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Albendazole and praziquantel combination versus albendazole alone in children with multiple neurocysticercosis: An
Vijay Rani1, Virender K Gehlawat1, Vandana Arya1
1Department of Pediatrics, Pt. BD Sharma PGIMS, Rohtak, Haryana, India.
Insights
The combination of albendazole and praziquantel is as effective as albendazole alone for treating multiple neurocysticercosis in children. Both treatments showed similar cyst resolution and calcification rates with comparable safety profiles.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Neurocysticercosis is a significant cause of epilepsy and neurological disorders in children.
- The combination therapy of albendazole and praziquantel has shown promise but requires further investigation in pediatric populations.
- Limited studies exist on the comparative efficacy of combination therapy versus albendazole monotherapy for multiple neurocysticercosis in children.
Purpose of the Study:
- To compare the efficacy and safety of albendazole plus praziquantel versus albendazole alone.
- To evaluate the proportion of cysts with complete resolution or calcification at 6-month follow-up.
- To assess treatment outcomes in children with multiple neurocysticercosis.
Main Methods:
- A randomized controlled trial involving 52 children (aged 1-14 years) with newly diagnosed multiple neurocysticercosis.
- Group A (n=26) received albendazole plus praziquantel; Group B (n=26) received albendazole alone.
- Repeat MRI brain scans at 6 months assessed cyst resolution (complete, calcified, or persistent).
Main Results:
- Complete resolution rates were 38.33% in the combination group and 29.23% in the albendazole-alone group (not statistically significant).
- Calcification rates were comparable: 33.33% in the combination group and 30.77% in the albendazole-alone group.
- Both treatment groups demonstrated similar safety profiles.
Conclusions:
- Combination therapy with albendazole and praziquantel is not superior to albendazole monotherapy for treating multiple neurocysticercosis in children.
- Both treatment regimens achieve comparable rates of cyst resolution and calcification.
- The findings support albendazole monotherapy as an effective treatment option, with similar safety to combination therapy.
Context:
The efficacy of the combination of albendazole and praziquantel has not been thoroughly studied in multiple neurocysticercosis in children.
Objective:
To compare the efficacy and safety of albendazole and praziquantel combination versus albendazole alone in the treatment of children with multiple neurocysticercosis in terms of proportion of cysts undergoing complete resolution or calcification at 6-month follow-up.
Materials And Methods:
A total of 52 children, aged 1-14 years, with newly diagnosed two or more active neurocysticercosis were randomized to either group A or B. Group A (n = 26) received albendazole plus praziquantel, and Group B (n = 26) received albendazole alone. At the end of 6 months, a repeat MRI brain was performed to see for the resolution of cysts and was classified as complete resolution, calcified, or persistence of viable and noncalcified cysts.
Results:
The proportion of cysts undergoing complete resolution was higher in Group A (23/60 [38.33%]) than in Group B (19/65 [29.23%]), but the difference was not statistically significant. The proportion of cysts undergoing calcification was also comparable in Group A (20/60 [33.33%]) and Group B (20/65 [30.77%]). Both groups had comparable safety profiles.
Conclusion:
Albendazole and praziquantel combination therapy is as effective as albendazole alone in terms of complete resolution of viable cysts and calcification of cysts.Trial registration: CTRI/2021/12/038492.
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