COMPARATIVE TRIALS OF ANTIMONIAL DRUGS IN URINARY SCHISTOSOMIASIS

Abstract

Chemotherapeutic trials in urinary schistosomiasis are described and discussed. Their design and conduct were based on recommended statistical techniques, now generally accepted as the most appropriate approach to the assesst-ment of antischistosomal drugs. Randomization produced comparable host groups in whom multiple parasitic infection and radiological urinary tract damage were common. Treatment was with 1 of 3 antimonial compounds given at equivalent metallic dosage daily. Antimony sodium tartrate (AST) and antimony dimercaptosuccinate (TWSb) were equally efficient curatively but both produced many side-effects. Sodium antimonylgluconate (TSAG) was 4/5 as effective but tolerance was superior. Estimations of urinary antimony excretion showed that tissue retention of the metal was related to cure-rates and side-effects. It was concluded that none of the drugs were suitable for mass chemotherapy. More new non-toxic schistosomicides are urgently needed and for their assessment, the setting-up of multi-center trials, following international agreement on technical methods, is suggested.