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Evidence summaries

Diethylcarbamazine or Ivermectine for Bancroftian Filariasis

Ivermectine may be slightly less effective than diethylcarbamazine at suppressing miclofilaria counts and lowering microfilaria prevalence. Level of evidence: "C"

A systematic review 1 including 15 studies (8 RCTs compared ivermectine with diethylcarbamazine) with a total of 748 subjects was abstracted in DARE. In the dose-finding trials, approximately 90% of patients became microfilaraemia negative within one week after treatment. After 1 month, microfilariae were detected in one third, and by 3 months in about three-quarters. 80% of patients experienced at least one adverse event. The most commonly reported were fever (80%), headache (72%), weakness (49%), myalgia (48%). During the first month of treatment, miclofilaria-density was 1.5% to 1.9% in participants treated with ivermectine compared to 3.6% of those given standard course of DEC and 18.9% of those given the single dose of DEC. The standard DEC treatment seemed to be the most effective in suppression of microfilaraemia at two years follow-up. Systemic adverse effects were similar for both drugs. However, some studies demonstrated that localised reactions were more prominent with DEC.

Comment: The quality of evidence is downgraded by sparse data and limitations of review methodology.

References

Primary/Secondary Keywords