IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0005008.html
   My bibliography  Save this article

Efficacy and Safety of Moxidectin, Synriam, Synriam-Praziquantel versus Praziquantel against Schistosoma haematobium and S. mansoni Infections: A Randomized, Exploratory Phase 2 Trial

Author

Listed:
  • Beatrice Barda
  • Jean T Coulibaly
  • Maxim Puchkov
  • Jörg Huwyler
  • Jan Hattendorf
  • Jennifer Keiser

Abstract

Background: Schistosomiasis affects millions of people, yet treatment options are limited. The antimalarial Synriam (piperaquine 150 mg/arterolane 750 mg) and the anthelminthic moxidectin revealed promising antischistosomal properties in preclinical or clinical studies. Methodology: We conducted two single-blind, randomized exploratory Phase 2 trials in Schistosoma mansoni and S. haematobium-infected adolescents in northern and central Côte d’Ivoire. Our primary endpoints were cure rates (CRs) and egg reduction rates (ERRs) based on geometric mean and safety. Each subject was asked to provide two stool samples (S. mansoni trial) for Kato-Katz analysis or three urine samples (S. haematobium trial) for urine filtration and one finger prick for malaria screening at baseline and follow-up. Participants were randomly assigned to either moxidectin, Synriam, Synriam plus praziquantel or praziquantel. Principal Findings: 128 adolescents (age: 12–17 years) were included in each study. Against S. haematobium moxidectin and Synriam revealed low efficacy. On the other hand, Synriam plus praziquantel and praziquantel yielded CRs of 60.0% and 38.5% and ERRs of 96.0% and 93.5%, respectively. CRs observed in the treatment of S. mansoni were 13.0%, 6.7%, 27.0%, and 27.6% for moxidectin, Synriam, Synriam plus praziquantel and praziquantel, respectively. ERRs ranged from 64.9% (Synriam) to 87.5% (praziquantel). Conclusion/Significance: Synriam and moxidectin show low efficacy against S. haematobium, hence an ancillary benefit is not expected when these drugs are used for treating onchocerciasis and malaria in co-endemic settings. Further studies are needed to corroborate our findings that moxidectin and Synriam show moderate ERRs against S. mansoni. Author Summary: Schistosomiasis is a parasitic infection that affects millions of people all over the world and it is due to schistosomes, helminths (worms) that infect the intestine and the urinary bladder. Treatment options are limited, with praziquantel being the only used drug. The antimalarial Synriam and the anthelminthic moxidectin revealed good action against this worm in previous studies. We conducted two studies in Schistosoma mansoni and S. haematobium-infected adolescents in Côte d’Ivoire. Subjects positive for the infection were allocated by chance to the four groups of treatment (moxidectin, Synriam, Synriam plus praziquantel or praziquantel); participants did not know which drug they took. Our aim was to calculate how many participants were negative after the treatment and how did the intensity of infection change before and after treatment. Each subject provided stools and urines for examination. 128 adolescents were included in each study. Moxidectin and Synriam did not work well against S. haematobium. Against S. mansoni, only a small part of the participants were negative after treatment in all treatment groups, but the intensity of infections were reduced. Further studies are needed to better understand this result.

Suggested Citation

  • Beatrice Barda & Jean T Coulibaly & Maxim Puchkov & Jörg Huwyler & Jan Hattendorf & Jennifer Keiser, 2016. "Efficacy and Safety of Moxidectin, Synriam, Synriam-Praziquantel versus Praziquantel against Schistosoma haematobium and S. mansoni Infections: A Randomized, Exploratory Phase 2 Trial," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(9), pages 1-15, September.
  • Handle: RePEc:plo:pntd00:0005008
    DOI: 10.1371/journal.pntd.0005008
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005008
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005008&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0005008?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0005008. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.