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Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus

A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency...

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Autores principales: Dusabimana, Alfred, Tsebeni Wafula, Solomon, Raimon, Stephen Jada, Fodjo, Joseph Nelson Siewe, Bhwana, Dan, Tepage, Floribert, Abd-Elfarag, Gasim, Hotterbeekx, An, Abrams, Steven, Colebunders, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824398/
https://www.ncbi.nlm.nih.gov/pubmed/33396221
http://dx.doi.org/10.3390/pathogens10010021
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author Dusabimana, Alfred
Tsebeni Wafula, Solomon
Raimon, Stephen Jada
Fodjo, Joseph Nelson Siewe
Bhwana, Dan
Tepage, Floribert
Abd-Elfarag, Gasim
Hotterbeekx, An
Abrams, Steven
Colebunders, Robert
author_facet Dusabimana, Alfred
Tsebeni Wafula, Solomon
Raimon, Stephen Jada
Fodjo, Joseph Nelson Siewe
Bhwana, Dan
Tepage, Floribert
Abd-Elfarag, Gasim
Hotterbeekx, An
Abrams, Steven
Colebunders, Robert
author_sort Dusabimana, Alfred
collection PubMed
description A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency in PWE with and without anti-seizure medication in three onchocerciasis endemic areas (Maridi, South Sudan; Aketi, DRC; and Mahenge, Tanzania). Pre- and 3–5 months post-ivermectin microfilariae densities in skin snips and seizure frequency were assessed. After ivermectin, the median (IQR) percentage reduction in seizure frequency in the study sites ranged from 73.4% (26.0–90.0) to 100% (50.0–100.0). A negative binomial mixed model showed that ivermectin significantly reduced the seizure frequency, with a larger decrease in PWE with a high baseline seizure frequency. Mediation analysis showed that ivermectin reduced the seizure frequencies indirectly through reduction in microfilariae densities but also that ivermectin may have a direct anti-seizure effect. However, given the short half-life of ivermectin and the fact that ivermectin does not penetrate the healthy brain, such a direct anti-seizure effect is unlikely. A randomized controlled trial assessing the ivermectin effect in people infected with O. volvulus who are also PWE on a stable anti-seizure regimen may be needed to clarify the causal relationship between ivermectin and seizure frequency.
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spelling pubmed-78243982021-01-24 Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus Dusabimana, Alfred Tsebeni Wafula, Solomon Raimon, Stephen Jada Fodjo, Joseph Nelson Siewe Bhwana, Dan Tepage, Floribert Abd-Elfarag, Gasim Hotterbeekx, An Abrams, Steven Colebunders, Robert Pathogens Article A clinical trial performed in the Democratic Republic of Congo (DRC), among persons with epilepsy (PWE) infected with Onchocerca volvulus treated with anti-seizure medication suggested that ivermectin reduces the seizure frequency. We assessed the effect of ivermectin treatment on seizure frequency in PWE with and without anti-seizure medication in three onchocerciasis endemic areas (Maridi, South Sudan; Aketi, DRC; and Mahenge, Tanzania). Pre- and 3–5 months post-ivermectin microfilariae densities in skin snips and seizure frequency were assessed. After ivermectin, the median (IQR) percentage reduction in seizure frequency in the study sites ranged from 73.4% (26.0–90.0) to 100% (50.0–100.0). A negative binomial mixed model showed that ivermectin significantly reduced the seizure frequency, with a larger decrease in PWE with a high baseline seizure frequency. Mediation analysis showed that ivermectin reduced the seizure frequencies indirectly through reduction in microfilariae densities but also that ivermectin may have a direct anti-seizure effect. However, given the short half-life of ivermectin and the fact that ivermectin does not penetrate the healthy brain, such a direct anti-seizure effect is unlikely. A randomized controlled trial assessing the ivermectin effect in people infected with O. volvulus who are also PWE on a stable anti-seizure regimen may be needed to clarify the causal relationship between ivermectin and seizure frequency. MDPI 2020-12-31 /pmc/articles/PMC7824398/ /pubmed/33396221 http://dx.doi.org/10.3390/pathogens10010021 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dusabimana, Alfred
Tsebeni Wafula, Solomon
Raimon, Stephen Jada
Fodjo, Joseph Nelson Siewe
Bhwana, Dan
Tepage, Floribert
Abd-Elfarag, Gasim
Hotterbeekx, An
Abrams, Steven
Colebunders, Robert
Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title_full Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title_fullStr Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title_full_unstemmed Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title_short Effect of Ivermectin Treatment on the Frequency of Seizures in Persons with Epilepsy Infected with Onchocerca volvulus
title_sort effect of ivermectin treatment on the frequency of seizures in persons with epilepsy infected with onchocerca volvulus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824398/
https://www.ncbi.nlm.nih.gov/pubmed/33396221
http://dx.doi.org/10.3390/pathogens10010021
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