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Fourteen Days vs 28 Days of Albendazole Therapy for Neurocysticercosis in Children: An Open Label Randomized
Ankit Singla1, Seema Lekhwani2, Narain Das Vaswani1
1Department of Pediatrics, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana.
Insights
Fourteen-day albendazole therapy is as effective as 28-day treatment for pediatric neurocysticercosis (NCC) resolution. Both durations showed comparable outcomes, suggesting shorter treatment may be viable for active NCC management.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Limited evidence supports 14-day albendazole therapy for neurocysticercosis (NCC).
- Active NCC management in children requires effective and potentially shorter treatment durations.
Purpose of the Study:
- To compare the efficacy of 14-day versus 28-day albendazole therapy in children with newly diagnosed active neurocysticercosis (NCC).
Main Methods:
- An open-label, randomized controlled trial was conducted.
- Participants included children aged 1-14 years with newly diagnosed active NCC.
- Intervention involved albendazole (15 mg/kg/day) for either 14 or 28 days.
Main Results:
- Radiological resolution at 6 months was comparable between the 14-day and 28-day groups (18.8% vs. 27.3%).
- Seizure recurrence rates and calcification on follow-up imaging were also similar between groups.
- No major adverse events were reported in either treatment arm.
Conclusions:
- Fourteen-day albendazole therapy demonstrates comparable efficacy to 28-day therapy for radiological resolution in pediatric NCC.
- The high rate of calcification in both groups warrants further investigation with larger, longer-term studies.
Background:
There is a paucity of literature to support 14-days albendazole therapy for neurocysticercosis (NCC).
Objective:
To compare the efficacy of 14-day and 28-day albendazole therapy in the management of children with newly diagnosed active NCC.
Study Design:
Open-labelled randomized controlled trial.
Participants:
Children aged 1-14 years with newly diagnosed active neurocysticercosis.
Intervention:
Albendazole (15 mg/kg/day) for either 14 days or 28 days.
Outcome:
The primary outcome measure was proportion of children with radiological resolution of active lesion at 6-month follow up. Secondary outcome measures were proportion of children with seizure recurrence, duration to seizure recurrence and calcification on follow up imaging.
Results:
65 children with newly diagnosed NCC were rando-mized to receive albendazole therapy for 14 days (n=32) or 28 days (n=33). The proportion of children with complete resolution was comparable between the two groups [6 (18.8%) vs. 9 (27.3%); OR (95%CI):0.61 (0.19 to 1.98); P=0.56]. Similarly, proportion of children with seizure recurrence [5(15.6%) vs 2(6.1%); OR (95%CI): 2.87(0.51-16.0); P=0.26] and proportion of children with calcification on follow-up imaging [26(81.2%) vs 23(69.7%); OR (95%CI): 1.88 (0.59-5.99); P=0.39] were also comparable. There were no major side-effects noted during the study.
Conclusion:
14-day treatment with albendazole therapy is as effective as 28-day treatment in achieving radiological resolution at six-month follow up. However, high rate of calcification in both the groups indicates need for further evaluation with an adequately powered study and longer follow up.
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