="Y" last="Bernard">Y. Bernard</name>
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<author><name sortKey="Hightower, A W" sort="Hightower, A W" uniqKey="Hightower A" first="A W" last="Hightower">A W Hightower</name>
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<author><name sortKey="Spencer, H C" sort="Spencer, H C" uniqKey="Spencer H" first="H C" last="Spencer">H C Spencer</name>
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<series><title level="j">The American journal of tropical medicine and hygiene</title>
<idno type="ISSN">0002-9637</idno>
<imprint><date when="1991" type="published">1991</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Animals</term>
<term>Diethylcarbamazine (therapeutic use)</term>
<term>Double-Blind Method</term>
<term>Drug Tolerance</term>
<term>Elephantiasis, Filarial (blood)</term>
<term>Elephantiasis, Filarial (drug therapy)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Haiti</term>
<term>Humans</term>
<term>Ivermectin (therapeutic use)</term>
<term>Male</term>
<term>Microfilariae (drug effects)</term>
<term>Microfilariae (growth & development)</term>
<term>Middle Aged</term>
<term>Wuchereria bancrofti (drug effects)</term>
<term>Wuchereria bancrofti (growth & development)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Diethylcarbamazine</term>
<term>Ivermectin</term>
</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Microfilariae</term>
<term>Wuchereria bancrofti</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="growth & development" xml:lang="en"><term>Microfilariae</term>
<term>Wuchereria bancrofti</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Animals</term>
<term>Double-Blind Method</term>
<term>Drug Tolerance</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Haiti</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
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<front><div type="abstract" xml:lang="en">This three-phase study was designed to compare high dose ivermectin with a standard diethylcarbamazine (DEC) regimen for patient tolerability, potential to kill adult filaria, and duration of microfilarial suppression in 30 Haitian subjects with Wuchereria bancrofti microfilaremia. All were first given a 1-mg oral dose of ivermectin (phase 1) to reduce microfilaria densities. Participants were randomized into three groups: Group 1 received DEC (6mg/kg per day for 12 days), Group 2 received 200 mcg/kg of ivermectin, and Group 3 received 400 mcg/kg of ivermectin (200 mcg/kg per day for 2 days). All drug regimens were well tolerated with few adverse reactions. Most reactions occurred during phase I and consisted primarily of headache, fever, and myalgia. At the end of phase 1, 27 of 30 (90%) patients were microfilaria negative. During phase 2, four of the six men receiving DEC developed scrotal reactions suggesting killing adult worms; no such reactions were noted in 10 men receiving ivermectin (p less than 0.05). At one-year follow up (phase 3), all treatment groups had less than 10% return to pretreatment microfilaria levels. The mean percent of baseline microfilaria counts were for Group 1, 0.9% (range 0-5%); Group 2, 8.2% (range 0-31%); and Group 3, 3.8% (range 0-25%). Seven individuals in Group 1 were microfilaria-negative, while only one and three individuals were microfilaria-negative in Groups 2 and 3, respectively. These results suggest that DEC causes more damage to the adult worms and greater reduction in microfilaria densities than ivermectin, but that high doses of ivermectin may suppress microfilaremia in lymphatic filariasis for periods much longer than previously reported.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">1996738</PMID>
<DateCreated><Year>1991</Year>
<Month>03</Month>
<Day>27</Day>
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<DateCompleted><Year>1991</Year>
<Month>03</Month>
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<DateRevised><Year>2016</Year>
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<JournalIssue CitedMedium="Print"><Volume>44</Volume>
<Issue>1</Issue>
<PubDate><Year>1991</Year>
<Month>Jan</Month>
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</JournalIssue>
<Title>The American journal of tropical medicine and hygiene</Title>
<ISOAbbreviation>Am. J. Trop. Med. Hyg.</ISOAbbreviation>
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<ArticleTitle>Comparison of high dose ivermectin and diethylcarbamazine for activity against bancroftian filariasis in Haiti.</ArticleTitle>
<Pagination><MedlinePgn>3-10</MedlinePgn>
