title: Ivermectin 400 micrograms/kg: long-term suppression of microfilariae in Bancroftian filariasis.
abstract: Forty-three Wuchereria bancrofti carriers were given 4 successive semi-annual single doses of ivermectin 100 micrograms/kg (IVER 100). The geometric mean microfilaremia (mf) recurrence percentages, compared to the pre-initial treatment mf level, were 35%, 21%, 17% and 17% at 6, 12, 18 and 24 months respectively. However, the recurrence of mf 6 months after the fourth treatment remained high in 15 individuals, considered as 'bad responders'. At month 24, the subjects were randomly allocated into 2 groups: the first group was treated with a fifth dose of IVER 100 and the second with a first, single dose of 400 micrograms/kg of ivermectin (IVER 400). At month 30, the mf recurrence percentage was significantly higher in patients treated with IVER 100 than in those receiving IVER 400 (61% vs. 8%, P < 0.05). In the IVER 100 group, 6 of the 8 'bad responders' remained 'bad responders', whereas only 2 of 7 did so in the IVER 400 group. Only 3 additional patients in the IVER 100 group became consistently amicrofilaraemic, whereas 9 did so in the IVER 400 group. Two 'good responders' in the IVER 100 group became 'bad responders'. A single dose of 400 micrograms/kg of ivermectin has been demonstrated to be efficient for the treatment of carriers refractory to repeated doses of 100 micrograms/kg and to result in better long-term mf suppression. These results suggest a possible effect of 400 micrograms/kg of ivermectin on macrofilaria.
authors.affiliation: Institut Territorial de Recherches Médicales Louis Malardé, B.P., Tahiti, Polynése Française.
authors.forename: J P
authors.initials: JP
authors.lastname: Moulia-Pelat
authors.forename: P
authors.initials: P
authors.lastname: Glaziou
authors.forename: L N
authors.initials: LN
authors.lastname: Nguyen
authors.forename: S
authors.initials: S
authors.lastname: Chanteau
authors.forename: R
authors.initials: R
authors.lastname: Plichart
authors.forename: I
authors.initials: I
authors.lastname: Beylier
authors.forename: P M
authors.initials: PM
authors.lastname: Martin
authors.forename: J L
authors.initials: JL
authors.lastname: Cartel
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002353:Carrier State / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004605:Elephantiasis, Filarial / Q000188:drug therapy*; D006801:Humans; D007559:Ivermectin / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D014958:Wuchereria bancrofti
chemical_list: D007559:Ivermectin