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 

 

  Table 3. Summary of Cyst Responses to Albendazole Treatment in Cystic Echinococcosis 

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