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Synthesis and antiplasmodial activity of regioisomers and epimers of second-generation dual acting ivermectin hybrids. Sci Rep 2022; 12:564. [PMID: 35022455 PMCID: PMC8755717 DOI: 10.1038/s41598-021-04532-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022] Open
Abstract
With its strong effect on vector-borne diseases, and insecticidal effect on mosquito vectors of malaria, inhibition of sporogonic and blood-stage development of Plasmodium falciparum, as well as in vitro and in vivo impairment of the P. berghei development inside hepatocytes, ivermectin (IVM) continues to represent an antimalarial therapeutic worthy of investigation. The in vitro activity of the first-generation IVM hybrids synthesized by appending the IVM macrolide with heterocyclic and organometallic antimalarial pharmacophores, against the blood-stage and liver-stage infections by Plasmodium parasites prompted us to design second-generation molecular hybrids of IVM. Here, a structural modification of IVM to produce novel molecular hybrids by using sub-structures of 4- and 8-aminoquinolines, the time-tested antiplasmodial agents used for treating the blood and hepatic stage of Plasmodium infections, respectively, is presented. Successful isolation of regioisomers and epimers has been demonstrated, and the evaluation of their in vitro antiplasmodial activity against both the blood stages of P. falciparum and the hepatic stages of P. berghei have been undertaken. These compounds displayed structure-dependent antiplasmodial activity, in the nM range, which was more potent than that of IVM, its aglycon or primaquine, highlighting the superiority of this hybridization strategy in designing new antiplasmodial agents.
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Pessanha de Carvalho L, Kreidenweiss A, Held J. Drug Repurposing: A Review of Old and New Antibiotics for the Treatment of Malaria: Identifying Antibiotics with a Fast Onset of Antiplasmodial Action. Molecules 2021; 26:2304. [PMID: 33921170 PMCID: PMC8071546 DOI: 10.3390/molecules26082304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Malaria is one of the most life-threatening infectious diseases and constitutes a major health problem, especially in Africa. Although artemisinin combination therapies remain efficacious to treat malaria, the emergence of resistant parasites emphasizes the urgent need of new alternative chemotherapies. One strategy is the repurposing of existing drugs. Herein, we reviewed the antimalarial effects of marketed antibiotics, and described in detail the fast-acting antibiotics that showed activity in nanomolar concentrations. Antibiotics have been used for prophylaxis and treatment of malaria for many years and are of particular interest because they might exert a different mode of action than current antimalarials, and can be used simultaneously to treat concomitant bacterial infections.
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Affiliation(s)
- Lais Pessanha de Carvalho
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
- Centre de Recherches Medicales de Lambaréné (CERMEL), Lambaréné BP 242, Gabon
| | - Jana Held
- Institute of Tropical Medicine, University of Tuebingen, 72074 Tuebingen, Germany; (L.P.d.C.); (A.K.)
- Centre de Recherches Medicales de Lambaréné (CERMEL), Lambaréné BP 242, Gabon
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Singh L, Fontinha D, Francisco D, Mendes AM, Prudêncio M, Singh K. Molecular Design and Synthesis of Ivermectin Hybrids Targeting Hepatic and Erythrocytic Stages of Plasmodium Parasites. J Med Chem 2020; 63:1750-1762. [PMID: 32011136 DOI: 10.1021/acs.jmedchem.0c00033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Ivermectin is a powerful endectocide, which reduces the incidence of vector-borne diseases. Besides its strong insecticidal effect on mosquito vectors of the disease, ivermectin inhibits Plasmodium falciparum sporogonic and blood stage development and impairs Plasmodium berghei development inside hepatocytes, both in vitro and in vivo. Herein, we present the first report on structural modification of ivermectin to produce dual-action molecular hybrids with good structure-dependent in vitro activity against both the hepatic and erythrocytic stages of P. berghei and P. falciparum infection, suggesting inclusion of ivermectin antimalarial hybrids in malaria control strategies. The most active hybrid displayed over threefold and 10-fold higher in vitro activity than ivermectin against hepatic and blood stage infections, respectively. Although an overwhelming insecticidal effect against Anopheles stephensi mosquitoes in laboratory conditions was not noticed, in silico docking analysis supports allosteric binding to glutamate-gated chloride channels similar to ivermectin.
