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Effect of Adding a Six-Week Course of Doxycycline to Intensive Hygiene-Based Care for Improving Lymphedema in a Rural Setting of Mali: A Double-Blind, Randomized Controlled 24-Month Trial. | LitMetric

AI Article Synopsis

  • - Lymphedema (LE), a serious condition resulting from lymphatic filariasis, is primarily treated through limb hygiene and local care, with a study exploring doxycycline's potential benefits.
  • - A multicenter trial in Mali tested doxycycline (200 mg/day) against a placebo for 6 weeks in patients with LE stages 1-3, measuring the disease's progression over 24 months.
  • - Results showed no significant difference in LE progression between the doxycycline and placebo groups, but both experienced reduced acute adenolymphangitis attacks; doxycycline was well tolerated but not more effective than hygiene alone.

Article Abstract

Lymphedema (LE) is one the most disfiguring chronic manifestations of lymphatic filariasis. Its management relies primarily on limb hygiene and local care. A previous study in Ghana demonstrating a beneficial effect of doxycycline on LE led to the current multicenter trial on the efficacy of doxycycline in filarial LE. A randomized placebo-controlled trial was initiated in two rural health districts in Mali. Patients with LE stages 1-3 were randomized to receive either doxycycline (200 mg/day) or placebo over a 6-week monitored treatment period and were then followed every 6 months for 2 years. Both groups received materials for limb hygiene that was carried out daily for the entire 2-year study. The primary endpoint was lack of progression in LE stage at 24 months. One hundred patients were enrolled in each study arm. The baseline sociodemographic characteristics of each group were largely similar. There was no significant difference at month 24 after treatment initiation in the number of subjects showing progression in LE stage between the two treatment arms (P = 0.5921). Importantly, however, the number of attacks of acute adenolymphangitis (ADLA) was reduced in both arms, but there was no significant difference between the two groups at any follow-up time point (all P >0.23). Doxycycline was well tolerated in those receiving the drug. When added to daily self-administered limb hygiene, a 6-week course of doxycycline (200 mg) was not superior to placebo in increasing the improvement associated with hygiene alone in LE volume, stage, or frequency of ADLA attacks over a 24-month period.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448486PMC
http://dx.doi.org/10.4269/ajtmh.23-0908DOI Listing

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