Abstract
Suramin and Mel W are the only two drugs at present known to be effective against the adult worms of Onchocerca volvulus, but in view of the unpredictable occurrence of fatal arsenical encephalopathy in a small proportion of patients receiving Mel W, suramin remains the preferred macrofilaricide in the treatment of onchocerciasis. It is therefore important to determine the suramin dosage schedules that will produce parasitological cures with minimal concomitant risks of toxic reactions. The criteria by which cures should be judged must also be appreciated.
Courses of different duration and employing doses of 1.0 g, 0.5 g and 0.25 g suramin have been investigated for their action on adult worms and microfilariae, for the toxic reactions which they produce on the kidney, and for the level of suramin reached in the serum during treatment. A course of 5 or 6 weekly doses of 1.0 g has been shown to be the optimum for adults.
It is sometimes stated without good foundation that different brands of suramin differ in their purity and chemical composition, thus producing inconsistent effects on the parasites and grave risks of toxic manifestations. The three main brands in current use in Africa (Antrypol, Moranyl and Naganol) have therefore been compared in a group of patients, using the same optimum dosage schedule for each preparation and recording the action of the various brands on the parasites, as well as their comparative toxicities and the serum suramin levels achieved. No significant differences between the brands were recorded.
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Selected References
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- BURCH T. A., ASHBURN L. L. Experimental therapy of onchocerciasis with suramin and hetrazan; results of a three-year study. Am J Trop Med Hyg. 1951 Sep;31(5):617–623. doi: 10.4269/ajtmh.1951.s1-31.617. [DOI] [PubMed] [Google Scholar]
- Boursnell J. C., Dangerfield W. G., Wormall A. Studies on Bayer 205 (Germanin) and Antrypol: Further observations on the method of determination and on the retention of this drug in the animal body. Biochem J. 1939 Jan;33(1):81–89. doi: 10.1042/bj0330081. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DUKE B. O. The reappearance, rate of increase and distribution of the microfilariae of Onchocerca volvulus following treatment with diethylcarbamazine. Trans R Soc Trop Med Hyg. 1957 Jan;51(1):37–44. doi: 10.1016/0035-9203(57)90004-4. [DOI] [PubMed] [Google Scholar]
- Dangerfield W. G., Gaunt W. E., Wormall A. Studies on Bayer 205 (Germanin) and Antrypol: The determination of small amounts of Bayer 205 (and Antrypol). II. The persistence of Bayer 205 in the blood stream after injection into animals. Biochem J. 1938 Jan;32(1):59–70. doi: 10.1042/bj0320059. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Duke B. O., Lewis D. J., Moore P. J. Onchocerca-Simulium complexes. I. Transmission of forest and Sudan-savanna strains of Onchocerca volvulus, from Cameroon, by Simulium damnosum from various West African bioclimatic zones. Ann Trop Med Parasitol. 1966 Sep;60(3):318–326. [PubMed] [Google Scholar]
- Gage J. C., Rose F. L., Scott M. The estimation of suramin in plasma. Biochem J. 1948;42(4):574–577. [PMC free article] [PubMed] [Google Scholar]