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Affiliation(s)
- Lovepreet Singh
- Department of Chemistry , Guru Nanak Dev University , Amritsar 143 005 , India
| | - Diana Fontinha
- Instituto de Medicina Molecular , Faculdade de Medicina da Universidade de Lisboa , Av. Prof. Egas Moniz , Lisboa 1649-028 , Portugal
| | - Denise Francisco
- Instituto de Medicina Molecular , Faculdade de Medicina da Universidade de Lisboa , Av. Prof. Egas Moniz , Lisboa 1649-028 , Portugal
| | - Antonio M Mendes
- Instituto de Medicina Molecular , Faculdade de Medicina da Universidade de Lisboa , Av. Prof. Egas Moniz , Lisboa 1649-028 , Portugal
| | - Miguel Prudêncio
- Instituto de Medicina Molecular , Faculdade de Medicina da Universidade de Lisboa , Av. Prof. Egas Moniz , Lisboa 1649-028 , Portugal
| | - Kamaljit Singh
- Department of Chemistry , Guru Nanak Dev University , Amritsar 143 005 , India
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Impact of ivermectin administered for scabies treatment on the prevalence of head lice in Atoifi, Solomon Islands. PLoS Negl Trop Dis 2018; 12:e0006825. [PMID: 30252856 PMCID: PMC6173439 DOI: 10.1371/journal.pntd.0006825] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/05/2018] [Accepted: 09/07/2018] [Indexed: 11/17/2022] Open
Abstract
Background Scabies and head lice are ubiquitous ectoparasitic infestations that are common across the Pacific Islands. Ivermectin is an effective treatment for both conditions, although the doses used vary. At a community level, mass drug administration (MDA) with ivermectin is an effective strategy to decrease prevalence of scabies. To what extent MDA with ivermectin will also reduce prevalence of head lice is unknown. Methodology Head lice prevalence was assessed before and after MDA with oral ivermectin (at a dose of 200 micrograms per kilogram of body weight) administered on day 1 and day 8. The primary outcome was the change in prevalence of head louse infestation at two weeks compared to baseline. Longer term efficacy was assessed three months after MDA. Results 118 participants were enrolled. Baseline prevalence of active head louse infestation was 25.4% (95% CI 18.4–34.0). At two-week follow-up, prevalence was 2.5% (95% CI 0.9–7.2), a relative reduction of 89.1% (95% CI 72.7–91.4%, p<0.001). At three-month follow-up, prevalence was 7.5% (95% CI 2.7–12.3), a relative reduction of 70.6% (95% CI 72.7%-91.4%, p <0.001). Head louse infestation was associated with younger age (age ≤10 years: prevalence 46.7%; adjusted odds ratio compared to adults of 7.2, 95%CI 2.0–25.9) and with having at least one other member of the household with active head louse infestation (adjusted odds ratio 4.3, 95%CI 1.7–11.1). Conclusions Head louse infestation is common in the Solomon Islands. This proof of principle study shows that oral ivermectin at a dose of 200 micrograms per kilogram can reduce the burden of active head louse infestation, offering an additional collateral benefit of MDA with ivermectin for scabies control. Trial registration ClinicalTrials.gov NCT03236168. Head lice and scabies are both caused by ectoparasites and lead to itchy skin conditions that are associated with secondary bacterial infections and social stigma. Both are common in developing countries. In the Solomon Islands, mass treatment of communities using ivermectin (at dose of 200 micrograms per kilogram) has been shown to be an effective strategy in reducing scabies prevalence. This study shows that the same dose of ivermectin and the same regime of mass drug administration is also effective at reducing the burden of head louse infestation, offering an additional benefit to community wide treatment.
