Treatment of patients with Schistosomiasis mansoni: a double blind clinical trial comparing praziquantel with oxamniquine

Abstract

SUMMARYA double-blind clinical trial involving 120 patients with chronic schistosomiasis was carried out to compare the tolerability and efficacy of praziquantel and oxamniquine. The patients were randomly allocated into two groups. One was treated with praziquantel, 55 mg/kg of body weight CBWT), and the other one with oxamniquine, 15mg/kg bwt, administered in a single oral dose. The diagnosis and the parasitological follow-up was based on stool examinations by quantitative Kato-Katz method and on rectal biopsies. Side-effects -mainly dizziness, sleepness, abdominal distress, headache, nausea and diarrhea -were observed in 87% of the cases. Their incidence, intensity and duration were similar for both drugs but abdominal pain was significantly more frequent after praziquantel intake and severe dizziness was more commonly reported after oxamniquine. A significant increase of alanine-aminotransferase and y-glutamyltransferase was found with the latter drug and of total bilirubin with the former one. A total of 48 patients treated with praziquantel and 46 with oxamniquine completed with negative findings the required three post-treatment parasitological controls -three slides of each stool sample on the first, third and sixth month. The achieved cure rates were 79.2% and 84.8%, respectively, a difference without statistical significance. The non-cured cases showed a mean reduction in the number of eggs per gram of feces of 93.5% after praziquantel and of 84.1% after oxamniquine. This diference also was not significant. Five patients retreated with praziquantel were cured but only one out of three treated a second time with oxamniquine. These findings show that both drugs -despite their different chemical structures, pharmacological properties and mechanisms-of-action -induce similar sid&effects as well as a comparable therapeutical efficacy, in agreement with the results reported from analogous investigations.

Long‐Term Results of Esophagogastric Devascularization and Splenectomy Associated with Endoscopic Treatment in Schistosomal Portal Hypertension

“…In contrast to patients suffering from cirrhosis, the Schistosomal population is represented by young, economically active individuals with preserved hepatic function [9, 10].…”

The efficacy of human schistosomicide treatment may depend on the rate of transmission

“…In some studies, it has been observed that there are no differences in the efficacy of these two drugs (Branchini et al 1982;Silva et al 1986;Zwingenberger et al 1987;Incani et al 1987;Santiago et al 1988). Some authors have reported a synergistic effect experimentally when these drugs are used in combination due to the preferential effect of each drug over female or male adult parasites (Delgado et al 1992).…”

Safety of praziquantel in persons with and without schistosomiasis: systematic review and meta-analysis

“…The search retrieved 3202 studies; 3047 studies from electronic databases and 155 studies from other sources including grey literature and contacts with experts. Seventy-three ( 73 Ninety-four of the 134 studies (70.1%) were conducted in Africa; 17 studies (12.7%) in Asia of which eight were conducted in Philippines (Belizario et al 2007;Olds et al 1999c;Olliaro et al 2011c;Olveda et al 2016;Santos et al 1979;Santos et al 1984;Watt 1986;Watt et al 1988), seven in China (Fu-Yuan et al 1984;Hou et al 2008;Minggang et al 1983;Minggang et al 1985;Ming-he 1991;Olds et al 1999a;Qian 2016), one in Japan (Ishizaki 1979) and one in Thailand (Na-bangchang et al 2006); 15 studies (11.2%) were conducted in the Americas, 14 in Brazil Carvalho et al 1984;Coutinho et al 1983;Da Cuhna et al 1987;da Cunha and Pedrosa 1986;da Silva et al 1981;da Silva et al 1986;de Quieroz et al 2010;Ferrari et al 2003;Katz et al 1979;Katz et al 1982;Katz et al 1983;Olliaro et al 2011a) and one in the USA (Nash et al 1982); four studies (3.0%) in the Middle East, two in Saudi Arabia (Al-Aska et al 1990;Azher et al 1990), one in Israel (Cherit et al 2014) and one in Yemen (Groning et al 1985); and three studies (2.2%) in Europe, one each France, Germany and Spain (Bagheri et al 2004;Bada et al 1988) (Table 1<...>…”