Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Zaha, Osamu; Hirata, Tetsuya; Kinjo, Fukunori; Saitô, Atsushi; Fukuhara, Hiroshi

doi:10.1007/s101560200013

Cited by 76 publications

(52 citation statements)

References 10 publications

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“…As expected, the use of relatively polar solvents, such as toluene and tetrahydrofuran (THF), reduced selectivity (entries 7,8). Unexpectedly, acetylation in N,N-dimethylformamide (DMF) gave the C-4″-O-acetylate 10a as a major isomer (9a : 10a=1.0 : 5.2 (entry 9)).…”

Section: Resultssupporting

confidence: 61%

“…1). Ivermectin (1, 2), a mixture of dihydro derivatives of avermectins B 1a (3) and B 1b (4), is used to treat internal and external parasites, [2][3][4] including those that cause onchocerciasis, 5) lymphatic filariasis, 6) strongyloidiasis, 7) and scabies 8) in humans and external parasites and insect vectors, such as mites. 9) Indeed, over 300 million people are taking ivermectin once annually to combat onchocerciasis and lymphatic filariasis.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Organocatalytic Site-Selective Acylation of Avermectin B<sub>2a</sub>, a Unique Endectocidal Drug

Yamada

Suzuki

Hirose

et al. 2016

CHEMICAL & PHARMACEUTICAL BULLETIN

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The organocatalytic site-selective monoacylation of avermectin B 2a , an insecticidal and anti-parasitic drug, was accomplished. Although an acetylation of avermectin B 2a using a 4-dimethylaminopyridine (DMAP) as a catalyst gave poor site-selectivity, use of our organocatalyst increased site-selectivity of the acylation at the C-5-OH as well as the yield of monoacetate. This catalyst was also effective in other acylations. Interestingly, trihaloacetylation under same conditions gave poor site-selectivity. However, the use of an enantiomer of our organocatalyst provided the C-4″-O-trihaloacetyl avermectin B 2a with excellent siteselectivity. These results indicate that the site-selective acylation of avermectin B 2a can be controlled by the combination of a suitable organocatalyst and an acid anhydride.

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Section: Resultssupporting

confidence: 61%

mentioning

confidence: 99%

Organocatalytic Site-Selective Acylation of Avermectin B<sub>2a</sub>, a Unique Endectocidal Drug

Yamada

Suzuki

Hirose

et al. 2016

CHEMICAL & PHARMACEUTICAL BULLETIN

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“…Single dose of Ivermectin (200 microgram per kilogram of bodyweight) orally was also shown to have superior cure rate of 97% vs 63% with high dose Albendazole 800mg orally daily for seven days [41] . Currently, oral Ivermectin in the dose of 200 microgram per kilogram of bodyweight repeated on two consecutive days or after 2 wk is the preferred drug for treatment of Strongyloides stercoralis (Table 4) [48,49] . In patients who cannot tolerate it orally, alternate routes like subcutaneous administration of Ivermectin has been advised [50] .…”

Section: Sensitivity and Specificity Remarksmentioning

confidence: 99%

Strongyloidiasis: A case with acute pancreatitis and a literature review

Makker¹,

Balar²,

Niazi³

et al. 2015

WJG

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Strongyloides stercoralis, a soil transmitted helminth infection, affects millions with varying prevalence worldwide. A large number of affected hosts are asymptomatic. Symptoms pertaining to pulmonary and gastrointestinal involvement may be present. Manifestations of involvement beyond lung and intestine can be seen with dissemination of infection and lethal hyperinfection. Immunosuppression secondary to use of steroids or other immunosuppressants and coexistence of human T-lymphotropic virus type-1 are the known risk factors for dissemination and hyperinfection. Diagnostic modalities comprise stool examination, serology and molecular testing. Stool tests are inexpensive but are limited by low sensitivity, whereas serologic and molecular tests are more precise but at the expense of higher cost. Treatment with Ivermectin or Albendazole as an alternative is safe and efficacious. We present a rare case of acute pancreatitis secondary to Strongyloides. High index of suspicion in patients specifically from endemic countries of origin and lack of other common etiologies of acute pancreatitis may help in early diagnosis and prompt treatment of this potentially fatal infection.

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“…However, this response rate was lower than expected. Previous studies with the same drug regimens (2,10,14,25,41,43,61,62) reported eradication rates ranging from 85% to 100%. Given the absence of a reference diagnostic strategy, these studies employed a variety of follow-up protocols.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of an Indirect Immunofluorescence Assay for Strongyloidiasis as a Tool for Diagnosis and Follow-Up

Boscolo

Gobbo

Mantovani

et al. 2007

Clin Vaccine Immunol

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The diagnostic accuracy of an indirect immunofluorescence antibody test (IFAT) for Strongyloides stercoralis at different serum antibody titers was evaluated. To assess diagnostic sensitivity, sera from 156 patients with known strongyloidiasis were collected. Negative control sera were obtained from a composite group of 427 subjects (blood donors and hospitalized patients). With an area under the receiver-operating characteristic plot of 0.98, the IFAT showed a high level of diagnostic accuracy for strongyloidiasis. An antibody titer of >1:20, with 97% sensitivity and 98% specificity, was identified as the diagnostic threshold with the best overall performance. Cross-reactions were evaluated with 41 additional samples from patients with other known helminth infections, and the IFAT detected low-titer positivity in only one subject with filariasis. A positive IFAT result at an antibody dilution of >1:80 was virtually 100% specific, with 71% sensitivity. To test the usefulness of the IFAT as a monitoring tool, the changes in specific-antibody titers after treatment in a group of 155 patients were evaluated. Seroreversion or a decrease in antibody titer of twofold or more was observed in 60% of the patients. Response to treatment was directly correlated to the initial antibody titer, and a baseline titer of >1:80 was identified as the best predictor of response. In conclusion, a positive IFAT result at an antibody dilution of >1:20 is the optimal cutoff for screening. A titer of >1:80, with virtually no false-positive result, is a reliable cutoff for a serological assessment of treatment efficacy and for inclusion in clinical trials.

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Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Cited by 76 publications

References 10 publications

Organocatalytic Site-Selective Acylation of Avermectin B<sub>2a</sub>, a Unique Endectocidal Drug

Organocatalytic Site-Selective Acylation of Avermectin B<sub>2a</sub>, a Unique Endectocidal Drug

Strongyloidiasis: A case with acute pancreatitis and a literature review

Evaluation of an Indirect Immunofluorescence Assay for Strongyloidiasis as a Tool for Diagnosis and Follow-Up

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