title: Enhanced efficacy of sequential administration of Albendazole for the clearance of Wuchereria bancrofti infection: Double blind RCT.
abstract: Till today, there is no effective treatment protocol for the complete clearance of Wuchereria bancrofti (W.b) infection that causes secondary lymphoedema. In a double blind randomized control trial (RCT), 146 asymptomatic W. b infected individuals were randomly assigned to one of the four regimens for 12 days, DEC 300 mg + Doxycycline 100 mg coadministration or DEC 300 mg + Albendazole 400 mg co-administration or DEC 300 mg + Albendazole 400 mg sequential administration or control regimen DEC 300 mg and were followed up at 13, 26 and 52 weeks post-treatment for the clearance of infection. At intake, there was no significant variation in mf counts (F(3,137)=0.044; P=0.988) and antigen levels (F(3,137)=1.433; P=0.236) between the regimens. Primary outcome analysis showed that DEC + Albendazole sequential administration has an enhanced efficacy over DEC + Albendazole co-administration (80.6 Vs 64.7%), and this regimen is significantly different when compared to DEC + doxycycline co-administration and control (P<0.05), in clearing microfilaria in 13 weeks. Secondary outcome analysis showed that, all the trial regimens were comparable to control regimen in clearing antigen (F(3, 109)=0.405; P=0.750). Therefore, DEC + Albendazole sequential administration appears to be a better option for rapid clearance of W. b microfilariae in 13 weeks time. (Clinical trials.gov identifier - NCT02005653).
authors.affiliation: Unit of Clinical Epidemiology & Chemotherapy, Vector Control Research Centre, Pondicherry, India.
authors.forename: R L
authors.initials: RL
authors.lastname: De Britto
authors.affiliation: All India Institute of Medical Sciences, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Vanamail
authors.affiliation: Unit of Microbiology & Immunology, Vector Control Research Centre, Pondicherry, India.
authors.forename: T
authors.initials: T
authors.lastname: Sankari
authors.affiliation: Unit of Clinical Epidemiology & Chemotherapy, Vector Control Research Centre, Pondicherry, India.
authors.forename: G
authors.initials: G
authors.lastname: Vijayalakshmi
authors.affiliation: Unit of Clinical Epidemiology & Chemotherapy, Vector Control Research Centre, Pondicherry, India.
authors.forename: L K
authors.initials: LK
authors.lastname: Das
authors.affiliation: Faculty of Medicine, Quest International University Perak, Malaysia.
authors.forename: S P
authors.initials: SP
authors.lastname: Pani
mesh_terms: D000328:Adult; D015766:Albendazole / Q000008:administration & dosage*; D000818:Animals; D004049:Diethylcarbamazine / Q000008:administration & dosage; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005368:Filariasis / Q000188:drug therapy*; D005369:Filaricides / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014958:Wuchereria bancrofti / Q000187:drug effects*
chemical_list: D005369:Filaricides; D015766:Albendazole; D004318:Doxycycline; D004049:Diethylcarbamazine