The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis
Background Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is e...
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| Veröffentlicht in: | Transactions of the Royal Society of Tropical Medicine and Hygiene 2015-11, Vol.109 (11), p.738-746 |
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| container_title | Transactions of the Royal Society of Tropical Medicine and Hygiene |
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| creator | Romo, Matthew L. Wyka, Katarzyna Carpio, Arturo Leslie, Denise Andrews, Howard Bagiella, Emilia Hauser, W. Allen Kelvin, Elizabeth A. |
| description | Background
Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type.
Methods
In this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n=88) or placebo (n=90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up.
Results
Treatment with albendazole was associated with a reduction in the number of seizures during 24 months of follow-up, but this was only significant for generalized seizures during months 1–12 (unadjusted rate ratio [RR] 0.19; 95% CI: 0.04–0.91) and months 1–24 (unadjusted RR 0.06; 95% CI: 0.01–0.57). We did not detect a significant effect of albendazole on reducing the number of focal seizures or on the probability of having a seizure, regardless of seizure type or time period.
Conclusions
Albendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis. |
| doi_str_mv | 10.1093/trstmh/trv078 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1722419805</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/trstmh/trv078</oup_id><sourcerecordid>1722419805</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-5401f20bbe8378b5a08e19216ff595b75d6a75a0f0735d652f8f81fd61d61b153</originalsourceid><addsrcrecordid>eNqFUE1LAzEUDKLYWj16lRy9rOaj2c0epfgFBS_1vGSzL3Zls1mTrNL-elNa9Sg8mGFmmAeD0CUlN5SU_Db6EO06wScp5BGaUlnIjAvCj9GUEC6ykhE-QWchvBPCBBXlKZqwfM45lXyK3lZrwGAM6IidwaqroW_U1nWAowcVLfTJ6HGAdjt6wG6M2lkIuO3xoGKb7IC_2rjGYWOH6GzSNO5h9E5vQuLgtQttOEcnRnUBLg44Q68P96vFU7Z8eXxe3C0zzXMRMzEn1DBS1yB5IWuhiARaMpobI0pRF6LJVZFUQwqeuGBGGklNk9N0NRV8hq73vYN3HyOEWNk2aOg61YMbQ0ULxua0lGQXzfZR7V0IHkw1-NYqv6koqXbbVvttq_22KX91qB5rC81v-mfMv99uHP7p-gYw8Ieq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1722419805</pqid></control><display><type>article</type><title>The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Romo, Matthew L. ; Wyka, Katarzyna ; Carpio, Arturo ; Leslie, Denise ; Andrews, Howard ; Bagiella, Emilia ; Hauser, W. Allen ; Kelvin, Elizabeth A.</creator><creatorcontrib>Romo, Matthew L. ; Wyka, Katarzyna ; Carpio, Arturo ; Leslie, Denise ; Andrews, Howard ; Bagiella, Emilia ; Hauser, W. Allen ; Kelvin, Elizabeth A. ; Ecuadorian Neurocysticercosis Group</creatorcontrib><description>Background
Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type.
Methods
In this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n=88) or placebo (n=90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up.
Results
Treatment with albendazole was associated with a reduction in the number of seizures during 24 months of follow-up, but this was only significant for generalized seizures during months 1–12 (unadjusted rate ratio [RR] 0.19; 95% CI: 0.04–0.91) and months 1–24 (unadjusted RR 0.06; 95% CI: 0.01–0.57). We did not detect a significant effect of albendazole on reducing the number of focal seizures or on the probability of having a seizure, regardless of seizure type or time period.
