THURSDAY, June 25 (HealthDay News) -- In the treatment of sleeping sickness, nifurtimox-eflornithine combination therapy is as effective as eflornithine monotherapy, has a better safety profile, and is suitable for first-line use in control programs in sub-Saharan Africa, according to a study published online June 25 in The Lancet.

Gerardo Priotto, M.D., of Epicentre in Paris, and colleagues randomly assigned 287 patients with sleeping sickness in the Republic of Congo and the Democratic Republic of Congo to either intravenous eflornithine (400 mg/kg per day, every six hours) for 14 days or intravenous eflornithine (400 mg/kg per day, every 12 hours) for seven days with oral nifurtimox (15 mg/kg per day, every eight hours) for 10 days.

After an 18-month follow-up, the researchers found that combination nifurtimox-eflornithine was associated with a higher cure rate than eflornithine monotherapy (96.5 versus 91.6 percent), and a lower rate of drug-related adverse events (14 percent versus 28.7 percent).

"There is already an established and growing parasite resistance to melarsoprol, and the increasing large-scale use of eflornithine monotherapy could see this drug exposed to the same threat," the authors conclude. "To avert the development of eflornithine resistance, full-scale implementation of the nifurtimox-eflornithine combination therapy regimen should be a priority for human African trypanosomiasis control programs."

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