Matthew L Romo1, Katarzyna Wyka2, Arturo Carpio3, Denise Leslie4, Howard Andrews5, Emilia Bagiella5, W Allen Hauser6, Elizabeth A Kelvin7. 1. Epidemiology & Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, New York 10035, USA CUNY School of Public Health, 2180 Third Avenue, New York, New York 10035, USA. 2. Epidemiology & Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, New York 10035, USA CUNY School of Public Health, 2180 Third Avenue, New York, New York 10035, USA Doctor of Public Health Program, The Graduate Center, City University of New York, 365 5th Avenue, New York, New York 10016, USA. 3. Facultad de Ciencias Médicas, Universidad de Cuenca, Av. 12 de Abril s/n, Cuenca, Ecuador Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, New York 10032, USA. 4. MRI Diagnostics of Westchester, 503 Grasslands Road, Suite 100, Valhalla, New York 10595, USA. 5. Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, New York 10032, USA. 6. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, New York 10032, USA Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, New York 10032, USA. 7. Epidemiology & Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, New York 10035, USA CUNY School of Public Health, 2180 Third Avenue, New York, New York 10035, USA Doctor of Public Health Program, The Graduate Center, City University of New York, 365 5th Avenue, New York, New York 10016, USA ekelvin@hunter.cuny.edu.
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.
RCT Entities:
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.
Authors: Kriti Thapa; Matthew L Romo; Arturo Carpio; Denise Leslie; Howard Andrews; W Allen Hauser; Elizabeth A Kelvin Journal: Trans R Soc Trop Med Hyg Date: 2018-02-01 Impact factor: 2.184
Authors: Arturo Carpio; Mindy Chang; Hongbin Zhang; Matthew L Romo; Alex Jaramillo; W Allen Hauser; Elizabeth A Kelvin Journal: Epilepsia Date: 2019-07-29 Impact factor: 5.864
Authors: A Clinton White; Christina M Coyle; Vedantam Rajshekhar; Gagandeep Singh; W Allen Hauser; Aaron Mohanty; Hector H Garcia; Theodore E Nash Journal: Clin Infect Dis Date: 2018-04-03 Impact factor: 9.079
Authors: Hector H Garcia; Andres G Lescano; Isidro Gonzales; Javier A Bustos; E Javier Pretell; John Horton; Herbert Saavedra; Armando E Gonzalez; Robert H Gilman Journal: Clin Infect Dis Date: 2016-03-16 Impact factor: 9.079