Kumaraswami V, Ottesen E A, Vijayasekaran V, Devi U, Swaminathan M, Aziz M A, Sarma G R, Prabhakar R, Tripathy S P
Tuberculosis Research Centre, Indian Council of Medical Research, Madras.
JAMA. 1988 Jun 3;259(21):3150-3.
Ivermectin treatment was evaluated for efficacy and side effects in 40 patients in South India who had microfilaremia and bancroftian filariasis. Ivermectin was administered once orally at four dose levels (range, 25 to 200 micrograms/kg), and at each it was found to be completely effective in clearing blood microfilariae within five to 12 days. In most patients, microfilariae reappeared by three months; by six months the levels averaged 14% to 32% of pretreatment values in the four study groups, and all groups showed equivalent efficacy. Detailed monitoring identified some side effects in almost all patients: usually fever, headache, light-headedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. These were most frequent and severe in patients with the greatest microfilaremia, but only when treated with the two higher doses of ivermectin (100 and 200 micrograms/kg). The low-dose (25 micrograms/kg) ivermectin group, despite equivalent efficacy in parasite killing, had clinical reaction scores that were minimal and that were not correlated with parasitemia. Since efficacy and side effects of ivermectin therapy compare favorably with those reported for treatment with the standard antifilarial drug diethylcarbamazine citrate, the major advantage of single-oral-dose administration makes ivermectin the best candidate to replace diethylcarbamazine as the treatment of choice for bancroftian filariasis.
在印度南部的40名患有微丝蚴血症和班氏丝虫病的患者中，对伊维菌素治疗的疗效和副作用进行了评估。伊维菌素以四个剂量水平（范围为25至200微克/千克）口服给药一次，发现在每个剂量水平下，它在五至12天内清除血液中的微丝蚴完全有效。在大多数患者中，微丝蚴在三个月时再次出现；到六个月时，四个研究组中的微丝蚴水平平均为治疗前值的14%至32%，且所有组显示出同等疗效。详细监测发现几乎所有患者都有一些副作用：通常为发热、头痛、头晕、肌痛、喉咙痛或咳嗽，这些症状在治疗后18至36小时最为明显。这些症状在微丝蚴血症最严重的患者中最频繁且最严重，但仅在使用两种较高剂量的伊维菌素（100和200微克/千克）治疗时出现。低剂量（25微克/千克）伊维菌素组尽管在杀灭寄生虫方面疗效相同，但其临床反应评分极低，且与寄生虫血症无关。由于伊维菌素治疗的疗效和副作用与标准抗丝虫药物枸橼酸乙胺嗪治疗所报告的疗效和副作用相比更具优势，单次口服给药的主要优点使伊维菌素成为替代枸橼酸乙胺嗪作为班氏丝虫病首选治疗药物的最佳候选药物。
