• Hector H Garcia, Andres G Lescano, Isidro Gonzales, Javier A Bustos, E Javier Pretell, John Horton, Herbert Saavedra, Armando E Gonzalez, Robert H Gilman, and Cysticercosis Working Group in Peru.
• Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurologicas Department of Microbiology, School of Sciences Center for Global Health.
• Clin. Infect. Dis. 2016 Jun 1; 62 (11): 1375-9.

BackgroundThe efficacy of current antiparasitic treatment for cerebral Taenia solium cysticercosis with either albendazole (ABZ) or praziquantel (PZQ) is suboptimal. A recent study demonstrated that combining these 2 antiparasitic drugs improves antiparasitic efficacy. We present here the parasiticidal efficacy data obtained during a previous phase II pharmacokinetic study that compared combined ABZ plus PZQ with ABZ alone.MethodsThe study was a randomized, double-blinded, placebo-controlled phase II evaluation of the pharmacokinetics of ABZ (15 mg/k/d, for 10 days) and PZQ (50 mg/k/d, for 10 days) in intraparenchymal brain cysticercosis. Patients received the usual concomitant medications, including an antiepileptic drug (phenytoin or carbamazepine), dexamethasone, and ranitidine. Randomization was stratified by antiepileptic drug. Patients underwent safety laboratory evaluations at days 4, 7, and 11, as well as magnetic resonance (MR) imaging at 6 months to assess parasiticidal efficacy.ResultsThirty-two patients were included, 16 in each arm. All of them completed antiparasitic treatment and underwent follow-up brain MR imaging. Cysticidal efficacy was strikingly higher in the combined ABZ-plus-PZQ group than in the ABZ-alone group (proportion of cysts resolved, 78 of 82 [95%] vs 23 of 77 [30%] [relative risk {RR}, 3.18; 95% confidence interval {CI}, 2.08-4.88; P < .001]; patients with complete cyst clearance, 12 of 16 [75%] vs 4 of 16 [25%] [RR, 3.00; 95% CI, 1.23-7.34; P = .005]).ConclusionsThe combination of ABZ plus PZQ is more effective in destroying viable brain cysticercosis cysts than ABZ alone.Clinical Trials RegistrationNCT00441285.© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

24 keywords...

hide…