Pharmacokinetics, safety, and efficacy of a single co-administered dose of diethylcarbamazine, albendazole and ivermectin in adults with and without Wuchereria bancrofti infection in Côte d'Ivoire.

Bibliographic Details
Title: Pharmacokinetics, safety, and efficacy of a single co-administered dose of diethylcarbamazine, albendazole and ivermectin in adults with and without Wuchereria bancrofti infection in Côte d'Ivoire.
Authors: Constant Edi, Catherine M Bjerum, Allassane F Ouattara, Yashpal S Chhonker, Louis K Penali, Aboulaye Méité, Benjamin G Koudou, Gary J Weil, Christopher L King, Daryl J Murry
Source: PLoS Neglected Tropical Diseases, Vol 13, Iss 5, p e0007325 (2019)
Publisher Information: Public Library of Science (PLoS), 2019.
Publication Year: 2019
Collection: LCC:Arctic medicine. Tropical medicine
LCC:Public aspects of medicine
Subject Terms: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
More Details: BackgroundA single co-administered dose of ivermectin (IVM) plus diethylcarbamazine (DEC) plus albendazole (ALB), or triple-drug therapy, was recently found to be more effective for clearing microfilariae (Mf) than standard DEC plus ALB currently used for mass drug administration programs for lymphatic filariasis (LF) outside of sub-Saharan Africa. Triple-drug therapy has not been previously tested in LF-uninfected individuals from Africa. This study evaluated the pharmacokinetics (PK), safety, and efficacy of triple-drug therapy in people with and without Wuchereria bancrofti infection in West Africa.MethodsIn this open-label cohort study, treatment-naïve microfilaremic (>50 mf/mL, n = 32) and uninfected (circulating filarial antigen negative, n = 24) adults residing in Agboville district, Côte d'Ivoire, were treated with a single dose of IVM plus DEC plus ALB, and evaluated for adverse events (AEs) until 7 days post treatment. Drug levels were assessed by liquid chromatography and mass spectrometry. Persons responsible for assessing AEs were blinded to participants' infection status.FindingsThere was no difference in AUC0-inf or Cmax between LF-infected and uninfected participants (P>0.05 for all comparisons). All subjects experienced mild AEs; 28% and 25% of infected and uninfected participants experienced grade 2 AEs, respectively. There were no severe or serious adverse events. Only fever (16 of 32 versus 4 of 24, PConclusionsModerate to heavy W. bancrofti infection did not affect PK parameters for IVM, DEC or ALB following a single co-administered dose of these drugs compared to uninfected individuals. The drugs were well tolerated. This study confirmed the efficacy of the triple-drug therapy for clearing W. bancrofti Mf and has added important information to support the use of this regimen in LF elimination programs in areas of Africa without co-endemic onchocerciasis or loiasis.Trial registrationClinicalTrials.gov NCT02845713.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1935-2727
1935-2735
Relation: https://doaj.org/toc/1935-2727; https://doaj.org/toc/1935-2735
DOI: 10.1371/journal.pntd.0007325
Access URL: https://doaj.org/article/e858831dfe9c42ae826008b594ce3094
Accession Number: edsdoj.858831dfe9c42ae826008b594ce3094
Database: Directory of Open Access Journals
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More Details
ISSN:19352727
19352735
DOI:10.1371/journal.pntd.0007325
Published in:PLoS Neglected Tropical Diseases
Language:English