Taenia solium neurocysticercosis is the single major cause of acquired epileptic seizures in the world, and a common diagnosis in immigrant populations in the USA and other industrialized countries. We have demonstrated that the prognosis of the associated seizure disorder improves by killing brain cysts using anti-parasitic treatment. Cyst death is not the direct result of the drug but actually results from the host's immune system destroying the parasite after antigenic exposure caused by treatment-associated damage. Current regimes of antiparasitic treatment offer only partial efficacy, killing 75% of brain cysts or less. We hypothesize that combined treatment with two different anti-parasitic drugs will improve clearance of brain parasites and thus provide better cysticidal efficacy, and will perform a double-blind, randomized clinical trial to determine if a 10-days combined regime of regime of praziquantel (PZQ) and albendazole (ABZ) improves the parasiticidal efficacy of ABZ alone at the same dose and length of treatment. A secondary aim to be examined is also whether complete cyst destruction (patients free of any viable cysts) is associated with fewer seizures in a 18-months follow up period. There will be two associated substudies: i) pharmacokinetics of ABZ and PZQ in patients with neurocysticercosis, and ii) immunological markers of complete cure after treatment for neurocysticercosis. The parent study will determine the benefits of combined antiparasitic therapy in terms of parasiticidal effect and control of seizures. This mode of therapy would have worldwide applicability. The two sub-studies should add useful data on the pharmacokinetics of the drugs and assess the possibility of early prediction of complete cure.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
3R01NS054805-05S2
Application #
8550207
Study Section
Special Emphasis Panel (ZRG1-CRFS-C (01))
Program Officer
Fureman, Brandy E
Project Start
2006-06-20
Project End
2013-05-31
Budget Start
2010-06-01
Budget End
2013-05-31
Support Year
5
Fiscal Year
2012
Total Cost
$206,000
Indirect Cost
Name
Universidad Peruana Cayetano Heredia
Department
Type
DUNS #
934798430
City
Lima
State
Country
Peru
Zip Code
LIMA -31
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Garcia, Hector H; Gonzales, Isidro; Lescano, Andres G et al. (2014) Enhanced steroid dosing reduces seizures during antiparasitic treatment for cysticercosis and early after. Epilepsia 55:1452-9
Garcia, Hector H; Gonzales, Isidro; Lescano, Andres G et al. (2014) Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a double-blind, randomised controlled trial. Lancet Infect Dis 14:687-95
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Singh, G; Rajshekhar, V; Murthy, J M K et al. (2010) A diagnostic and therapeutic scheme for a solitary cysticercus granuloma. Neurology 75:2236-45
Garcia, Hector H (2008) Antiparasitic drugs in neurocysticercosis: albendazole or praziquantel? Expert Rev Anti Infect Ther 6:295-8