Scientists have discovered a promising new drug combination that could revolutionize treatment for intestinal worm infections, particularly in children. The study, published in The Lancet, shows significantly higher cure rates compared to traditional treatments. Researchers tested the fixed-dose combination across three African countries, finding it more effective against multiple parasite species. This breakthrough could be a game-changer for controlling neglected tropical diseases in endemic regions.
"An FDC of albendazole plus ivermectin has a similar safety profile but superior efficacy" - Barcelona Institute of Global Health Researchers by IANS
New Delhi, Jan 12: A
fixed-dose combination of albendazole and ivermectin may be a better tool
against soil-transmitted helminths, that cause intestinal infections, according
to results of phase II-III clinical trial.
Key Points
1. New
drug combination shows high cure rates against intestinal parasites
2. Clinical
trial tested treatment across multiple African countries
3. Offers potential solution for challenging worm infections
Four species of parasitic worms (Ascaris lumbricoides,
Trichuris trichiura, and the hookworms Ancylostoma duodenale and Necator
americanus) are responsible for soil-transmitted helminthiases (STH). These
parasitic worms get transmitted via contact with contaminated soil or water,
causing a significant impact on nutrition and health, particularly in children
and women of reproductive age.
The results of the randomised clinical trial,
published in the journal The Lancet Infectious Diseases, may help endemic
countries reach the control goals set in WHO's 2021-2030 Roadmap for Neglected
Tropical Diseases.
“Treatments for soil-transmitted helminthiases face
challenges, especially in addressing Trichuris trichiura. Combination regimens,
particularly of ivermectin and albendazole, are promising,” said the
international team of researchers led by the Barcelona Institute of Global
Health (ISGlobal) in Spain.
The study aimed to assess the safety, efficacy, and
palatability of a combination tablet for the treatment of T trichiura,
hookworm, and Strongyloides stercoralis infections among school-aged children
in the African nations Ethiopia, Kenya, and Mozambique.
The current strategy against these infections include
regular deworming treatments with albendazole for at-risk populations, along
with improvements in water, sanitation, and hygiene.
While albendazole is highly efficient against Ascaris
but its efficacy against T. trichiura has been declining, probably due to
emerging drug resistance. Albendazole is also not effective against
Strongyloides stercoralis.
Between January 2022, and March 2023, the team
recruited 1,001 participants (46 per cent were female and 54 per cent were
male).
About 64 per cent were infected with T trichiura, 36
per cent with hookworm, and 10 per cent with S stercoralis. Nine per cent of
the 1,001 participants had co-infections and were included in the analysis of
each infecting species.
A total of 243 participants were allocated to the
albendazole group, 381 to the single dose of a fixed-dose combination (FDC×1)
of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), and 377 to the three
consecutive daily doses (FDC×3) of albendazole (400 mg) plus ivermectin (9 mg
or 18 mg).
In both phase 2 and 3 trials, gastrointestinal
symptoms were the most common mild-to-moderate adverse events in the FDC groups
but resolved within 48 hours without intervention.
For T trichiura, both FDC groups had a higher cure
rate (97·2 per cent for FDC×3 and 82·9 per cent for FDC×1) than albendazole
(35·9 per cent).
For hookworms, FDC×3 had a higher cure rate (95·0 per
cent than albendazole alone (65·1 per cent), whereas FDC×1 had a similar cure
rate (79·8 per cent to albendazole). The sample size for efficacy evaluation of
S stercoralis was not met, the researchers said.
“An FDC of albendazole plus ivermectin has a similar
safety profile but superior efficacy to albendazole alone against T trichiura
infection and hookworms. These findings open opportunities for control of all
soil-transmitted helminth species of interest, including potentially S
stercoralis,” said the team, calling for further studies in larger populations
for evaluation of safety of the drug regimen.
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