Conclusions
Albendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis.</description><identifier>ISSN: 0035-9203</identifier><identifier>EISSN: 1878-3503</identifier><identifier>DOI: 10.1093/trstmh/trv078</identifier><identifier>PMID: 26433183</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Albendazole - therapeutic use ; Animals ; Anthelmintics - therapeutic use ; Anti-Inflammatory Agents - therapeutic use ; Brain - parasitology ; Brain - pathology ; Cysts - parasitology ; Drug Therapy, Combination ; Ecuador - epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Neurocysticercosis - complications ; Neurocysticercosis - drug therapy ; Neurocysticercosis - physiopathology ; Prednisone - therapeutic use ; Recurrence ; Seizures - parasitology ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Transactions of the Royal Society of Tropical Medicine and Hygiene, 2015-11, Vol.109 (11), p.738-746</ispartof><rights>The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2015</rights><rights>The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-5401f20bbe8378b5a08e19216ff595b75d6a75a0f0735d652f8f81fd61d61b153</citedby><cites>FETCH-LOGICAL-c365t-5401f20bbe8378b5a08e19216ff595b75d6a75a0f0735d652f8f81fd61d61b153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26433183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romo, Matthew L.</creatorcontrib><creatorcontrib>Wyka, Katarzyna</creatorcontrib><creatorcontrib>Carpio, Arturo</creatorcontrib><creatorcontrib>Leslie, Denise</creatorcontrib><creatorcontrib>Andrews, Howard</creatorcontrib><creatorcontrib>Bagiella, Emilia</creatorcontrib><creatorcontrib>Hauser, W. Allen</creatorcontrib><creatorcontrib>Kelvin, Elizabeth A.</creatorcontrib><creatorcontrib>Ecuadorian Neurocysticercosis Group</creatorcontrib><title>The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis</title><title>Transactions of the Royal Society of Tropical Medicine and Hygiene</title><addtitle>Trans R Soc Trop Med Hyg</addtitle><description>Background
Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type.
Methods
In this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n=88) or placebo (n=90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up.
Results
Treatment with albendazole was associated with a reduction in the number of seizures during 24 months of follow-up, but this was only significant for generalized seizures during months 1–12 (unadjusted rate ratio [RR] 0.19; 95% CI: 0.04–0.91) and months 1–24 (unadjusted RR 0.06; 95% CI: 0.01–0.57). We did not detect a significant effect of albendazole on reducing the number of focal seizures or on the probability of having a seizure, regardless of seizure type or time period.
Conclusions
Albendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis.</description><subject>Albendazole - therapeutic use</subject><subject>Animals</subject><subject>Anthelmintics - therapeutic use</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Brain - parasitology</subject><subject>Brain - pathology</subject><subject>Cysts - parasitology</subject><subject>Drug Therapy, Combination</subject><subject>Ecuador - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Neurocysticercosis - complications</subject><subject>Neurocysticercosis - drug therapy</subject><subject>Neurocysticercosis - physiopathology</subject><subject>Prednisone - therapeutic use</subject><subject>Recurrence</subject><subject>Seizures - parasitology</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0035-9203</issn><issn>1878-3503</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUE1LAzEUDKLYWj16lRy9rOaj2c0epfgFBS_1vGSzL3Zls1mTrNL-elNa9Sg8mGFmmAeD0CUlN5SU_Db6EO06wScp5BGaUlnIjAvCj9GUEC6ykhE-QWchvBPCBBXlKZqwfM45lXyK3lZrwGAM6IidwaqroW_U1nWAowcVLfTJ6HGAdjt6wG6M2lkIuO3xoGKb7IC_2rjGYWOH6GzSNO5h9E5vQuLgtQttOEcnRnUBLg44Q68P96vFU7Z8eXxe3C0zzXMRMzEn1DBS1yB5IWuhiARaMpobI0pRF6LJVZFUQwqeuGBGGklNk9N0NRV8hq73vYN3HyOEWNk2aOg61YMbQ0ULxua0lGQXzfZR7V0IHkw1-NYqv6koqXbbVvttq_22KX91qB5rC81v-mfMv99uHP7p-gYw8Ieq</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Romo, Matthew L.</creator><creator>Wyka, Katarzyna</creator><creator>Carpio, Arturo</creator><creator>Leslie, Denise</creator><creator>Andrews, Howard</creator><creator>Bagiella, Emilia</creator><creator>Hauser, W. Allen</creator><creator>Kelvin, Elizabeth A.