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Sanchezruiz WL, Nuzum DS, Kouzi SA. Oral ivermectin for the treatment of head lice infestation. Am J Health Syst Pharm 2018; 75:937-943. [PMID: 29789316 DOI: 10.2146/ajhp170464] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Published literature describing the use of oral ivermectin for the treatment of head lice infestation is reviewed. SUMMARY In the United States and globally, head lice infestation, or pediculosis capitis, remains a public health issue with both social and medical implications. Treatment with oral or topical medications is typically required for head lice eradication. Resistance to traditional topical therapies for head lice infestation is increasing, creating a need for consideration of additional treatment options. A growing body of data describing the potential role of oral ivermectin for the treatment or prevention of head lice infestation is available. A literature search identified 5 clinical trials that evaluated safety and/or effectiveness outcomes of oral ivermectin use as an alternative to malathion, other topical prescription medications, and traditional, nonprescription remedies; those studies were conducted in various parts of the world (e.g., Australia, Brazil, Mexico, Egypt) and likely involved varying types and degrees of lice resistance. Clinical research findings to date, while not consistently robust, suggest that oral ivermectin is comparable or superior in effectiveness to other topical treatment options for head lice infestation while being well tolerated and favorably perceived by patients and caretakers. CONCLUSION Oral ivermectin is an option for the treatment of head lice infestation, especially in individuals who have experienced a treatment failure. Published evidence from clinical trials indicates that oral ivermectin is as effective as currently available topical treatments.
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Ullio-Gamboa G, Palma S, Benoit JP, Allemandi D, Picollo MI, Toloza AC. Ivermectin lipid-based nanocarriers as novel formulations against head lice. Parasitol Res 2017; 116:2111-2117. [DOI: 10.1007/s00436-017-5510-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/08/2017] [Indexed: 11/29/2022]
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Leulmi H, Diatta G, Sokhna C, Rolain JM, Raoult D. Assessment of oral ivermectin versus shampoo in the treatment of pediculosis (head lice infestation) in rural areas of Sine-Saloum, Senegal. Int J Antimicrob Agents 2016; 48:627-632. [DOI: 10.1016/j.ijantimicag.2016.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 11/27/2022]
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Ōmura S. Ein vortreffliches Geschenk der Erde: Ursprünge und Auswirkungen der Avermectine (Nobel-Aufsatz). Angew Chem Int Ed Engl 2016. [DOI: 10.1002/ange.201602164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Satoshi Ōmura
- Kitasato University; Kitasato Institute for Life Sciences; Minato-ku, 9-1, Shirokane 5-chome Tokyo 108-8642 Japan
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Ōmura S. A Splendid Gift from the Earth: The Origins and Impact of the Avermectins (Nobel Lecture). Angew Chem Int Ed Engl 2016; 55:10190-209. [PMID: 27435664 DOI: 10.1002/anie.201602164] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Indexed: 11/08/2022]
Abstract
Japanese soil was the origin of one of the most important drugs of the world: ivermectin. No other drug has such importance for the health of millions of people, particularly in the poor regions of the world. The discovery of the parent compounds of the avermectines is described first hand by S. Ōmura.
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Affiliation(s)
- Satoshi Ōmura
- Kitasato University, Kitasato Institute for Life Sciences, Minato-ku, 9-1, Shirokane 5-chome, Tokyo, 108-8642, Japan.
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Tagka A, Lambrou GI, Braoudaki M, Panagiotopoulos T, Papanikolaou E, Laggas D. Socioeconomical Factors Associated With Pediculosis (Phthiraptera: Pediculidae) in Athens, Greece. JOURNAL OF MEDICAL ENTOMOLOGY 2016; 53:919-922. [PMID: 27134208 DOI: 10.1093/jme/tjw055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 06/05/2023]
Abstract
Pediculosis in humans and especially in children is a very common dermatological disorder caused by the ectoparasite Pediculus humanus capitis De Geer. We investigated the socioeconomic factors affecting the prevalence of pediculosis in the Greek urban area of Athens during 2004-2006. The target population consisted of children from kindergartens. In total, 434 children from single- or two-parent families were investigated with respect to socioeconomic factors such as education, income and family composition, and the prevalence of pediculosis. The overall pediculosis rate was 5.30%. Head louse infestations were significantly higher in female children and in two-parent families. Lice infestations peaked in low- and medium-income families. Head louse infestation rates were influenced by income, parents' education, and nationality.
