Controlled Trial and Dose-Finding Study of Ivermectin for Treatment of Onchocerciasis

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Abstract
Ivermectin, given as a single oral dose, has shown considerable promise as a new treatment for onchocerciasis. We assessed the safety and efficacy of ivermectin and tried to determine the optimal dose. Two hundred Liberians received 100, 150, or 200 µg of ivermectin/ kg or placebo and were followed up for 12 months. Therapy was associated with only minimal systemic and ocular side effects. A 200-µg/kg dose was associated with greater systemic reaction than was a 100-µg/kg dose. Each treatment group had significant reduction in skin microfilaria counts by day 3 and a decrease of ∼95% at three months. At three months the proportion of persons with no micro filariae in a specimen of skin was significantly less in the 100-µg/kg group than in the 150-µg/kg or 200-µg/kg groups. At 12 months, the level of microfilariae in skin was still reduced ∼80%. Significant reduction in ocular involvement was seen in all groups. These results confirm that single-dose ivermectin is effective and well-tolerated and suggest that 150 µg of ivermectin/kg may be the optimal dose for initial therapy.

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