Title
Cysticidal efficacy of combined treatment with praziquantel and albendazole for parenchymal brain cysticercosis
Date Issued
01 June 2016
Access level
open access
Resource Type
journal article
Publisher(s)
Oxford University Press
Abstract
Background. The efficacy of current antiparasitic treatment for cerebral Taenia solium cysticercosis with either albendazole (ABZ) or praziquantel (PZQ) is suboptimal. A recent study demonstrated that combining these 2 antiparasitic drugs improves antiparasitic efficacy. We present here the parasiticidal efficacy data obtained during a previous phase II pharmacokinetic study that compared combined ABZ plus PZQ with ABZ alone. Methods. The study was a randomized, double-blinded, placebo-controlled phase II evaluation of the pharmacokinetics of ABZ (15 mg/k/d, for 10 days) and PZQ (50 mg/k/d, for 10 days) in intraparenchymal brain cysticercosis. Patients received the usual concomitant medications, including an antiepileptic drug (phenytoin or carbamazepine), dexamethasone, and ranitidine. Randomization was stratified by antiepileptic drug. Patients underwent safety laboratory evaluations at days 4, 7, and 11, as well as magnetic resonance (MR) imaging at 6 months to assess parasiticidal efficacy. Results. Thirty-two patients were included, 16 in each arm. All of them completed antiparasitic treatment and underwent follow-up brain MR imaging. Cysticidal efficacy was strikingly higher in the combined ABZ-plus-PZQ group than in the ABZ-alone group (proportion of cysts resolved, 78 of 82 [95%] vs 23 of 77 [30%] [relative risk {RR}, 3.18; 95% confidence interval {CI}, 2.08-4.88; P <. 001]; patients with complete cyst clearance, 12 of 16 [75%] vs 4 of 16 [25%] [RR, 3.00; 95% CI, 1.23-7.34; P =. 005]). Conclusions. The combination of ABZ plus PZQ is more effective in destroying viable brain cysticercosis cysts than ABZ alone.
Start page
1375
End page
1379
Volume
62
Issue
11
Language
English
OCDE Knowledge area
Parasitología Neurociencias
Scopus EID
2-s2.0-84971578326
PubMed ID
Source
Clinical Infectious Diseases
ISSN of the container
1058-4838
Sponsor(s)
This study was funded by the National Institute of Neurological Diseases and Stroke, NIH (grant R01 054805), Fogarty International Center, NIH (training grants TW001140 for the training of study team members and 2D43 TW00739 to A. G. L.), and Wellcome Trust (International Senior Research Fellowship in Public Health and Tropical Medicine to H. H. G.). Medical Research Council - MR/K007467/1 .
Sources of information: Directorio de Producción Científica Scopus