Effects of albendazole treatment on neurocysticercosis: a randomised controlled trial
- A Carpio1,2,
- E A Kelvin2,3,
- E Bagiella4,
- D Leslie5,6,
- P Leon7,
- H Andrews3,4,
- W A Hauser2,8,
- the Ecuadorian Neurocysticercosis Group
- 1School of Medicine, University of Cuenca, Cuenca, Ecuador
- 2GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, USA
- 3Data Coordinating Center at the New York State Psychiatric Institute and Columbia University, New York, USA
- 4Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, USA
- 5MRI Diagnostics of Westchester, New York, USA
- 6Good Samaritan Hospital, Suffern, New York, USA
- 7Instituto de Diagnóstico por Imágenes, Cuenca, Ecuador
- 8Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
- W A Hauser, Gertrude H Sergievsky Center, Columbia University, 622 West 168th Street, New York, NY 10032, USA; wahausera{at}optonline.net
- Received 18 January 2008
- Revised 27 March 2008
- Accepted 1 April 2008
- Published Online First 21 May 2008
Abstract
Aim: The aim of this trial was to evaluate the effects of albendazole (ALB) on cyst disappearance, reduction of the number of cysts and seizure recurrence.
Methods: 178 patients with new onset symptoms due to active or transitional neurocysticercosis were randomly assigned to receive either 800 mg of ALB daily or placebo for 8 days. All patients also received prednisone. Imaging studies were done at baseline and at months 1, 6 and 12 of follow-up.
Results: Active cysts were identified in 59 of 88 people randomised to ALB and 57 of the 90 in the placebo arm. By 1 month, 31% were free of active cysts in the treatment group compared with 7% in the placebo group (p = 0.001). In addition, the ALB group had a greater reduction in the number of active cysts compared with the placebo group (p = 0.001). After 1 month following treatment there was no additional gain by treatment group in the disappearance or reduction in the number of active cysts. ALB treatment had little effect on cysts in the transitional or calcification stage. We found no difference between the ALB and placebo groups in symptoms during treatment or in seizure recurrence during the 12 months after treatment.
Conclusion: Albendazole plus symptomatic treatment leads to the disappearance of active cysts in 31% of patients compared with 7% of those with symptomatic treatment alone. This treatment effect occurs within the first 30 days after treatment.
Trial registration number: NCT00283699.
Footnotes
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Competing interests: None.
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Funding: This study was supported by NINDS grant #R01-NS39403; Glaxo/SKB and Acromax Co supplied active drug and placebo.
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The Ecuadorian Neurocysticercosis Group: Noemi Lisanti, (“Comprehensive Epilepsy Center”, Cuenca), Rafael Aguirre, (“Teodoro Maldonado” Hospital, Guayaquil), Marcos Serrano, (“Carlos Andrade Marín” Hospital, Quito), Jorge Pesantes, Jorge Moncayo, (“Eugenio Espejo” Hospital, Quito) and Marcelo Roman, (“Baca Ortiz” Hospital, Quito).
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Ethics approval: Approval for the study was granted by the Institutional Review Board of Columbia University, the Office for Human Research Protection (OHRP) of the National Institutes of Health in the USA, as well as the ethics committees at each of the participating hospitals.
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See Editorial Commentary, p 978
