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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Doxycycline improves filarial lymphedema independent of active filarial infection: A randomized controlled trial
Clinical Infectious Diseases, Volume 55, No. 5, Year 2012
Notification
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Description
Background.The aim of this study was to determine whether improvement of filarial lymphedema (LE) by doxycycline is restricted to patients with ongoing infection (positive for circulating filarial antigen [CFA]), or whether the majority of CFA-negative patients with LE would also show a reduction in LE severity.Methods.One hundred sixty-two Ghanaian participants with LE stage 1-5 (Dreyer) were randomized blockwise into 2 groups (CFA positive or negative) and allocated to 3 treatment arms of 6 weeks: (1) amoxicillin (1000 mg/d), (2) doxycycline (200 mg/d), or (3) placebo matching doxycycline. All groups received standard hygiene morbidity management. The primary outcome was reduction of LE stages. Secondary outcomes included frequency of acute attacks and ultrasonographic assessment of skin thickness at the ankles. Parameters were assessed before treatment and after 3, 12, and 24 months.Results.Doxycycline- treated patients with LE stage 2-3 showed significant reductions in LE severity after 12 and 24 months, regardless of CFA status. Improvement was observed in 43.9 of doxycycline-treated patients, compared with only 3.2 and 5.6 in the amoxicillin and placebo arms, respectively. Skin thickness was correlated with LE stage improvement. Both doxycycline and amoxicillin were able to reduce acute dermatolymphangioadenitis attacks.Conclusions.Doxycycline treatment improves mild to moderate LE independent of ongoing infection. This finding expands the benefits of doxycycline to the entire population of patients suffering from LE. Patients with LE stage 1-3 should benefit from a 6-week course of doxycycline every other year or yearly, which should be considered as an improved tool to manage morbidity in filarial LE.Clinical Trials Registration.ISRCTN 90861344. © The Author 2012.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3412691/bin/cis486_Supplementary_Data.zip
https://efashare.b-cdn.net/share/pmc/articles/PMC3412691/bin/supp_55_5_621__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC3412691/bin/supp_cis486_cis486supp.doc
Authors & Co-Authors
Mand, Sabine
Unknown Affiliation
Debrah, Yaw Alex
Unknown Affiliation
Klarmann-Schulz, Ute
Unknown Affiliation
Batsa, Linda
Unknown Affiliation
Marfo-Debrekyei, Yeboah
Unknown Affiliation
Kwarteng, Alexander
Unknown Affiliation
Specht, Sabine
Unknown Affiliation
Belda-Domene, Aurea
Unknown Affiliation
Fimmers, Rolf
Unknown Affiliation
Taylor, Mark John
Unknown Affiliation
Adjei, Ohene
Unknown Affiliation
Hoerauf, Achim M.
Unknown Affiliation
Statistics
Citations: 90
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1093/cid/cis486
ISSN:
10584838
e-ISSN:
15376591
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Quantitative