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Effect of Albendazole Dose on Treatment of Lymphatic Filariasis

Phase 2
Completed
Conditions
Lymphatic Filariasis
Interventions
Registration Number
NCT00511004
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief Summary

This study is conducted in Kerala, India. It will determine whether a new treatment regimen of albendazole and diethylcarbamazine (DEC) for lymphatic filariasis can eliminate the disease more quickly than the standard regimen. Lymphatic filariasis is caused by infection with very small parasitic worms that are spread by mosquitoes. The disease can cause swelling of the arms, legs, breast and scrotum and can progress to permanent swelling of the legs or arms called elephantiasis. The study will see if a higher and more frequent dose of albendazole is better at clearing filarial worms from the blood than the current treatment.

Healthy people between 18 and 55 years of age who are in good health and who are infected with filarial worms may be eligible for this study.

Participants undergo the following procedures:

3-day hospital stay at the Filariasis Chemotherapy Unit of the T.D. Medical College Hospital in Kerala, India

* Random assignment to receive either: 400 mg albendazole and DEC 300 mg given once a year for 2 years (standard treatment); or 800 mg albendazole and DEC 300 mg given once a year for 2 years; or 800 mg albendazole and DEC 300 mg given twice a year for 2 years.

* Urine pregnancy test for women of childbearing age .

* Ultrasound test to look for filarial worms.

* Treatment dose.

* Monitoring for symptoms

6-month 3-day hospital stay

* Medical history, physical examination and blood test.

* Repeat ultrasound in subjects whose first ultrasound detected adult worms.

* Treatment dose for subjects receiving medicine every 6 months.

* Urine pregnancy test for women of childbearing age.

1-year 3-day hospital stay

* Medical history, physical examination and blood test.

* Treatment dose.

* Repeat ultrasound in subjects whose first ultrasound detected adult worms.

* Urine pregnancy test for women of childbearing age.

18-month 3-day hospital stay

* Medical history, physical examination and blood test.

* Treatment dose for subjects receiving medicine every 6 months.

* Urine pregnancy test for women of childbearing age.

24-month 3-day hospital stay

* Medical history, physical examination and blood test.

* Treatment dose.

* Repeat ultrasound in subjects whose first ultrasound detected adult worms.

* Urine pregnancy test for women of childbearing age.

Detailed Description

Albendazole and diethylcarbamazine (DEC) are currently used in combination for annual mass treatment of lymphatic filariasis in all parts of the world except Africa. Although the drugs have been donated, the cost of such programs is very high and has proven to be a major impediment to the success of programs in many countries with limited financial resources. Data from albendazole treatment of other filarial infections and one study comparing single to multi-dose DEC/albendazole in lymphatic filariasis suggest that increased dose and/or frequency of albendazole dosing may be more effective in clearing microfilariae. In this study, 75 volunteers with microfilaremic Brugia malayi infection will be randomized to receive standard annual therapy (albendazole 400 mg + DEC 300 mg), annual therapy with increased dosing of albendazole (albendazole 800 mg + DEC 300 mg), or semiannual therapy with an increased albendazole dose (albendazole 800 mg + DEC 300 mg). Microfilarial levels will be followed every 6 months for 2 years to determine whether the higher dose, and/or the more frequent regimen, is more effective.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Diethylcarbamazine/Albendazole -STDAlbendazoleStandard therapy of DEC (300mg) and albendazole (400mg) yearly
Diethylcarbamazine/Albendazole- HD1AlbendazoleHigh dose of DEC (300mg) and albendazole (800mg) yearly
Diethylcarbamazine/Albendazole -STDDiethylcarbamazineStandard therapy of DEC (300mg) and albendazole (400mg) yearly
Diethylcarbamazine/Albendazole- HD1DiethylcarbamazineHigh dose of DEC (300mg) and albendazole (800mg) yearly
Diethylcarbamazine/Albendazole-HD2AlbendazoleHigh dose of DEC (300mg) and albendazole (800mg) twice yearly (every 6 months)
Diethylcarbamazine/Albendazole-HD2DiethylcarbamazineHigh dose of DEC (300mg) and albendazole (800mg) twice yearly (every 6 months)
Primary Outcome Measures
NameTimeMethod
Microfilarial Counts at 1 Year1 year from time enrolled

Night time microfilarial counts at 1 year

Secondary Outcome Measures
NameTimeMethod
Microfilarial Levels at 2 Years2 years from time enrolled

Night time microfilarial levels at 2 years

Adult Worm Burdens at 2 Years2 years from the time enrolled.

Doppler detected worm nests at 2 years

Brugia Specific Immunoglobulin G4 (IgG4) Antibodies2 years

IgG4 antibodies directed against Brugia malayi antigen

Trial Locations

Locations (1)

Filariasis Chemotherapy Unit (FCU), T.D. Medical Hospital

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Alleppey, Kerala, India

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