Options for clinical trials of pre and post-natal treatments for congenital toxoplasmosis
Mem. Inst. Oswaldo Cruz
;
104(2): 299-304, Mar. 2009. ilus
Article
in English
| LILACS
| ID: lil-533521
ABSTRACT
Clinical trials comparing different drug regimens and strategies for the treatment of congenital toxoplasmosis and its clinical manifestations in the liveborn child in different clinical settings should aim at formally evaluating the net benefit of existing treatments and at developing new therapeutic options. Currently, there is no ideal drug for congenital toxoplasmosis; future research should focus on the screening of new active drugs and on their pre-clinical and early clinical development, with a focus on pharmacokinetic/dynamic studies and teratogenicity. For the prenatal treatment of congenital toxoplasmosis, a trial comparing spiramycine to pyrimethamine-sulphadiazine and placebo would allow a formal estimation of the effect of both drugs in infected pregnant women. In newborn children, the net benefit of pyrimethamine-sulphadiazine should also be formally assessed. These trials will be implemented in settings where prenatal screening for Toxoplasma gondii is currently implemented. Trials should be carefully designed to allow for translation to other settings and modelling tools like cost-effectiveness analysis should be used to provide clinicians and founders with the best available evidence to establish recommendations.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Toxoplasmosis, Congenital
/
Antiprotozoal Agents
Type of study:
Controlled clinical trial
/
Practice guideline
Limits:
Humans
/
Infant, Newborn
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2009
Type:
Article
Affiliation country:
France
Institution/Affiliation country:
Bordeaux University/FR
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