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Albendazole sulfoxide plasma levels and efficacy of antiparasitic treatment in patients with parenchymal neurocysticercosis

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dc.contributor.author Arroyo Hurtado, Gianfranco
dc.contributor.author Bustos Palomino, Javier Arturo
dc.contributor.author Lescano Guevara, Andres Guillermo
dc.contributor.author Gonzales, Isidro
dc.contributor.author Saavedra Pastor, Herbert
dc.contributor.author Rodriguez, Silvia
dc.contributor.author Pretell, E. Javier
dc.contributor.author Bonato, Pierina S.
dc.contributor.author Lanchote, Vera L.
dc.contributor.author Takayanagui, Osvaldo M.
dc.contributor.author Horton, John
dc.contributor.author Gonzalez Zariquiey, Armando Emiliano
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author García Lescano, Héctor Hugo
dc.date.accessioned 2019-07-04T16:59:18Z
dc.date.available 2019-07-04T16:59:18Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6716
dc.description.abstract Background: The efficacy of albendazole therapy in patients with parenchymal neurocysticercosis (NCC) is suboptimal. Plasma levels of albendazole sulfoxide (ASOX), the active metabolite of albendazole, are highly variable among patients. We hypothesized that high ASOX plasma levels during albendazole therapy may be associated with an increased antiparasitic efficacy. Methods: ASOX plasma levels were measured at treatment day 7 in 118 patients with parenchymal NCC enrolled in a treatment trial. The relationships between increasing ASOX plasma levels with the proportion of cysts resolved and the proportion of patients with complete cyst resolution (evaluated by 6-month brain magnetic resonance) were assessed. Results: There was a trend toward a higher proportion of cysts resolved and a higher proportion of patients cured with increasing quartiles of ASOX plasma levels. In patients with 3 or more brain cysts, the regression analysis adjusted by the concomitant administration of praziquantel (PZQ) showed a 2-fold increase in the proportion of cysts resolved (risk ratio [RR], 1.98; 95% confidence interval [CI], 1.01–3.89; P = .048) and 2.5-fold increase in the proportion of patients cured (RR, 2.45; 95% CI, .94–6.36; P = .067) when ASOX levels in the highest vs the lowest quartile were compared. No association was found in patients with 1–2 brain cysts. Conclusions: We suggest an association between high ASOX plasma levels and increased antiparasitic efficacy in patients with parenchymal NCC. Nonetheless, this association is also influenced by other factors including parasite burden and concomitant administration of PZQ. These findings may serve to individualize and/or adjust therapy schemes to avoid treatment failure. en_US
dc.description.sponsorship Este trabajo fue parcialmente financiado por el Consejo Nacional de Ciencia, Tecnología e Innovación del Perú [CONCYTEC/CIENCIA ACTIVA, beca EF033-235-2015] es_PE
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Clinical Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject albendazole en_US
dc.subject albendazole sulfoxide en_US
dc.subject praziquantel en_US
dc.subject neurocysticercosis en_US
dc.title Albendazole sulfoxide plasma levels and efficacy of antiparasitic treatment in patients with parenchymal neurocysticercosis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/cid/ciz085
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1537-6591


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