DOLF Project Research On A New Treatment For LF Is Published In The NEJM

DOLF investigators Christopher King and James Kazura from Case Western Reserve University in Cleveland with colleagues at the Papua New Guinea Institute for Medical Research and at Washington University in St. Louis have just published important results from a randomized clinical trial. This trial tested the safety and efficacy of a new triple drug treatment for lymphatic filariasis (LF). The study found that “IDA,” a combination of ivermectin, diethylcarbamazine (DEC), and albendazole, was safe and more effective than the previous two-drug treatment (DEC plus albendazole) that is distributed to hundreds of millions of people in more than 50 tropical countries each year.  This randomized, controlled trial was conducted in Papua New Guinea in an area where LF is extremely common. The study results showed that IDA was far superior to the two drug treatment for clearing microfilariae (larval filarial worms) from the blood, thus halting the active infection. Read the full article here

IDA represents a potential game changer for the Global Program to Eliminate Lymphatic Filariasis, because it should greatly shorten the time required for elimination in many countries. Beyond the specific findings of this study, this research represents a paradigm shift in the translation of scientific discovery to policy change for global health programs. When preliminary results were available from the PNG clinical trial, key stakeholders convened to discuss the implications of the remarkable data. Instead of the usual process of waiting for peer-reviewed publication of results, stakeholders immediately took actions that later accelerated the policy change process. World Health Organization officials outlined the additional studies and data that would be required to change policy, the Bill and Melinda Gates Foundation funded a massive safety study to test whether the new treatment was safe for widespread use, and donor agencies and companies were brought on board so that they would have time to consider implications of the potential approval of the new regimen. As results of the additional studies became available, WHO convened a meeting of experts to review the unpublished data.  Their recommendations were reviewed internally at WHO, and the official policy change to endorse IDA for treatment of LF announced a few months later. This was quickly followed by a commitment from Merck to expand their donation of ivermectin so that IDA treatment could be implemented by national LF elimination programs on a large scale. A number of countries have already started using IDA for LF elimination, and many others will follow in the next two years.

DOLF project researchers and administrators in St. Louis are proud to have been a part of this study. We congratulate our colleagues at Case-Western for conducting the study and writing the publication, and we extend our special thanks to everyone involved in Papua New Guinea including the clinical subjects.

Read the official Case Western press release here

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