Table 1. Criteria for the Evaluation of Patients with Cystic Echinococcosis
Response to Single Cyst
Cured Cyst undetectable post-treatment
Improved If cyst size reported : >25% reduction in cyst size.
If cyst not measurable, clinically assessed as improved. Cyst changes occurring during or post therapy on X-ray, ultrasound (US), or Computed tomography (CT), associated with disturbance in cyst function, i.e. increase in density on CT or US, loss of daughter cysts, appearance of lamination, separation of layers in cyst wall, appearance of calcification.
No change Cysts not showing any change in appearance and, if measures, <25% reduction in size
Worse Any increase in cyst size or appearance of new cysts
Global (Patient) Evaluation
Cured All cysts "cured", or demonstrated non-viable
Improved Either some cysts "cured" and some "improved", or some "improved" while others "unchanged"
No change All cysts apparently "no change"
Worse One or more cysts increasing in size; new cysts appearing
Table 2. Patient Response to Albendazole Treatment in Cystic Echinococcosis
Data Set |
No. Evaluable |
Cure (%) |
Improved (%) |
No Change (%) |
Worse (%) |
European data |
253 |
72 (28.5) |
129 (51.0) |
46 (18.1) |
6 (2.4) |
Publications |
1116 |
372 (33.3) |
469 (42.0) |
275 (24.6) |
|
Australian data |
Not evaluable |
-- |
-- |
-- |
-- |
U.S. data |
35 |
4 (11.8) |
14 (41.2) |
16 (47.1) |
1 (2.9) |
Total |
1448 |
448 (30.9) |
612 (42.3) |
344 (23.8) |
|
From Horton, 1997
Data Set |
No. Evaluable |
Cure (%) |
Improved (%) |
No Change (%) |
Worse (%) |
European data |
435 |
60 (35.2) |
187 (41.1) |
102 (22.4) |
6 (1.3) |
Publications |
2912 |
663 (22.8) |
1418 (48.7) |
83 (28.5) |
|
Australian data |
72 |
10 (14) |
24 (33) |
36 (50) |
2 (3) |
U.S. data |
35 |
4 (11.8) |
14 (41.2) |
16 (47.1) |
1 (2.9) |
From Horton, 1997
Table 4. Effect of Treatment Duration on Albendazole Efficacy in Cystic Echinococcosis
Treatment Duration
No. Studies
No. Patients
Cure(%)
Improved (%)
No Change (%)
< 3 Months
12
51
18 (35.3)
12 (23.5)
21 (41.2)
3 – 5 Months
22
344
101 (29.3)
153 (44.4)
90 (26.1)
> 6 Months
7
152
42 (27.6)
84 (55.3)
26 (17.1)
From Horton, 1997
Table 5. Comparison of Efficacy of Albendazole & Mebendazole (Global Evaluation) of Patient Response [Download PDF]
Author |
Drug |
Dose |
#Patients |
Cure (%) |
Improve (%) |
No change (%) |
Davis et al. (1986)
Davis et al. (1989)
Todorov et al. (1993)
Issacs et al. (1987)
Overall Response |
Alb Meb
Alb Meb
Alb Meb
Alb Meb
Alb Meb |
800 mg x 2-3 50 mg/kg x 3
10 mg/kg x 4 4.5g x 6
10 mg/kg x 4 30-70 mg/kg x 6-24
800 mg x 2-4 1.5-3.0g x 2-8
|
30 85
64 41
47 51
2 7
143 184 |
5 (16.7) 8 (9.4)
18 (28.1) 3 (6.7)
20 (42.5) 17 (33.3)
1 (50) 1 (14.3)
44 (30.7) 29 (15.8) |
18 (60) 44 (51.8)
31 (48.4) 20 (44.4)
14 (29.8) 12 (23.5)
1 (50) 2 (28.6)
64 (44.8) 78 (42.4) |
7 (23.3) 33 (38.8)
15 (23.4) 18 (40.0)
13 (27.6) 22 (43.1)
- 4 (53.1)
35 (24.5) 77 (41.8) |
From Horton, 1996
Table 6. Comparison of Efficacy of Albendazole & Mebendazole (Cyst Evolution) of Patient Response [Download PDF]
Author |
Drug |
Dose |
#Cysts |
Cure (%) |
Improve (%) |
No change (%) |
Teggi et al. (1993)
Todorov et al. (1993)
Overall |
Alb
Meb
Alb Meb
Alb Meb |
10-12 mg/kg x 3 mo continuous Tt. 50 mg/kg x 3-12 mo
10 mg/kg x 4 cycles 30-70 mg/kg x 6-24 mo
|
411
243
254 273
665 516 |
203 (49.3)
16 (6.6)
117 (46.1) 128 (46.9)
320 (48.1) 144 (27.9) |
78 (19.0)
116 (47.7)
83 (32.7) 37 (13.5)
161 (24.2) 153 (29.7) |
130 (31.5)
111 (45.7)
54 (21.2) 108 (39.6)
184 (27.7) 219 (42.4) |
From Horton, 1996
Table 7. Adverse Clinical Events and Fatal Events in Patients Treated with Albendazole for Various Reasons
|
Adverse events |
Fatal events |
||||
Echinococcosis |
Cysticercosis |
Others§ |
Echinococcosis |
Cysticercosis |
AIDS |
|
Body system/patients no. |
3282 |
899 |
|
13 |
4 |
104 |
Body as a whole Body as a whole Metabolic Neoplasia Resistance mechanism |
54
4 |
14 2 |
45 5 3 27 |
10
1 |
1
1 |
29 4 5 41 |
Cardiovascular Cardiovascular general Heart rate/rhythm Myocardial/valves Vascular extracardiac |
1 |
|
7 2 1 3 |
|
1 |
1 |
Nervous system Central and peripheral NS Psychiatric |
57 |
180 5 |
30 11 |
|
|
4 1 |
Special senses Hearing Special senses other Vision |
|
7 |
1 1 4 |
|
|
|
Gastrointestinal Gastrointestinal Liver/biliary |
220 355 |
72 3 |
39 32 |
2
|
|
2 1 |
Musculoskeletal |
2 |
4 |
|
|
|
|
Blood elements Platelets/clotting Red blood cell White cell/RES |
4 8 31 |
|
5 6 15 |
1 |
|
|
Respiratory |
8 |
5 |
1 |
12 |
|
|
Skin and appendages |
68 |
9 |
38 |
|
|
|
Urinary/reproductive Urinary Reproductive Female |
1 |
|
5 9 |
|
|
2 |
No specified |
4 |
6 |
|
|
|
1 |
From Horton, 1997
Others§ : refers to the use of albendazole in indications with other dosages and regimens (especially in patients with heavy Ascaris infection)
AIDS: patients with acquired immuno-deficiency syndrome