For two decades, albendazole has been donated to a large-scale program for the treatment of lymphatic filariasis. An updated Cochrane review examined the efficacy of albendazole in lymphatic filariasis.
Lymphatic filariasis is a mosquito-borne disease commonly found in tropical and subtropical regions caused by a parasitic filariasis infection. After infection, the larvae grow into adults and mate to form microfilariae (mf). MF is then collected by mosquitoes while feeding on blood, and the infection can be transmitted to another person.
Infection can be diagnosed by tests for circulating MF (microfilaraemia) or parasite antigens (antigenemia) or by detection of live adult worms by ultrasound.
The World Health Organization (WHO) recommends mass treatment of the entire population annually for at least five years. The basis of treatment is a combination of two drugs: albendazole and the microfilaricidal (antimalarial) drug diethylcarbamazine (DEC) or ivermectin.
Albendazole semiannually is recommended in areas where loiasis is co-endemic, and DEC or ivermectin should not be used due to the risk of serious side effects.
Both ivermectin and DEK cleared up mf infections quickly and could inhibit their recurrence. However, mf production will resume due to limited exposure in adults. Albendazole was considered for the treatment of lymphatic filariasis because a study reported that high doses administered over several weeks resulted in serious side effects suggesting the death of the adult worms.
An informal report of the WHO consultation subsequently suggested that albendazole has a killing or fungicidal effect on adults. In 2000, GSK began donating albendazole to the Lymphatic Filariasis Treatment Program.
Randomized clinical trials (RCTs) have examined the efficacy and safety of albendazole alone or in combination with ivermectin or DEC. This has been followed by several systematic reviews of RCTs and observational data, but it is unclear whether albendazole has any benefit in lymphatic filariasis.
In light of this, a Cochrane review published in 2005 has been updated to assess the impact of albendazole on populations and communities with lymphatic filariasis.