Triple Drug Therapy “IDA” for Lymphatic Filariasis

The DOLF project conducted pioneering work to study the impact of a three drug combination treatment using ivermectin, DEC and albendazole, shortened to “IDA” for lymphatic filariasis. Clinical trials in Papua New Guinea, Cote d’Ivoire, and Indonesia showed that IDA is much more effective than a widely used two-drug regimen with albendazole and DEC, for clearing microfilariae (e.g. the larval form of parasitic worm) from the blood. IDA is a potential game changer for LF elimination outside of Africa and in areas of Africa that are not coendemic with loiasis or onchocerciasis. Extensive safety data were required before the World Health Organization could recommend IDA for use in filariasis elimination programs.

Community Studies in 5 Countries

With the help of international collaborators and partners, DOLF investigators conducted a large, multicenter safety study that enrolled more than 26,000 people in study sites in five countries (India, Papua New Guinea, Haiti, Indonesia, and Fiji). The study generated evidence that IDA is as safe as the two-drug treatment for LF. The WHO carefully reviewed these results in May of 2017, and they issued a formal endorsement of IDA for use in LF elimination programs in November 2017. Several countries have started using IDA for LF elimination, and many more will start soon. If high rates of compliance can be achieved, mass treatment with IDA has the potential to accelerate elimination of LF in many countries around the world.

Publications

King CL, Suamani J, Sanuku N, Cheng YC, Satofan S, Mancuso B, Robinson LJ, Siba P, Weil GJ, Kazura JW. A Trial of a Triple-Drug Treatment for Lymphatic Filariasis. N Eng J Med 2018; 379:1801-1810.

Weil GJ, Bogus J, Christian M, Dubray C, Djuardi Y, Fischer PU, et al. The safety of double- and triple-drug community mass drug administration for lymphatic filariasis: A multicenter, open-label, cluster-randomized study. PLoS Med 2019;16:e1002839.