Hassan Waleed Attia, Ramadan Haidi Karam-Allah, Gaber Mona, Alkhalil Samia S, Ahmad Alzahraa Abdelraouf
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
Trop Med Infect Dis. 2025 Aug 6;10(8):221. doi: 10.3390/tropicalmed10080221.
Triclabendazole (TCBZ) is the gold standard treatment for fascioliasis. However, reports on resistance are increasing, emphasizing the need for alternative therapy. Combining TCBZ with ivermectin (IVM) was found to be effective for treating animal fascioliasis. Building on this, we aimed to evaluate the efficacy of the TCBZ/IVM combination therapy for human fascioliasis. This study enrolled 136 patients with from Upper Egypt, and they were divided into the first group ( = 65), who received TCBZ monotherapy, and the second group ( = 71), who received the TCBZ/IVM combination. Assessments were to evaluate treatment response based on clinical, eosinophilic, and radiological parameters. Chronic fasciolosis was diagnosed in 17 patients (12.5%). No differences were observed in age and sex. Significant improvements were noted in all parameters in both groups, with more pronounced effects observed in the second group. A significantly higher complete response, including clinical, eosinophilic, and radiological improvements, was reported in the combined therapy group, with 53.3% compared to 26.2% in the monotherapy group ( < 0.001). A high baseline eosinophilic count was significantly associated with response. The efficacy of the TCBZ/IVM combination for treating human fascioliasis suggested a possible boosting effect, which can benefit regions of TCBZ failure. Further large-scale randomized studies are warranted to confirm these findings.
三氯苯达唑（TCBZ）是治疗肝片吸虫病的金标准疗法。然而，关于耐药性的报道日益增多，这凸显了替代疗法的必要性。研究发现，将TCBZ与伊维菌素（IVM）联合使用对治疗动物肝片吸虫病有效。基于此，我们旨在评估TCBZ/IVM联合疗法对人类肝片吸虫病的疗效。本研究招募了136名来自上埃及的患者，他们被分为第一组（n = 65），接受TCBZ单药治疗；第二组（n = 71），接受TCBZ/IVM联合治疗。评估旨在根据临床、嗜酸性粒细胞和影像学参数来评估治疗反应。17名患者（12.5%）被诊断为慢性肝片吸虫病。两组在年龄和性别方面未观察到差异。两组的所有参数均有显著改善，第二组的效果更为明显。联合治疗组报告的完全缓解率显著更高，包括临床、嗜酸性粒细胞和影像学改善，为53.3%，而单药治疗组为26.2%（P < 0.001）。高基线嗜酸性粒细胞计数与反应显著相关。TCBZ/IVM联合疗法治疗人类肝片吸虫病的疗效表明可能存在增效作用，这可能使TCBZ治疗失败的地区受益。有必要进行进一步的大规模随机研究来证实这些发现。