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<Abstract><AbstractText>This three-phase study was designed to compare high dose ivermectin with a standard diethylcarbamazine (DEC) regimen for patient tolerability, potential to kill adult filaria, and duration of microfilarial suppression in 30 Haitian subjects with Wuchereria bancrofti microfilaremia. All were first given a 1-mg oral dose of ivermectin (phase 1) to reduce microfilaria densities. Participants were randomized into three groups: Group 1 received DEC (6mg/kg per day for 12 days), Group 2 received 200 mcg/kg of ivermectin, and Group 3 received 400 mcg/kg of ivermectin (200 mcg/kg per day for 2 days). All drug regimens were well tolerated with few adverse reactions. Most reactions occurred during phase I and consisted primarily of headache, fever, and myalgia. At the end of phase 1, 27 of 30 (90%) patients were microfilaria negative. During phase 2, four of the six men receiving DEC developed scrotal reactions suggesting killing adult worms; no such reactions were noted in 10 men receiving ivermectin (p less than 0.05). At one-year follow up (phase 3), all treatment groups had less than 10% return to pretreatment microfilaria levels. The mean percent of baseline microfilaria counts were for Group 1, 0.9% (range 0-5%); Group 2, 8.2% (range 0-31%); and Group 3, 3.8% (range 0-25%). Seven individuals in Group 1 were microfilaria-negative, while only one and three individuals were microfilaria-negative in Groups 2 and 3, respectively. These results suggest that DEC causes more damage to the adult worms and greater reduction in microfilaria densities than ivermectin, but that high doses of ivermectin may suppress microfilaremia in lymphatic filariasis for periods much longer than previously reported.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Richards</LastName>
<ForeName>F O</ForeName>
<Initials>FO</Initials>
<Suffix>Jr</Suffix>
<AffiliationInfo><Affiliation>Division of Parasitic Diseases, Centers for Disease Control, US Department of Health and Human Services, Atlanta, GA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Eberhard</LastName>
<ForeName>M L</ForeName>
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</Author>
<Author ValidYN="Y"><LastName>Bryan</LastName>
<ForeName>R T</ForeName>
<Initials>RT</Initials>
</Author>
<Author ValidYN="Y"><LastName>McNeeley</LastName>
<ForeName>D F</ForeName>
<Initials>DF</Initials>
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<Author ValidYN="Y"><LastName>Lammie</LastName>
<ForeName>P J</ForeName>
<Initials>PJ</Initials>
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<Author ValidYN="Y"><LastName>McNeeley</LastName>
<ForeName>M B</ForeName>
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<Author ValidYN="Y"><LastName>Bernard</LastName>
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<Author ValidYN="Y"><LastName>Hightower</LastName>
<ForeName>A W</ForeName>
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<Author ValidYN="Y"><LastName>Spencer</LastName>
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<Language>eng</Language>
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<MedlineJournalInfo><Country>United States</Country>
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<Chemical><RegistryNumber>V867Q8X3ZD</RegistryNumber>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
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<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
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<MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName>
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<MeshHeading><DescriptorName UI="D004049" MajorTopicYN="N">Diethylcarbamazine</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
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<MeshHeading><DescriptorName UI="D004311" MajorTopicYN="N">Double-Blind Method</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004361" MajorTopicYN="N">Drug Tolerance</DescriptorName>
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<MeshHeading><DescriptorName UI="D004605" MajorTopicYN="N">Elephantiasis, Filarial</DescriptorName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006205" MajorTopicYN="N">Haiti</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007559" MajorTopicYN="N">Ivermectin</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008842" MajorTopicYN="N">Microfilariae</DescriptorName>
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<QualifierName UI="Q000254" MajorTopicYN="N">growth & development</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014958" MajorTopicYN="Y">Wuchereria bancrofti</DescriptorName>
<QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName>
<QualifierName UI="Q000254" MajorTopicYN="N">growth & development</QualifierName>
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