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Efficacy of moxidectin versus ivermectin against Strongyloides stercoralis infections: a randomized controlled non-inferiority trial

Barda, Beatrice and Sayasone, Somphou and Phongluxa, Khampheng and Xayavong, Syda and Keoduangsy, Khonsavanh and Odermatt, Peter and Puchkov, Maxim and Huwyler, Jörg and Hattendorf, Jan and Keiser, Jennifer. (2017) Efficacy of moxidectin versus ivermectin against Strongyloides stercoralis infections: a randomized controlled non-inferiority trial. Clinical Infectious Diseases, 65 (2). pp. 276-281.

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Abstract

Infections with Strongyloides stercoralis are of considerable public health relevance. Moxidectin, a well-established drug in veterinary medicine under consideration for regulatory submission for the treatment of onchocerciasis, might serve as an alternative to the widely used ivermectin.; We conducted an exploratory, randomized, single-blind trial to evaluate the efficacy and safety of moxidectin (8 mg) vs ivermectin (200 μg/kg) against S. stercoralis infections. Cure rate (CR) against S. stercoralis was the primary outcome. Safety and efficacy against coinfections with soil-transmitted helminths and Opisthorchis viverrini were secondary outcomes. Noninferiority required the lower limit of the 95% confidence interval (CI) of the differences in CRs not exceed 7 percentage points.; A total of 127 participants were enrolled and randomly assigned to the 2 treatments whereby 1 participant per arm was lost to follow-up. We observed a CR of 93.7% (59/63) for moxidectin compared to 95.2% (59/62) for ivermectin. Differences between CRs were estimated as -1.5% percentage points (95% CI, -9.6 to 6.5), thus the lower limit of the CI exceeds the noninferiority margin of 7 percentage points. No side effects were observed. CRs against hookworm infection were 57% (moxidectin) and 56% (ivermectin). Low efficacy for both drugs against O. viverrini was observed.; Moxidectin might be a safe and efficacious alternative to ivermectin for the treatment of S. stercoralis infection, given that only slight differences in CRs were observed. However, noninferiority could not be demonstrated. Larger clinical trials should be conducted once the drug is marketed.; Current Controlled Trials: ISRCTN11983645.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Helminth Drug Development (Keiser)
UniBasel Contributors:Barda, Beatrice and Sayasone, Somphou and Phongluxa, Khampheng and Odermatt, Peter and Hattendorf, Jan and Keiser, Jennifer
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
ISSN:1058-4838
e-ISSN:1537-6591
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:17 May 2018 09:21
Deposited On:21 Dec 2017 12:42

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