Tolerability of ivermectin in gnathostomiasis

Area of Science:

• Tropical Medicine
• Parasitology
• Clinical Pharmacology

Background:

• Cutaneous gnathostomiasis lacks a universally effective treatment.
• Albendazole, commonly prescribed, shows limited efficacy (around 20%) in inducing parasite migration.
• There is a need for alternative, more effective treatments.

Purpose of the Study:

• To assess the safety and tolerability of single oral doses of ivermectin in Thai patients with cutaneous gnathostomiasis.
• To evaluate a range of ivermectin dosages (50-200 microg/kg bodyweight).

Main Methods:

• Prospective, open-labeled study involving 20 Thai patients.
• Patients were divided into four groups, receiving single oral doses of ivermectin at 50, 100, 150, or 200 microg/kg.
• Adverse events and laboratory tests were monitored before and after treatment.

Main Results:

• No serious adverse events were reported.
• Forty possible ivermectin-related adverse events occurred, primarily mild and self-limiting (e.g., malaise, myalgia, drowsiness).
• Adverse events were not dose-related; laboratory abnormalities were transient and found in only 15% of patients.

Conclusions:

• Single oral doses of ivermectin, ranging from 50 to 200 microg/kg bodyweight, are safe in Thai patients with cutaneous gnathostomiasis.
• Ivermectin shows potential as a safe treatment for this condition.
• Future clinical trials investigating ivermectin for human gnathostomiasis can utilize dosages up to 200 microg/kg.