Ivermectin in Loiasis and Concomitant O. Volvulus and M. Perstans Infections

Dominique Richard-Lenoble Department of Parasitology and Tropical Diseases, CUSS, Libreville, Gabon

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Maryvonne Kombila Department of Parasitology and Tropical Diseases, CUSS, Libreville, Gabon

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Elizabeth A. Rupp Merck Sharp & Dohme Research Laboratories, Rahway, New Jersey 07065

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Elaine S. Pappayliou Merck Sharp & Dohme Research Laboratories, Rahway, New Jersey 07065

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Philippe Gaxotte Laboratoire Merck Sharp & Dohme, Chibret, Paris, France

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Christophe Nguiri Department of Parasitology and Tropical Diseases, CUSS, Libreville, Gabon

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Mohammed A. Aziz Merck Sharp & Dohme Research Laboratories, Rahway, New Jersey 07065

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DOI:
https://doi.org/10.4269/ajtmh.1988.39.480
Volume/Issue:
Volume 39: Issue 5
Page(s):
480–483
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Two clinical studies were carried out in Gabon, Africa to evaluate the efficacy, safety, and tolerability of ivermectin in the treatment of patients with Loa loa infection. In the first study, 35 patients received single oral doses of ivermectin, 5–200 mcg/kg body weight. Blood microfilariae levels did not decrease after a single oral 5, 10, 30, or 50 mcg/kg dose of ivermectin, but levels did decrease after doses of 100, 150, and 200 mcg/kg. The most efficacious dose was 200 mcg/kg; mean blood microfilariae levels decreased to 12% of mean pretreatment values by day 15 and remained decreased for 28 days.

A second study evaluated the safety and efficacy of ivermectin in patients with multifilarial infections. All 17 patients had concomitant Loa loa and O. volvulus infection. M. perstans affected 5 of the patients. Sixteen patients also had infections due to intestinal nematodes. The patients each received single oral doses of 200 mcg/kg ivermectin. Ten days later, the mean Loa loa blood microfilariae level had decreased to 20% of the mean pretreatment level. O. volvulus dermal microfilariae densities were reduced to 2% of the pretreatment levels. A minimal increase in blood microfilaria levels was observed on day 28. In contrast, dermal microfilariae levels remained near zero for the duration of the study. Intestinal infection due to Ascaris was eradicated in all of the affected patients by day 23; efficacy against Trichuris and hookworm infections, however, was poor. All patients tolerated ivermectin well including those with multiple infections.

Author Notes

Deceased.

Address reprint requests to: Elaine S. Pappayliou, Clinical Pharmacology, Merck Sharpe & Dohme Research Laboratories, P.O. Box 2000, Rahway, NJ 07065.

Copyright:
Copyright © 1988 by The American Society of Tropical Medicine and Hygiene 1988
Published Online:
Nov 1988
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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