MedPath

Ivermectin/ Permethrin for Scabies

Phase 4
Completed
Conditions
Scabies
Interventions
Registration Number
NCT05819983
Lead Sponsor
Universitas Padjadjaran
Brief Summary

Scabies is a skin disease characterized by intense itching that worsens at night. It is very contagious, still has a high occurrence rate, and impacts patient quality of life. The use of scabicide followed by a clean and healthy lifestyle is the principle of scabies therapy. The primary treatment option for scabies is permethrin 5% cream. Ivermectin is an alternate treatment for scabies.

Detailed Description

Permethrin acts by disrupting the sodium channel current, resulting in delayed repolarization, paralysis, and death of the parasite. Sodium channels are ubiquitous and therefore permethrin acts at all stages of the life cycle of the parasite. Permethrin 5% cream is applied overnight once a week for two weeks to the entire body. This drug has a number of negative side effects, such as being expensive, uncomfortable, less applicable, and in some cases resistant to permethrin. Ivermectin is an alternate treatment for scabies and should be administered twice, one week apart. Ivermectin acts by binding selectively and with high affinity to glutamate-gated chloride ion channels, which are present in invertebrate nerve and muscle cells, resulting in paralysis and death of the parasite. Two doses of ivermectin one week apart are recommended for scabies treatment. Due to its specific site of action, ivermectin may not be effective against the younger stages of the parasite inside the egg because the nervous system has not yet developed. This drug is safe, more affordable, more practical to use, and has minimal side effects. The disadvantage of ivermectin is it does not kill all the stages of S. scabiei, necessitating multiple doses. According to several earlier research, topical permethrin is just as effective as oral ivermectin at one or two doses.

There hasn't been any research on how well three doses of oral ivermectin treat scabies. As a result of no data, our trial is looking forward to answering the comparison of the effectiveness between three dosages of oral ivermectin, two dosages of oral ivermectin, and two applications of topical permethrin in scabies patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Male or female
  • Age 6 years or above
  • Body weight 15kg or above
  • Clinical establishment of diagnosed scabies
Exclusion Criteria
  • Pregnant or breastfeeding woman
  • Scabies with secondary infection
  • Scabies with eczematization
  • History of receiving scabies treatment in the last four weeks
  • History of drug hypersensitivity

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Oral ivermectin 2 dosages and placeboIvermectin TabletsTwenty patients will be administered randomly oral ivermectin 200µg/kg BW on days 1 and 8 and also oral placebo on day 2, placebo cream on days 1 and 8 Placebo cream: Cream base
Permethrin 5% cream 2 applications and placeboPermethrin CreamTwenty patients will be administered randomly permethrin 5% cream on days 1 and 8 and also oral placebo on days 1, 2, and 8 Placebo: vitamin B complex
Oral ivermectin 3 dosages and placeboIvermectin TabletsTwenty patients will be administered randomly oral ivermectin 200µg/kg BW on days 1, 2, and 8 and also placebo cream on days 1 and 8 Placebo cream: Cream base
Primary Outcome Measures
NameTimeMethod
The severity of scabetic lesions5 weeks

Determined by counting the number of lesions and graded as:

0 = Free of lesions (no scabies) 10 or fewer lesions = Mild 11-49 lesions= Moderate 50 or more lesions= Severe

The severity of pruritus5 weeks

Evaluated by the patients graded on a scale 0-10 (using VAS score):

0= No pruritus 1-3= Mild 4-6= Moderate 7-10= Severe

Secondary Outcome Measures
NameTimeMethod
Clinical improvement4 weeks

Defined as a reduction in both the number of lesions and symptoms and graded as:

Mild= Less than 50% reduction in the number of lesions and pruritus Moderate= More than or equal to 50% reduction in the number of lesions and pruritus Good= Complete clearance of the lesion and pruritus

Side effects4 weeks

Evaluated the side effects after using oral ivermectin or permethrin 5% cream.

Trial Locations

Locations (1)

Ciumbuleuit Public Health Centre

🇮🇩

Bandung, West Java, Indonesia

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