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Affiliation(s)
- Anna Tagka
- Department of Dermatology, University of Athens Medical School, Andreas Syggros Hospital, Athens, Greece ,
| | - George I Lambrou
- First Department of Pediatrics, Choremeio Research Laboratory, University of Athens, Athens-Goudi 11527, Greece (; ),
| | - Maria Braoudaki
- First Department of Pediatrics, Choremeio Research Laboratory, University of Athens, Athens-Goudi 11527, Greece (; )
| | - Takis Panagiotopoulos
- Department of Child Health, National School of Public Health, 196 Alexandras Av., 11521 Athens, Greece (; )
| | - Eleni Papanikolaou
- Division of Endocrinology, Metabolism and Diabetes, University of Athens Medical School, "Eugenideion" Hospital, Athens, Greece
| | - Dimitris Laggas
- Department of Child Health, National School of Public Health, 196 Alexandras Av., 11521 Athens, Greece (; )
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Prevalence of Head Lice Infestation and Its Associated Factors among Primary School Students in Iran: A Systematic Review and Meta-analysis. Osong Public Health Res Perspect 2015; 6:346-56. [PMID: 26835244 PMCID: PMC4700766 DOI: 10.1016/j.phrp.2015.10.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 10/28/2015] [Indexed: 11/22/2022] Open
Abstract
Objectives Head lice infestation is one of the most important health problems, generally involving children aged 5–13 years. This study aims to estimate the prevalence of head lice infestation and its associated factors among primary school children using systematic review and meta-analysis methods. Methods Different national and international databases were searched for selecting the relevant studies using appropriate keywords, Medical Subject Heading terms, and references. Relevant studies with acceptable quality for meta-analysis were selected having excluded duplicate and irrelevant articles, quality assessment, and application of inclusion/exclusion criteria. With calculating standard errors according to binomial distribution and also considering the Cochrane's Q test as well as I-squared index for heterogeneity, pediculosis prevalence rate was estimated using Stata SE V.11 software. Results Forty studies met the inclusion criteria of this review and entered into the meta-analysis including 200,306 individuals. Using a random effect model, the prevalence (95% confidence interval) of head lice infestation among primary school children was estimated as 1.6% (1.2–2.05), 8.8% (7.6–9.9), and 7.4% (6.6–8.2) for boys, girls, and all the students, respectively. The infestation rate was found to be associated with low educational level of parents, long hair, family size, mother's job (housewife), father's job (worker/unemployed), using a common comb, lack of bathrooms in the house, and a low frequency of bathing. Conclusion This meta-analysis revealed that the prevalence of head lice infestation among Iranian primary school children is relatively high with more prevalence among girls. We also found that economic, social, cultural, behavioral, and hygienic factors are associated with this infestation.
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Abstract
An endeavour to delineate the salient details of the treatment of head lice infestation has been made in the present article. Treatment modalities including over the counter permethrin and pyrethrin, and prescription medicines, including malathion, lindane, benzyl alcohol, spinosad are discussed. Salient features of alternative medicine and physical treatment modalities are outlined. The problem of resistance to treatment has also been taken cognizance of.
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Affiliation(s)
- Prashant Verma
- Department of Dermatology and STD, North DMC Medical College, Hindu Rao Hospital, New Delhi, India
| | - Chaitanya Namdeo
- Department of Dermatology and STD, S.S Medical College, Rewa, Madhya Pradesh, India
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Omura S, Crump A. Ivermectin: panacea for resource-poor communities? Trends Parasitol 2014; 30:445-55. [PMID: 25130507 DOI: 10.1016/j.pt.2014.07.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 07/12/2014] [Accepted: 07/15/2014] [Indexed: 02/03/2023]
Abstract
The 2014 Gairdner Global Health Award was conferred for discovery of the unique microorganism that is the sole source of the endectocidal avermectins, and the Public sector/Private sector Partnership that developed innovative biopharmaceuticals with immeasurably beneficial impact on public health worldwide. Ivermectin is already labelled a 'wonder drug', essential for campaigns to eliminate two disfiguring and devastating tropical diseases. New uses for it are identified regularly, including possible antibacterial, antiviral, and anticancer potential. Hundreds of millions of people are taking ivermectin to combat various diseases and afflictions, and mass administration of ivermectin in polyparasitised poor communities around the world is increasingly recognised as a mechanism to easily and cost-effectively improve overall health and quality of life for everyone.
