Efficacy of two triclabendazole regimens for treating human chronic fasciolosis and a controlled efficacy trial in sheep using human-isolate metacercariae in Cajamarca, Peru.
Pedro Ortiz, Cristian Hobán, César A Murga-Moreno et al.
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In 30 seconds
This randomized controlled study evaluated two triclabendazole (TCBZ) regimens in 26 people with egg-positive chronic Fasciola hepatica infection in Cajamarca, Peru, and tested TCBZ in sheep infected with metacercariae from human cases that had not been cured. Human therapeutic efficacy was 92.31% (95% CI: 63.97-99.81) with 10 mg/kg and 69.21% (95% CI: 38.57-90.91) with 20 mg/kg; the difference was not statistically significant. In sheep, treatment efficacy was -37.24%, indicating treatment failure. The authors considered the failures potentially linked to emerging regional TCBZ resistance.
Key findings
- Human therapeutic efficacy was 92.31% (95% CI: 63.97-99.81) with 10 mg/kg and 69.21% (95% CI: 38.57-90.91) with 20 mg/kg; no significant difference was detected (p > 0.05).
- In sheep infected with metacercariae from human treatment failures, TCBZ efficacy was -37.24%, indicating treatment failure.
Why it matters
The findings show that human treatment outcomes and efficacy in an animal model using parasites from treatment failures may differ. The sheep result raises concern about reduced TCBZ susceptibility in the region, while the small human comparison did not establish a difference between the tested regimens. Together, these results support attention to treatment failures and local efficacy evidence.
What to keep in mind
The human comparison included only 26 patients, and the sheep trial used 12 animals infected with parasites from human cases that had not been cured.