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Neurocysticercosis: Combined Treatment With Praziquantel and Albendazole
This study is ongoing, but not recruiting participants.
First Received: February 27, 2007   Last Updated: May 19, 2009   History of Changes
Sponsor: Universidad Peruana Cayetano Heredia
Collaborator: National Institute of Neurological Disorders and Stroke (NINDS)
Information provided by: Universidad Peruana Cayetano Heredia
ClinicalTrials.gov Identifier: NCT00441285
  Purpose

The purpose of this study is to determine if combination drug therapy of praziquantel and albendazole is safe and effective to cure neurocysticercosis.


Condition Intervention Phase
Neurocysticercosis
Epilepsy
Drug: praziquantel
Drug: albendazole
Phase II
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Antiparasitic Therapy for Neurocysticercosis: Phase II/III Study on Safety and Efficacy of Combined Treatment With Praziquantel and Albendazole

Resource links provided by NLM:


Further study details as provided by Universidad Peruana Cayetano Heredia:

Primary Outcome Measures:
  • Maximum plasma concentration (Cmax) and area under the curve (AUC), for ABZSO4 and PZQ [ Time Frame: Treatment days 1 to 10 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Difference in plasma levels of ABZ between patients in the ABZ+PCB group compared to those in the ABZ+PZQ group. [ Time Frame: Treament days 1 to 10 ] [ Designated as safety issue: Yes ]
  • effects of phenytoin and carbamazepine in PZQ levels when given in addition to ABZ, dexamethasone, and ranitidine. [ Time Frame: Treatment days 1 to 10 ] [ Designated as safety issue: Yes ]
  • safety of the combination ABZ+PZQ compared to ABZ alone [ Time Frame: Days 1 to 90 ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 180
Study Start Date: July 2007
Estimated Study Completion Date: July 2008
Estimated Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
I: Experimental
ABZ+PZQ
Drug: praziquantel
Participants will receive ABZ and PZQ for 10 days. Combination of ABZ+PZQ (Addition of PZQ to the standard treatment for NCC.
Drug: albendazole
Participants will receive ABZ and placebo (an inactive substance) for 10 days.
II: Active Comparator
ABZ+Placebo
Drug: albendazole
Participants will receive ABZ and placebo (an inactive substance) for 10 days.

Detailed Description:

Neurocysticercosis (NCC) is the single major cause of acquired or late-onset epilepsy in the world, and a common diagnosis in immigrant populations in the United States and other industrialized countries. An estimated 50 million humans are affected by NCC. The disease occurs when a parasite called Taenia solium, or the pig tapeworm, infects the brain, forming cysts. NCC is generally treated with 1 of 2 drugs, praziquantel (PZQ) or albendazole (ABZ). However, current treatment with either of these drugs alone is not totally effective.

The goal of this trial is to determine if combination drug therapy of PZQ and ABZ is safe and more effective to cure NCC than either drug administered alone. This trial will consist of both a sub-study and a parent study.

In the sub-study—which will be performed as the initial part and guide to the design of the parent study—32 participants will be randomly chosen to receive either ABZ and PZQ or ABZ and placebo (an inactive substance) for 10 days. Both groups will also receive other standard medications to manage the disease. Participants will stay in the hospital for at least 2 weeks after treatment begins. After discharge from the hospital, participants will have follow-up visits. During one of the visits, participants will provide an additional blood sample for safety testing. Participants will be followed for 3 months. The purpose of this sub-study is to evaluate the safety and pharmacokinetics of ABZ and PZQ. Enrollment for the sub-study is now complete. Enrollment for the parent study has not yet begun.

In the parent study, a total of 180 participants (including the 32 participants from the sub-study) will be randomly chosen to receive either ABZ and PZQ or ABZ and placebo for 10 days. Both groups will also receive other standard medications to manage the disease including appropriate anti-epileptic drug therapy. Participants will stay in the hospital for at least 2 weeks after treatment begins, which includes 5 days after the end of anti-parasitic treatment. After discharge from the hospital, follow-up visits will be on days 22 and 30 after treatment begins, then monthly until day 90, and finally every 3 months until completing 18 months. Brain images will be taken at 6 and 12 months after treatment begins. For participants, duration of the trial is 1 year and a half.

  Eligibility

Ages Eligible for Study:   16 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female individuals between 16 to 65 years of age, with a diagnosis of NCC and 20 or less viable cysts.
  • Patients with a diagnosis of epilepsy secondary to NCC and a history of one or more spontaneous seizures within the previous year but not longer than 10 years.
  • Willingness to complete a minimum of two weeks of hospitalization.

Exclusion Criteria:

  • Primary generalized seizures (e.g., not caused by neurocysticercosis)
  • A history of generalized status epilepticus.
  • Patients with persistent or progressive symptomatic intracranial hypertension or intracranial hypertension.
  • Previous therapy with ABZ or PZQ in the past two years.
  • Pulmonary tuberculosis, or symptoms compatible with tuberculosis not otherwise explained.
  • Active hepatitis
  • Systemic disease that may affect short-term prognosis.
  • Patients in unstable condition (consistently abnormal vital signs: body temperature, heart rate, respiratory rate, and blood pressure)
  • Pregnancy during anti-parasitic treatment
  • History of hypersensitivity to ABZ or PZQ
  • Concurrent treatment with cimetidine or teophylline
  • Chronic alcohol or drug abuse
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00441285

Locations
Peru
Universidad Peruana Cayetano Heredia
Lima, Peru
Instituto Nacional de Ciencias Neurologicas
Lima, Peru
Hospital Alberto Sabogal
Lima, Peru
Sponsors and Collaborators
Universidad Peruana Cayetano Heredia
Investigators
Principal Investigator: Hector H. Garcia, MD Universidad Peruana Cayetano Heredia
Principal Investigator: E. Javier Pretell, MD Hospital Alberto
Principal Investigator: Javier A. Bustos, MD Universidad Peruana Cayetano Heredia
  More Information

No publications provided

Responsible Party: Universidad Peruana Cayetano Heredia ( Hector H. Garcia, Associate Professor, Department of Microbiology, )
Study ID Numbers: R01NS054805
Study First Received: February 27, 2007
Last Updated: May 19, 2009
ClinicalTrials.gov Identifier: NCT00441285     History of Changes
Health Authority: United States: Federal Government

Keywords provided by Universidad Peruana Cayetano Heredia:
neurocysticercosis
NCC
praziquantel
PZQ
albendazole
ABZ
parasite
pig tapeworm
Taenia solium
epilepsy
late-onset epilepsy
acquired epilepsy

Additional relevant MeSH terms:
Anti-Infective Agents
Antiprotozoal Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Central Nervous System Helminthiasis
Brain Diseases
Neurocysticercosis
Central Nervous System Parasitic Infections
Albendazole
Antiparasitic Agents
Therapeutic Uses
Cysticercosis
Parasitic Diseases
Taeniasis
Praziquantel
Helminthiasis
Antiplatyhelmintic Agents
Mitosis Modulators
Nervous System Diseases
Central Nervous System Diseases
Anthelmintics
Antimitotic Agents
Pharmacologic Actions
Anticestodal Agents
Central Nervous System Infections
Epilepsy
Tubulin Modulators
Cestode Infections

ClinicalTrials.gov processed this record on February 08, 2010