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. 1988 Aug;72(8):561–569. doi: 10.1136/bjo.72.8.561

Effect of single-dose ivermectin therapy on human Onchocerca volvulus infection with onchocercal ocular involvement.

H S Newland 1, A T White 1, B M Greene 1, S A D'Anna 1, E Keyvan-Larijani 1, M A Aziz 1, P N Williams 1, H R Taylor 1
PMCID: PMC1041529  PMID: 3046657

Abstract

Ivermectin has shown promise as a potentially safe and effective microfilaricidal drug for the treatment of onchocerciasis. Several limited studies have shown it to have fewer side effects, especially ocular complications, than the currently available drug, diethylcarbamazine. The detailed ocular findings in 200 moderately to heavily infected Liberians who were enrolled in a safety and dose-finding study are presented. They received either 0, 100, 150, or 200 micrograms/kg of ivermectin and were followed up for 12 months. In clinical studies so far carried out ivermectin in a dose of 100, 150, or 200 micrograms/kg has not been associated with any major adverse reactions nor were there any sight-threatening effects even in the presence of severe ocular disease. Each of these doses significantly reduced the ocular microfilaria load for at least 12 months when compared with either the placebo (p less than 0.05) or pretreatment values (p less than 0.001). However, the 100 and 150 micrograms/kg doses caused fewer minor side effects than the higher dose. These results confirm that ivermectin in a single oral dose may be a safe and effective microfilaricidal drug for the treatment of onchocerciasis and that it appears to be free of major ocular side effects.

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Selected References

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  1. Anderson J., Fuglsang H., de C Marshall T. F. Effects of suramin on ocular onchocerciasis. Tropenmed Parasitol. 1976 Sep;27(3):279–296. [PubMed] [Google Scholar]
  2. Awadzi K., Dadzie K. Y., Schulz-Key H., Gilles H. M., Fulford A. J., Aziz M. A. The chemotherapy of onchocerciasis. XI. A double-blind comparative study of ivermectin, diethylcarbamazine and placebo in human onchocerciasis in northern Ghana. Ann Trop Med Parasitol. 1986 Aug;80(4):433–442. doi: 10.1080/00034983.1986.11812044. [DOI] [PubMed] [Google Scholar]
  3. Awadzi K., Dadzie K. Y., Shulz-Key H., Haddock D. R., Gilles H. M., Aziz M. A. The chemotherapy of onchocerciasis X. An assessment of four single dose treatment regimes of MK-933 (ivermectin) in human onchocerciasis. Ann Trop Med Parasitol. 1985 Feb;79(1):63–78. [PubMed] [Google Scholar]
  4. Aziz M. A., Diallo S., Diop I. M., Lariviere M., Porta M. Efficacy and tolerance of ivermectin in human onchocerciasis. Lancet. 1982 Jul 24;2(8291):171–173. doi: 10.1016/s0140-6736(82)91026-1. [DOI] [PubMed] [Google Scholar]
  5. Aziz M. A., Diallo S., Lariviere M., Diop I. M., Porta I. M., Gaxotte P. Ivermectin in onchocerciasis. Lancet. 1982 Dec 25;2(8313):1456–1457. doi: 10.1016/s0140-6736(82)91350-2. [DOI] [PubMed] [Google Scholar]
  6. Bird A. C., el-Sheikh H., Anderson J., Fuglsang H. Changes in visual function and in the posterior segment of the eye during treatment of onchocerciasis with diethylcarbamazine citrate. Br J Ophthalmol. 1980 Mar;64(3):191–200. doi: 10.1136/bjo.64.3.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Campbell W. C., Fisher M. H., Stapley E. O., Albers-Schönberg G., Jacob T. A. Ivermectin: a potent new antiparasitic agent. Science. 1983 Aug 26;221(4613):823–828. doi: 10.1126/science.6308762. [DOI] [PubMed] [Google Scholar]
  8. Coulaud J. P., Lariviere M., Aziz M. A., Gervais M. C., Gaxotte P., Deluol A. M., Cenac J. Ivermectin in onchocerciasis. Lancet. 1984 Sep 1;2(8401):526–527. doi: 10.1016/s0140-6736(84)92608-4. [DOI] [PubMed] [Google Scholar]
  9. Diallo S., Aziz M. A., Lariviere M., Diallo J. S., Diop-Mar I., N'Dir O., Badiane S., Py D., Schulz-Key H., Gaxotte P. A double-blind comparison of the efficacy and safety of ivermectin and diethylcarbamazine in a placebo controlled study of Senegalese patients with onchocerciasis. Trans R Soc Trop Med Hyg. 1986;80(6):927–934. doi: 10.1016/0035-9203(86)90262-2. [DOI] [PubMed] [Google Scholar]
  10. Greene B. M., Taylor H. R., Cupp E. W., Murphy R. P., White A. T., Aziz M. A., Schulz-Key H., D'Anna S. A., Newland H. S., Goldschmidt L. P. Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis. N Engl J Med. 1985 Jul 18;313(3):133–138. doi: 10.1056/NEJM198507183130301. [DOI] [PubMed] [Google Scholar]
  11. Keyvan-Larijani E., Newland H. S., Taylor H. R. An ocular reaction index for use in the study of onchocerciasis. Trop Med Parasitol. 1985 Dec;36(4):241–243. [PubMed] [Google Scholar]
  12. Lariviere M., Vingtain P., Aziz M., Beauvais B., Weimann D., Derouin F., Ginoux J., Schulz-Key H., Gaxotte P., Basset D. Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement. Lancet. 1985 Jul 27;2(8448):174–177. doi: 10.1016/s0140-6736(85)91496-5. [DOI] [PubMed] [Google Scholar]
  13. Taylor H. R., Greene B. M. Ocular changes with oral and transepidermal diethylcarbamazine therapy of onchocerciasis. Br J Ophthalmol. 1981 Jul;65(7):494–502. doi: 10.1136/bjo.65.7.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Taylor H. R., Murphy R. P., Newland H. S., White A. T., D'Anna S. A., Keyvan-Larijani E., Aziz M. A., Cupp E. W., Greene B. M. Treatment of onchocerciasis. The ocular effects of ivermectin and diethylcarbamazine. Arch Ophthalmol. 1986 Jun;104(6):863–870. doi: 10.1001/archopht.1986.01050180097039. [DOI] [PubMed] [Google Scholar]
  15. Taylor H. R. Recent developments in the treatment of onchocerciasis. Bull World Health Organ. 1984;62(4):509–515. [PMC free article] [PubMed] [Google Scholar]
  16. Terada M., Ishii A. I., Kino H., Sano M. Angiostrongylus cantonensis: paralysis due to avermectin B1a and ivermectin. Exp Parasitol. 1984 Apr;57(2):149–157. doi: 10.1016/0014-4894(84)90074-2. [DOI] [PubMed] [Google Scholar]
  17. White A. T., Newland H. S., Taylor H. R., Erttmann K. D., Keyvan-Larijani E., Nara A., Aziz M. A., D'Anna S. A., Williams P. N., Greene B. M. Controlled trial and dose-finding study of ivermectin for treatment of onchocerciasis. J Infect Dis. 1987 Sep;156(3):463–470. doi: 10.1093/infdis/156.3.463. [DOI] [PubMed] [Google Scholar]

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