Evaluation of activity of triclabendazole against Taenia solium metacestode in naturally infected pigs

Objective:To assess the efficacy of triclabendazole(TCBZ) in porcine cysticercosis.Methods:Eighteen naturally infected cysticercotic pigs were divided into 3 groups of 6 individuals each.The first group was treated orally with TCBZ at a single dose of 30 mg/kg of body weight,the second group was treated orally with oxfendazole at a single dose of 30 mg/kg of body weight and the third group received a placebo(control group).All animals were kept under the same management conditions.The pigs were euthanized 17 wk post-treatment and the number of surviving cysts in muscles was assessed and compared between groups.Results:All pigs treated with oxfendazole had only degenerated cysts in their carcasses.In contrast,TCBZ had very little effect against the parasitic cysts.Cysts from pigs in the TCBZ group looked apparently normal after treatment.However,histological evaluation showed a mild to moderate degree of inflammation.Conclusions:TCBZ is not an efficacious drug against Taenia solium cysticercosis in swine using a single dose.

Triclabendazole (Egaten)

2019年2月13日,由诺华制药公司研发的Tricla-bendazole(商品名Egaten)经美国FDA批准上市,用于治疗6岁以上的片形吸虫病(Fascioliasis),这是FDA批准用于这一疾病的第一款药物。Egaten为口服片剂,推荐剂量为10 mg·kg-1,给药间隔为12 h.

Experimental observation of effects of triclabendazole on Paragonimus westermani infection in dogs

Objective To observe the therapeutic effects of triclabendazole in the treatment of dogs with Paragonimiasis westermani. Methods Six dogs were experimentally infected, each with 100 metacercariae of Paragonimus westermani intraperitoneally and divided into untreated and treated groups, 3 dogs were treated orally with triclabendazole 100 mg/kg·d 1 for 2 consecutive days on day 170 after infection. Stool egg count was done by Stoll method. All dogs were killed on day 38 after treatment and the number of worm cysts and worms in the lungs were examined by naked eye and microscopically. Results Stool eggs became negative from day 7 to day 14 after starting chemotherapy in treated dogs. The numbers of worm cysts in the lungs of untreated dogs were 18, 24 and 24 on necropsy,while those in the treated dogs were 10, 7 and 4, respectively. The numbers of adult worms in the untreated dogs were 38, 51 and 42, while in the treated dogs only 2 small adult worms were found in one dog and no worm was found in the other two dogs. The mean worm reduction rate was 98.5%. Conclusion Triclabendazole is highly effective against Paragonimus westermani in experimentally infected dogs.

Triclabendazole in the treatment of Paragonimiasis skrjabini

Objective To observe triclabendazole effect on Paragonimus skrjabini in experimentally infected rats, and to develop a new drug for treating paragonimiasis.Methods Metacercariae of Paragonimus skrjabini were isolated from crabs (Sinopotamon) collected from endemic area. Wistar rats were infected intraperitoneally. One and two months after infection, they were treated with triclabendazole at the dosage of 300 mg · kg -1 · 2d-1, 450 mg ·kg -1 · 3d -1 and 600 mg · kg-1 · 3d-1 respectively. Five patients with Paragonimus skrjabini were treated, with Triclabendazole dosage of 10 mg/kg bid x3 days.Results The worm reduction rates were 50. 3%, 80. 8% and 86. 7% respectively one month after completion of treatment. Dead worms of sesame size recovered from muscles, liver, abdominal cavity, chest cavity and lung were greatly diminished in size and weight in comparison with that of the control group. Many large (about 1 cm) black-colored distended worm cysts were found in the lungs of the control rats. Usually there were two adult worms pairs with numerous eggs in each worm cyst. Most worm cysts in the treated groups of rats were changed into hemorrhagic-necrotic patches. All five patients were cured.Conclusion Triclabendazole was highly active against Paragonimus skrjabini in rats experimentally infected and patients.

Clinical presentation and management of Fasciola hepatica infection:Single-center experience

AIM:To identify the characteristic clinical,laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS:Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study.Initial clinical,laboratory and radiological findings were recorded.All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.RESULTS:Fasciola hepatica infection was diagnosed in 30 patients(24 females;mean age:42.6 years) between January 2008 and February 2011.Twentytwo(73%) patients had hepatic phase fascioliasis,5 patients had biliary phase,and 3 patients had biliary phase associated with acute pancreatitis.Of the 8 patients with biliary phase fascioliasis,2 patients displayed features that overlapped with both hepatic and biliary phase.Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients.Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase(100% and 50%,respectively).Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase.Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography(ERCP) findings in patients with biliary phase.Patients with hepatic phase were treated with triclabendazole alone,and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP.CONCLUSION:Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.

Large number of <i>Fasciola hepatica</i>discovered during endoscopic retrograde cholangiopancreatography (ERCP)

Fascioliasis is a zoonotic infection of herbiviores, occasionally affecting humans who ingest fresh water plants. We report a case of a young woman who presented to our center with vague abdominal discomfort & discovered on abdominal ultrasound to have gall stones & dilated common bile duct. She was scheduled for ERCP which revealed a large number of fasciola worms draining from the common bile duct to the duodenum.

Effectiveness of the Experimental Fosfatriclaben in Comparison with Two Commercial Fasciolicides in Cattle

The aim of the present study was to compare the fasciolicidal efficacy in cattle of an experimental water-soluble compound, named fosfatriclaben, a prodrug of triclabendazole, with two commercial fasciolicides. For this, twenty-four cross mixed milking cows, aged between 1 to 3 years, naturally infected with Fasciola hepatica, were used. To apply the treatment, animals were divided into 4 groups of 6 animals each being ranked according to their fecal fluke-egg count from the highest to the lowest number of eggs. The compounds were administered in the groups with a single dose. Group 1 (G1) was treated with 6 mg/kg/IM of fosfatriclaben, G2 was treated with triclabendazole at 12 mg/kg/PO;G3 was treated with 5% closantel at 10 mg/kg/SC and G4 was administered with 5 mL/IM of deionized water and served as untreated control. Fecal samples were analyzed on days—8, 0 (treatment day), 7, 14, 21 and 28 to count the number of fasciola eggs before and after the treatment using the sedimentation test. The efficacy was assessed as the percentage of fluke-egg reduction on treated groups relative to the untreated control. The resulting data were analyzed by the Kruskal-Wallis non-parametric test, using the statistical IBM SPSS 24.0 (2016) program. Results indicated a fluke-egg reduction of 100% for fosfatriclaben along the study;triclabendazole showed an efficacy of 99.7% - 100% from day 7 to day 28. In the case of closantel, values from 98.8% to 99.6% were recorded from day 7 to day 28. No statistical differences between treatments were observed (P < 0.05). It was concluded that the experimental fosfatriclaben administered at 6 mg/kg/IM to naturally infected cattle exerted a fasciolicidal efficacy similar to the drugs of choice for the treatment of fasciolosis (triclabendazole) when administered at 12 mg/kg/ PO, and closantel injected at 10 mg/kg/SC.