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Affiliation(s)
- Satoshi Omura
- The Kitasato Institute and Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan
| | - Andy Crump
- The Kitasato Institute and Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo 108-8641, Japan.
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Speare R, Harrington H, Canyon D, Massey PD. A systematic literature review of pediculosis due to head lice in the Pacific Island Countries and Territories: what country specific research on head lice is needed? BMC DERMATOLOGY 2014; 14:11. [PMID: 24962507 PMCID: PMC4078391 DOI: 10.1186/1471-5945-14-11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 06/20/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lack of guidelines on control of pediculosis in the Solomon Islands led to a search for relevant evidence on head lice in the Pacific Island Countries and Territories (PICTs). The aim of this search was to systematically evaluate evidence in the peer reviewed literature on pediculosis due to head lice (Pediculus humanus var capitis) in the 22 PICTs from the perspective of its value in informing national guidelines and control strategies. METHODS PubMed, Web of Science, CINAHL and Scopus were searched using the terms (pediculosis OR head lice) AND each of the 22 PICTs individually. PRISMA methodology was used. Exclusion criteria were: i) not on topic; ii) publications on pediculosis not relevant to the country of the particular search; iii) in grey literature. RESULTS Of 24 publications identified, only 5 were included. Four related to treatment and one to epidemiology. None contained information relevant to informing national guidelines. CONCLUSIONS Current local evidence on head lice in the PICTs is minimal and totally inadequate to guide any recommendations for treatment or control. We recommend that local research is required to generate evidence on: i) epidemiology; ii) knowledge, attitudes and practices of health care providers and community members; iii) efficacy of local commercially available pharmaceutical treatments and local customary treatments; iv) acceptability, accessibility and affordability of available treatment strategies; and iv) appropriate control strategies for families, groups and institutions. We also recommend that operational research be done by local researchers based in the PICTs, supported by experienced head lice researchers, using a two way research capacity building model.
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Affiliation(s)
- Rick Speare
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia.
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Meinking TL, Mertz-Rivera K, Villar ME, Bell M. Assessment of the safety and efficacy of three concentrations of topical ivermectin lotion as a treatment for head lice infestation. Int J Dermatol 2013; 52:106-12. [PMID: 23278618 DOI: 10.1111/j.1365-4632.2012.05629.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ivermectin is a broad-spectrum parasiticide in widespread systemic use, including as an off-label treatment for head lice infestation. The potential of the topical use of ivermectin as a treatment for head lice infestation was suggested by an in vitro report of a novel lotion formulation. OBJECTIVES This study investigated the relative effectiveness of three ivermectin lotion concentrations (0.15, 0.25, and 0.5%) compared with vehicle placebo in eliminating head lice infestation. METHODS In this randomized, blinded study, 78 head lice-infested subjects, aged 2-62 years, received a single, 10-minute application of product on day 1. Evaluations were completed at two and six hours post-application, and on days 2, 8 (±1), and 15 (+2). Safety was assessed according to the evaluations of trained observers and adverse event (AE) reports. Efficacy was assessed according to scalp and hair examinations. RESULTS Compared with placebo, all ivermectin concentrations resulted in the statistically significant (P ≤ 0.003) eradication of head lice through to day 15, with the highest level of eradication (73.7%) in subjects who received the 0.5% concentration. The severity of pruritus decreased from baseline in all treatment groups, including the placebo group, from six hours post-treatment to day 15, with the greatest reduction in the 0.5% concentration group. No ocular irritation was observed. All three ivermectin treatment strengths and vehicle were well tolerated. CONCLUSIONS A single application of a 0.5% concentration of this ivermectin lotion formulation shows promise as a safe and effective treatment for head lice infestation and the associated signs of pruritus.
