Michelle A Montgomery1,2, Marcel Ramos1,2, Elizabeth A Kelvin1,2, Arturo Carpio3,4, Alexander Jaramillo5, W Allen Hauser4,6, Hongbin Zhang1,2. 1. Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, New York 10027, USA. 2. CUNY Institute for Implementation Science in Population Health, City University of New York, 55 West 125th Street, New York, New York 10027, USA. 3. School of Medicine, University of Cuenca, Av 12 de Abril s/n Ciudadela Universitaria, 010201 Cuenca, Ecuador. 4. Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, 630 168th Street, Columbia University, New York, New York 10032, USA. 5. Instituto de Diagnóstico por Imágenes, Inés Salcedo 1-99, Cuenca, Ecuador. 6. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, New York 10032, USA.
Abstract
BACKGROUND: In neurocysticercosis, the larval form of the pork tapeworm Taenia solium appears to evolve through three phases-active, degenerative and sometimes calcification-before disappearance. The antihelmintic drug, albendazole, has been shown to hasten the resolution of active cysts in neurocysticercosis. Little is known about the time cysts take to progress through each phase, with or without treatment. METHODS: We reconfigured brain imaging data from patient level to cyst level for 117 patients in a randomized clinical trial of albendazole in which images were taken at baseline, 1, 6, 12 and 24 mo. Applying a multistate model, we modelled the hazard of a cyst evolving to subsequent cyst phases before the next imaging (vs no change). We examined the impact of albendazole treatment overall and by patient and cyst characteristics on the hazard. RESULTS:Albendazole accelerated the evolution from the active to degenerative phase (HR=2.7, 95% CI 1.3 to 6.5) and from the degenerative phase to disappearance (HR=1.9, 95% CI 1.1 to 3.9). Albendazole's impact was stronger for patients who were male, did not have calcified cysts at baseline and who had multiple cysts in different locations. CONCLUSIONS: This research provides a better understanding of where in the cyst trajectory albendazole has the greatest impact.
RCT Entities:
BACKGROUND: In neurocysticercosis, the larval form of the pork tapewormTaenia solium appears to evolve through three phases-active, degenerative and sometimes calcification-before disappearance. The antihelmintic drug, albendazole, has been shown to hasten the resolution of active cysts in neurocysticercosis. Little is known about the time cysts take to progress through each phase, with or without treatment. METHODS: We reconfigured brain imaging data from patient level to cyst level for 117 patients in a randomized clinical trial of albendazole in which images were taken at baseline, 1, 6, 12 and 24 mo. Applying a multistate model, we modelled the hazard of a cyst evolving to subsequent cyst phases before the next imaging (vs no change). We examined the impact of albendazole treatment overall and by patient and cyst characteristics on the hazard. RESULTS:Albendazole accelerated the evolution from the active to degenerative phase (HR=2.7, 95% CI 1.3 to 6.5) and from the degenerative phase to disappearance (HR=1.9, 95% CI 1.1 to 3.9). Albendazole's impact was stronger for patients who were male, did not have calcified cysts at baseline and who had multiple cysts in different locations. CONCLUSIONS: This research provides a better understanding of where in the cyst trajectory albendazole has the greatest impact.
Authors: Luis Jean Pierre Meneses Quiroz; Isidro Gonzales; Edwin Javier Pretell; Herbert Saavedra; Hector H Garcia Journal: Neurol Clin Pract Date: 2015-12
Authors: Héctor H Garcia; E Javier Pretell; Robert H Gilman; S Manuel Martinez; Lawrence H Moulton; Oscar H Del Brutto; Genaro Herrera; Carlton A W Evans; Armando E Gonzalez Journal: N Engl J Med Date: 2004-01-15 Impact factor: 91.245
Authors: Ruth Ann Baird; Sam Wiebe; Joseph R Zunt; John J Halperin; Gary Gronseth; Karen L Roos Journal: Neurology Date: 2013-04-09 Impact factor: 9.910
Authors: Gabrielle Bonnet; Francesco Pizzitutti; Eloy A Gonzales-Gustavson; Sarah Gabriël; William K Pan; Hector H Garcia; Javier A Bustos; Percy Vilchez; Seth E O'Neal Journal: PLoS Comput Biol Date: 2022-05-19 Impact factor: 4.779