Combo of 3 drugs might eliminate painful elephantiasis

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A combination of three drugs could rapidly treat and even prevent the parasitic disease that causes elephantiasis, a painful and disfiguring condition.

Parasitic worms cause the tropical disease, called lymphatic filariasis, which is transmitted to people by mosquitoes. It threatens about one billion people globally, particularly in India, Indonesia, and Myanmar.

Many people with the disease develop elephantiasis or lymphoedema, which causes pain and profound disfigurement—such as large swelling of the arms, legs, or genitals—and leads to permanent disability.

Currently, people with lymphatic filariasis require multiple rounds of treatment, but if the drugs ivermectin, diethylcarbamazine, and albendazole are used together, the drugs are more effective at killing the worms.

“This more effective treatment has the potential to revolutionize the control of this disease, but it will require that in over a few rounds of treatment the programs are able to treat almost the whole population, even the most inaccessible,” says Deirdre Hollingsworth, who leads the Neglected Tropical Diseases (NTD) Modeling Consortium and is based at the University of Warwick’s Mathematics Institute and School of Life Sciences.

3 different mathematical models

Researchers used mathematical models to simulate a mass drug administration campaign in different settings. As there are many unknowns about the transmission of the disease and how a population responds to intervention, three independently developed models were used to estimate the impact of the new regimen.

Scientists from the University of Warwick, Erasmus Medical Centre, and Notre Dame University developed the models. All three were in agreement in the effectiveness of the regimen in reducing the prevalence of disease.

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“We use very different approaches, but our models all have the same message. This new drug regimen can reduce the number of rounds, but it still depends on the programs being well-run. Even with the best possible regimen elimination is difficult to achieve if many people repeatedly don’t participate in mass drug administration,” says Wilma Stolk from Erasmus Medical Centre.

The researchers note that more effective treatment with fewer drugs rounds is crucial in poorer countries where transmission is high but resources are low.

“Our results show that this regimen could potentially overcome important issues plagued by elimination campaigns, by making elimination as a public health problem achievable in a few years,” says Mike Irvine from the University of British Columbia in Canada, who is the first author of the paper published in The Lancet Infectious Diseases.

Source: University of Warwick