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151101</creationdate><title>The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis</title><author>Romo, Matthew L. ; Wyka, Katarzyna ; Carpio, Arturo ; Leslie, Denise ; Andrews, Howard ; Bagiella, Emilia ; Hauser, W. Allen ; Kelvin, Elizabeth A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-5401f20bbe8378b5a08e19216ff595b75d6a75a0f0735d652f8f81fd61d61b153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Albendazole - therapeutic use</topic><topic>Animals</topic><topic>Anthelmintics - therapeutic use</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Brain - parasitology</topic><topic>Brain - pathology</topic><topic>Cysts - parasitology</topic><topic>Drug Therapy, Combination</topic><topic>Ecuador - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Neurocysticercosis - complications</topic><topic>Neurocysticercosis - drug therapy</topic><topic>Neurocysticercosis - physiopathology</topic><topic>Prednisone - therapeutic use</topic><topic>Recurrence</topic><topic>Seizures - parasitology</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romo, Matthew L.</creatorcontrib><creatorcontrib>Wyka, Katarzyna</creatorcontrib><creatorcontrib>Carpio, Arturo</creatorcontrib><creatorcontrib>Leslie, Denise</creatorcontrib><creatorcontrib>Andrews, Howard</creatorcontrib><creatorcontrib>Bagiella, Emilia</creatorcontrib><creatorcontrib>Hauser, W. Allen</creatorcontrib><creatorcontrib>Kelvin, Elizabeth A.</creatorcontrib><creatorcontrib>Ecuadorian Neurocysticercosis Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transactions of the Royal Society of Tropical Medicine and Hygiene</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romo, Matthew L.</au><au>Wyka, Katarzyna</au><au>Carpio, Arturo</au><au>Leslie, Denise</au><au>Andrews, Howard</au><au>Bagiella, Emilia</au><au>Hauser, W. Allen</au><au>Kelvin, Elizabeth A.</au><aucorp>Ecuadorian Neurocysticercosis Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis</atitle><jtitle>Transactions of the Royal Society of Tropical Medicine and Hygiene</jtitle><addtitle>Trans R Soc Trop Med Hyg</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>109</volume><issue>11</issue><spage>738</spage><epage>746</epage><pages>738-746</pages><issn>0035-9203</issn><eissn>1878-3503</eissn><abstract>Background
Randomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type.
Methods
In this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n=88) or placebo (n=90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up.
Results
Treatment with albendazole was associated with a reduction in the number of seizures during 24 months of follow-up, but this was only significant for generalized seizures during months 1–12 (unadjusted rate ratio [RR] 0.19; 95% CI: 0.04–0.91) and months 1–24 (unadjusted RR 0.06; 95% CI: 0.01–0.57). We did not detect a significant effect of albendazole on reducing the number of focal seizures or on the probability of having a seizure, regardless of seizure type or time period.
Conclusions
Albendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>26433183</pmid><doi>10.1093/trstmh/trv078</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0035-9203 |
| ispartof | Transactions of the Royal Society of Tropical Medicine and Hygiene, 2015-11, Vol.109 (11), p.738-746 |
| issn | 0035-9203 1878-3503 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1722419805 |
| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Albendazole - therapeutic use Animals Anthelmintics - therapeutic use Anti-Inflammatory Agents - therapeutic use Brain - parasitology Brain - pathology Cysts - parasitology Drug Therapy, Combination Ecuador - epidemiology Female Follow-Up Studies Humans Male Neurocysticercosis - complications Neurocysticercosis - drug therapy Neurocysticercosis - physiopathology Prednisone - therapeutic use Recurrence Seizures - parasitology Time Factors Tomography, X-Ray Computed Treatment Outcome |
| title | The effect of albendazole treatment on seizure outcomes in patients with symptomatic neurocysticercosis |
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