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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/12712

Title: Doxycycline improves filarial lymphedema independent of active filarial infection: a randomized controlled trial
Authors: Mand, Sabine
Debrah, Alexander Yaw
Klarmann, Ute
Batsa, Linda
Kwarteng, Alexander
et. al
Issue Date: 18-May-2012
Publisher: Oxford University Press
Abstract: Background.The aim of this study was to determine whether improvement offilarial lymphedema (LE) bydoxycycline is restricted to patients with ongoing infection (positive for circulatingfilarial antigen [CFA]), orwhether the majority of CFA-negative patients with LE would also show a reduction in LE severity.Methods.One hundred sixty-two Ghanaian participants with LE stage 1–5 (Dreyer) were randomized block-wise into 2 groups (CFA positive or negative) and allocated to 3 treatment arms of 6 weeks: (1) amoxicillin (1000mg/d), (2) doxycycline (200 mg/d), or (3) placebo matching doxycycline. All groups received standard hygienemorbidity management. The primary outcome was reduction of LE stages. Secondary outcomes included frequen-cy of acute attacks and ultrasonographic assessment of skin thickness at the ankles. Parameters were assessedbefore treatment and after 3, 12, and 24 months.Results.Doxycycline-treated patients with LE stage 2–3 showed significant reductions in LE severity after 12 and24 months, regardless of CFA status. Improvement was observed in 43.9% of doxycycline-treated patients, comparedwith only 3.2% and 5.6% in the amoxicillin and placebo arms, respectively. Skin thickness was correlated with LEstage improvement. Both doxycycline and amoxicillin were able to reduce acute dermatolymphangioadenitis attacks.Conclusions.Doxycycline treatment improves mild to moderate LE independent of ongoing infection. Thisfinding expands the benefits of doxycycline to the entire population of patients suffering from LE. Patients with LEstage 1–3shouldbenefit from a 6-week course of doxycycline every other year or yearly, which should be consideredas an improved tool to manage morbidity infilarial LE.
Description: An article published by Oxford University Press and also available at DOI: 10.1093/cid/cis486
URI: http://hdl.handle.net/123456789/12712
Appears in Collections:College of Science

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