Fourteen Days vs 28 Days of Albendazole Therapy for Neurocysticercosis in Children: An Open Label Randomized Controlled Trial.

BACKGROUND

There is a paucity of literature to support 14-days albendazole therapy for neurocysticercosis (NCC).

OBJECTIVE

To compare the efficacy of 14-day and 28-day albendazole therapy in the management of children with newly diagnosed active NCC.

STUDY

DESIGN

Open-labelled randomized controlled trial.

PARTICIPANTS

Children aged 1-14 years with newly diagnosed active neurocysticercosis.

INTERVENTION: Albendazole (15 mg/kg/day) for either 14 days or 28 days.

OUTCOME: The primary outcome measure was proportion of children with radiological resolution of active lesion at 6-month follow up. Secondary outcome measures were proportion of children with seizure recurrence, duration to seizure recurrence and calcification on follow up imaging.

RESULTS

65 children with newly diagnosed NCC were rando-mized to receive albendazole therapy for 14 days (n=32) or 28 days (n=33). The proportion of children with complete resolution was comparable between the two groups [6 (18.8%) vs. 9 (27.3%); OR (95%CI):0.61 (0.19 to 1.98); P=0.56]. Similarly, proportion of children with seizure recurrence [5(15.6%) vs 2(6.1%); OR (95%CI): 2.87(0.51-16.0); P=0.26] and proportion of children with calcification on follow-up imaging [26(81.2%) vs 23(69.7%); OR (95%CI): 1.88 (0.59-5.99); P=0.39] were also comparable. There were no major side-effects noted during the study.

CONCLUSION

14-day treatment with albendazole therapy is as effective as 28-day treatment in achieving radiological resolution at six-month follow up. However, high rate of calcification in both the groups indicates need for further evaluation with an adequately powered study and longer follow up.