Tolerance and Efficacy of Single High-Dose Ivermectin for the Treatment of Loiasis

Martin‐Prével, Yves; Cosnefroy, Jean‐Yves; Tshipamba, Paul; Ngari, Paul; Chodakewitz, Jeffrey A.; Pinder, Margaret

doi:10.4269/ajtmh.1993.48.186

Cited by 58 publications

(30 citation statements)

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“…The peak number of events occurred slightly earlier in the DEC group, paralleling earlier peaks in both serum IL-5 and CD69 expression post-DEC. These findings are consistent with the tendency toward more rapid and complete microfilarial killing following single-dose DEC therapy and are supported by the data from prior single drug studies in loiasis and other filarial infections in which the peak of AEs following DEC is typically within 8 hours [15,16] compared with 24-36 hours post-IVM [17][18][19][20][21] (Supplementary Table 3).…”

Section: Discussionsupporting

confidence: 77%

Posttreatment Reactions After Single-Dose Diethylcarbamazine or Ivermectin in Subjects With Loa loa Infection

Herrick

Legrand

Gounoue

et al. 2017

Clinical Infectious Diseases

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Background. Severe adverse reactions have been observed in individuals withLoa loa infection treated with either diethylcarbamazine (DEC), the drug of choice for loiasis, or ivermectin (IVM), which is used in mass drug administration programs for control of onchocerciasis and lymphatic filariasis in Africa. In this study, posttreatment clinical and immunologic reactions were compared following single-dose therapy with DEC or IVM to assess whether these reactions have the same underlying pathophysiology.Methods. Twelve patients with loiasis and microfilarial counts <2000 mf/mL were randomized to receive single-dose DEC (8 mg/kg) or IVM (200 µg/kg). Clinical and laboratory assessments were performed at 4, 8, 24, 48, and 72 hours and 5, 7, 9, and 14 days posttreatment.Results. Posttreatment adverse events were similar following DEC or IVM, but peaked earlier in subjects who received DEC, consistent with a trend toward more rapid and complete microfilarial clearance in the DEC group. After a transient rise (post-IVM) or fall (post-DEC) in the first 24 hours posttreatment, the eosinophil count rose significantly in both groups, peaking at day 5 in the DEC group and day 9 in the IVM group. Serum interleukin 5 levels and eosinophil activation, as assessed by surface expression of CD69 and serum levels of eosinophil granule proteins, were increased posttreatment in both groups.Conclusions. Despite differences in eosinophil and lymphocyte counts during the first 24 hours posttreatment, the overall pattern of hematologic and immunologic changes suggest that posttreatment reactions following DEC and IVM share a common pathophysiology.Clinical Trials Registration. NCT01593722.

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Section: Discussionsupporting

confidence: 77%

Posttreatment Reactions After Single-Dose Diethylcarbamazine or Ivermectin in Subjects With Loa loa Infection

Herrick

Legrand

Gounoue

et al. 2017

Clinical Infectious Diseases

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“…The long-term effect reported in the present study indicates that ivermectin may also reduce the production of new mff. As suggested by Martin-Prével et al (1993), ivermectin could have a long-term effect on the reproductive activity, or longevity, of the adult worms. Further studies are needed to resolve this issue, which may have important implications for those attempting to limit the risk of Loa-associated encephalopathy following ivermectin treatment.…”

