The efficacy and tolerability of triclabendazole in Cuban patients with latent and chronic Fasciola hepatica infection.

Abstract

Abstract. Current chemotherapy for the treatment of infections caused by the liver fluke Fasciola hepatica is not satisfactory. Therefore, the efficacy and tolerability of triclabendazole (TCZ) was assessed for this indication. Eightytwo patients (51 female, 31 male, age 15-81 yr, mean 42 yr) with chronic or latent F. hepatica infection refractory to previous anti-helminthic chemotherapy were enrolled in a 60-day open, non-comparative trial. Patients received 20 mg/kg TCZ as two doses of 10 mg/kg administered after food 12 hr apart. Efficacy of treatment was assessed by stool microscopy, determination of Fasciola excretory-secretory antigen (FES) in feces, and by ultrasonography (US) which were systematically performed pre-therapy and on Days 1-7, 15, 30, and 60 post-therapy. For continuous safety assessment, patients were hospitalized during the first week after therapy and then monitored at home for the appearance of any adverse events. Clinical chemistry and hematology tests were carried out on Days 1, 3, 7, 15, and 60, and whenever an adverse effect occurred possibly related to therapy. Seventy-one (92.2%) of the 77 patients who completed the 60-day follow-up period became egg-negative. Efficacy of therapy was supported by the disappearance or decrease of FES antigen and of ultrasonography abnormalities. In the 6 remaining patients, parasitological cure was achieved by another single TCZ dose of 10 mg/kg on Day 60.

Fasciola hepatica infection at a University Clinic in Turkey

“…Despite medical treatment, 3 (7.6%) patients had to undergo a further invasive procedure. Studies on the efficacy of triclabendazole in fascioliasis revealed a success rate of 79.2% for one dose of 10 mg/kg/day, and a success rate of 92.2% for 10 mg/kg/day over two consecutive days [15,16]. We achieved a 92.4% success rate with the two-dose treatment.…”

Development of Two Antibody Detection Enzyme-Linked Immunosorbent Assays for Serodiagnosis of Human Chronic Fascioliasis

“…Since all serum samples were properly preserved at Ϫ70°C from their collection until use, it is possible to speculate that the sensitivities of the two assays were influenced by factors such as the intensity of infection, the persistence of antibodies postinfection, and parasite senescence (21). Northern Peru and Bolivian Altiplano are two regions in which human fascioliasis is highly endemic (3,6,(43)(44)(45)(46). Therefore, it is also possible that the size of the dose of infectious metacercariae could affect the development of a detectable antibody response to a particular antigen (47), as human subjects exposed to F. hepatica infections are likely to ingest low doses of metacercariae over long periods.…”

Human liver flukes

“…Double-dose therapy (10mg/kg dose given, and repeated at 12-24 hours) is recommended in heavy infections, or if there is no response to single-dose therapy (116) . Cure rates of 92·2-100% are described in adults with a two-dose regimen (117,118) , with 79·2% cure rates described with the single-dose regimen (119) . Cure rates of 95% using the 10mg/kg dose have recently been described in children, with 100% cure rates using two doses of 7.5mg/kg (120) .…”