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Hazan L, Berg JE, Bowman JP, Murray JV, Ryan WG. Pharmacokinetics and safety of 0.5% ivermectin lotion for head louse infestations. Pediatr Dermatol 2013; 30:323-8. [PMID: 23131185 DOI: 10.1111/pde.12033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The safety of a novel 0.5% ivermectin lotion (IVL) and potential for ivermectin absorption after application was investigated in an open-label study in young children, and a human repeat insult patch test (HRIPT) and cumulative irritation test (CIT) assessed any potential for cumulative dermal irritation and contact sensitization. In the pharmacokinetic and safety study, 30 head louse-infested children ages 6 months to 3 years received a 10-minute application of IVL on day 1. Blood was collected before application; 0.5, 1, and 6 hours after rinsing; and on days 2 and 8. Samples from 20 subjects were assayed for ivermectin (test sensitivity 0.05 ng/mL). Liver panel and complete blood counts were completed for all subjects. For the HRIPT/CIT, occlusive patches containing IVL or vehicle control lotion (CL) were repeatedly applied to 220 healthy adult subjects to assess contact sensitization; for cumulative dermal irritation testing, additional patches with normal saline and sodium dodecyl sulfate (SDS) were applied to 36 subjects. In the open-label study, all detected ivermectin plasma concentrations were <1 ng/mL. No safety signals emerged, and treatment was well tolerated. In the HRIPT/CIT, IVL was significantly less irritating than normal saline and SDS, with no evidence of dermal irritation or sensitization in human skin. IVL was safe when applied topically, absorption was de minimus, there was no evidence of irritation or sensitization from repeated exposures, and results support the safety of topical IVL use in children as young as 6 months.
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Affiliation(s)
- Lydie Hazan
- AXIS Clinical Trials, Los Angeles, California, USA
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Strycharz JP, Berge NM, Alves AM, Clark JM. Ivermectin acts as a posteclosion nymphicide by reducing blood feeding of human head lice (Anoplura: Pediculidae) that hatched from treated eggs. JOURNAL OF MEDICAL ENTOMOLOGY 2011; 48:1174-1182. [PMID: 22238876 DOI: 10.1603/me11051] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The 0.5% ivermectin topical cream formulation was not directly ovicidal to treated eggs of head lice, as hatchability was not decreased. Nevertheless, the percent of hatched lice from treated eggs that took a blood meal significantly decreased (80-95%) compared with lice that hatched from untreated eggs and all treated lice died within 48 h of hatching, including those that fed. Dilutions of ivermectin formulation of 0.15 and 0.2 microg/ml, which were topically applied to 0-8 d old eggs, were not lethal to lice at 24 h posteclosion. However, 9 and 16% less lice fed when hatched from these treated eggs, respectively. Total [3H] inulin ingested by untreated first instars significantly increased over a 48 h feeding interval but was significantly less in instars that hatched from eggs receiving the 0.15 (36% less) and 0.2 (55% less) microg/ml ivermectin treatments compared with placebo. The reduced feeding that occurred after the 0.15 and 0.2 microg/ml ivermectin treatments occurred in the absence of mortality and suggests a unique mode of action of ivermectin on feeding that is separate from the mode of action of ivermectin leading to mortality. Failure of hatched instars to take a blood meal after egg treatments with formulated ivermectin is likely responsible for its action as a posteclosion nymphicide.
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Affiliation(s)
- Joseph P Strycharz
- Department of Veterinary and Animal Science, Morrill 1, N311B, 639 N. Pleasant Street, University of Massachusetts, Amherst, MA 01003, USA
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Currie MJ, Ciszek K, Kljakovic M, Bowden FJ. Prevalence of head lice among children entering school in the ACT 2006 - 08. Aust N Z J Public Health 2011; 35:195-6. [DOI: 10.1111/j.1753-6405.2010.00692.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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