Section: Discussionmentioning

confidence: 96%

Loiasis: the individual factors associated with the presence of microfilaraemia

Pion

Demanou

Oudin

et al. 2005

Annals of Tropical Medicine & Parasitology

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No microfilariae are detectable in a significant percentage of those infected with the filarial worm Loa loa. While the probability of an infected individual becoming microfilaraemic is known to increase with age, the mechanisms underlying this trend are not well understood. Epidemiological data from an endemic village in central Cameroon were therefore explored, in an attempt to determine if, after taking into account any history of filaricidal treatment, the presence of Loa microfilaraemia in an individual was related to his/her gender, age, and/or exposure to the human-infective larvae of the parasite. An index of exposure, based on the monthly transmission potentials of the Chrysops in each of the main types of vegetation in a village and on the activity schedule of each inhabitant of the village, was developed. The results of the data analysis confirm that the acquisition of microfilaraemia is gender-dependent (males generally being more likely to be microfilaraemic than females), and indicate that, in males, a high level of exposure to infective larvae determines the shift from amicrofilaraemic to microfilaraemic status. They also indicate that filaricidal treatments have a long-lasting suppressive effect on Loa microfilaraemia, an observation that may have important implications for any strategy to limit the risk of Loa-associated encephalopathy following ivermectin treatment.

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“…Foram feitos exames hematológicos, de provas de função renal e hepática, tendo sido todos normais, com exceção de leve eosinofilia. Esse tratamento tem sido recomendado por ser muito menos tóxico que o anterior, com DEC (dietilcarbamazine), que apresentava freqüentes casos de encefalites 16 . Tem sido usada também como tratamento profilático, com doses repetidas a cada três meses, durante dois anos, de 200 µg/kg em populações de áreas endêmicas, onde mais de seiscentas pessoas se submeteram ao tratamento, não apresentando efeitos colaterais importantes e demonstrando assim tratar-se de um método excelente para se erradicar a filariose 5 .…”

Section: Uso Em Seres Humanosunclassified

“…A proposta deste trabalho, portanto, é estudar a possibilidade do tratamento da miíase humana cavitária com a ivermectina oral, uma droga bem conhecida no tratamento da miíase animal apresentando resultados excelentes na erradicação das larvas, e que não apresenta efeitos colaterais no tratamento de outras doenças no ser humano 16 .…”

Section: Uso Em Seres Humanosunclassified

Tratamento da miíase humana cavitária com ivermectina oral

Ribeiro¹,

Pereira²,

Alves³

et al. 2001

Rev. Bras. Otorrinolaringol.

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Treatment of human cavitary myiasis with oral ivermectinResumo / Summary ORIGINAL ARTICLE Introdução: Miíase humana é uma ocorrência relativamente comum e, no mínimo, constrangedora, quer seja para os pacientes ou para o médico que o atende. É bem mais freqüente nos países subdesenvolvidos e tropicais, mas há casos descritos em todas as regiões do Planeta. Normalmente, afeta pacientes doentes, idosos e deficientes mentais, mas pode ocorrer em pacientes tróficos e saudáveis. As larvas depositam seus ovos em tecidos doentes e necróticos, mas podem fazê-lo em zonas do corpo aparentemente sãs. Seu tratamento consiste na catação das larvas, um processo desagradável e doloroso, muitas vezes impossÍvel em regiões cavitárias. Alguns produtos foram usados no sentido de facilitar esse procedimento, sem grandes resultados. Forma de estudo: Prospectivo randomizado. Método: Neste trabalho, foi feito, em sete pacientes, o tratamento da miíase cavitária humana com ivermectina oral (até 300 µg/kg), medicamento já usado para o tratamento de outras doenças. Os pacientes foram submetidos a provas de função hepática e renal pré e pós-tratamento, e acompanhados clinicamente. Resultados: Todos os pacientes tiveram as larvas eliminadas; e nenhuma anormalidade, nos exames.

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Tolerance and Efficacy of Single High-Dose Ivermectin for the Treatment of Loiasis

Cited by 58 publications

References 0 publications

Posttreatment Reactions After Single-Dose Diethylcarbamazine or Ivermectin in Subjects With Loa loa Infection

Posttreatment Reactions After Single-Dose Diethylcarbamazine or Ivermectin in Subjects With Loa loa Infection

Loiasis: the individual factors associated with the presence of microfilaraemia

Tratamento da miíase humana cavitária com ivermectina oral

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