Centre Suisse de Recherche Scientifique en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
Université Nangui Abrogoua, Abidjan, Côte d'Ivoire.
Clin Infect Dis. 2022 Jul 6;74(12):2200-2208. doi: 10.1093/cid/ciab194.
Ivermectin (IVM) plus albendazole (ALB), or IA, is widely used in mass drug administration (MDA) programs that aim to eliminate lymphatic filariasis (LF) in Africa. However, IVM can cause severe adverse events in persons with heavy Loa loa infections that are common in Central Africa. ALB is safe in loiasis, but more information is needed on its efficacy for LF. This study compared the efficacy and safety of 3 years of semiannual treatment with ALB to annual IA in persons with bancroftian filariasis.
Adults with Wuchereria bancrofti microfilaremia (Mf) were randomized to receive either 3 annual doses of IA (N = 52), 6 semiannual doses of ALB 400 mg (N = 45), or 6 semiannual doses of ALB 800 mg (N = 47). The primary outcome is amicrofilaremia at 36 months.
IA was more effective for completely clearing Mf than ALB 400mg or ALB 800mg (79%, 95% confidence interval [CI]: 67-91; vs 48%, 95% CI: 32-66 and 57%, 95% CI: 41-73, respectively). Mean percentage reductions in Mf counts at 36 months relative to baseline tended to be greater after IA (98%, 95% CI: 88-100) than after ALB 400 mg (88%, 95% CI: 78-98) and ALB 800 mg (89%, 95% CI: 79-99) (P = .07 and P = .06, respectively). Adult worm nest numbers (assessed by ultrasound) were reduced in all treatment groups. Treatments were well tolerated.
Repeated semiannual treatment with ALB is macrofilaricidal for W. bancrofti and leads to sustained reductions in Mf counts. This is a safe and effective regimen that could be used as MDA to eliminate LF in areas where ivermectin cannot be used.
NCT02974049.
伊维菌素（IVM）加阿苯达唑（ALB），或 IA，广泛用于旨在消除非洲淋巴丝虫病（LF）的大规模药物管理（MDA）计划。然而，IVM 会在 Loa loa 感染严重的人中引起严重的不良事件，而 Loa loa 感染在中非很常见。ALB 在 loiasis 中是安全的，但需要更多关于其对 LF 疗效的信息。本研究比较了 3 年半年度 ALB 治疗与 IA 治疗在班氏丝虫病患者中的疗效和安全性。
有微丝蚴血症（Mf）的班氏吴策线虫成年人被随机分配接受 3 次 IA 年度剂量（N=52）、6 次 ALB 400mg 半年度剂量（N=45）或 6 次 ALB 800mg 半年度剂量（N=47）。主要结局是 36 个月时的微丝蚴血症。
IA 对完全清除 Mf 的效果优于 ALB 400mg 或 ALB 800mg（79%，95%置信区间[CI]：67-91；分别为 48%，95%CI：32-66 和 57%，95%CI：41-73）。与基线相比，36 个月时 Mf 计数的平均百分比降低趋势IA（98%，95%CI：88-100）高于 ALB 400mg（88%，95%CI：78-98）和 ALB 800mg（89%，95%CI：79-99）（P=0.07 和 P=0.06）。所有治疗组的成虫巢数量（通过超声评估）均减少。治疗均耐受良好。
重复半年度 ALB 治疗对 W. bancrofti 具有杀成虫作用，并导致 Mf 计数持续减少。这是一种安全有效的方案，可用于 MDA 在不能使用伊维菌素的地区消除 LF。
NCT02974049。
