Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan
Abstract Objectives The combination therapy of phenothrin (PHT) and ivermectin (PI regimen) was effective for pyrethroid‐resistant head lice in Okinawa; however, further investigations have been required to improve the regimen. This study aimed to investigate the efficacy of the modified PI (mPI) re...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Journal of Cutaneous Immunology and Allergy |
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| Online Access: | https://doi.org/10.1002/cia2.12149 |
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| author | Eiji Sato Masakazu Umezawa Atsushi Miyajima Noriko Koishi Arisa Kanaya Ayumi Yamanaka Manabu Fujimoto Yoshiyuki Ishii Aki Saito Sae Inoue Yasunari Mano Tatsunori Suzuki Rie Ozeki Norihisa Ishii Masayo Komoda |
| author_facet | Eiji Sato Masakazu Umezawa Atsushi Miyajima Noriko Koishi Arisa Kanaya Ayumi Yamanaka Manabu Fujimoto Yoshiyuki Ishii Aki Saito Sae Inoue Yasunari Mano Tatsunori Suzuki Rie Ozeki Norihisa Ishii Masayo Komoda |
| author_sort | Eiji Sato |
| collection | DOAJ |
| description | Abstract Objectives The combination therapy of phenothrin (PHT) and ivermectin (PI regimen) was effective for pyrethroid‐resistant head lice in Okinawa; however, further investigations have been required to improve the regimen. This study aimed to investigate the efficacy of the modified PI (mPI) regimen, which increased the maximum number of PHT treatments in the PI regimen by one, in Tsukuba, which has a low mutation rate compared to Okinawa. Methods An open‐label, uncontrolled, exploratory study was conducted at the Department of Dermatology, University of Tsukuba Hospital to investigate the treatment effect of mPI regimen. Genotypes were investigated for the knockdown (kdr) mutations at voltage‐sensitive sodium channel (VSSC) and glutamate‐gated chloride receptor‐encoding loci to identify their correlation with drug resistance. Results All the 8 patients treated with the mPI regimen resulted in lice free on day 29. Compared to baseline, the number of bodies, eggs, and itching grade significantly decreased on day 29. Mild erythema appeared after the second application of PHT on day 8 in one patient, persisted for 2 days, and recovered on day 15. No other adverse events were reported. Mutation rates were more than double in head lice collected from one patient for whom PHT was ineffective compared to those in lice from patients who responded to PHT. Furthermore, we identified four new haplotypes of VSSC loci in head lice. Conclusions The mPI regimen is a potential effective treatment for economically combating both PHT‐sensitive and resistant head lice. |
| first_indexed | 2024-03-08T08:36:55Z |
| format | Article |
| id | doaj.art-fdb0b11aa14b449891217f4ce30efef1 |
| institution | Directory Open Access Journal |
| issn | 2574-4593 |
| language | English |
| last_indexed | 2025-03-21T00:17:37Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Journal of Cutaneous Immunology and Allergy |
| spelling | doaj.art-fdb0b11aa14b449891217f4ce30efef12024-08-03T09:03:38ZengFrontiers Media S.A.Journal of Cutaneous Immunology and Allergy2574-45932021-02-014141210.1002/cia2.12149Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, JapanEiji Sato0Masakazu Umezawa1Atsushi Miyajima2Noriko Koishi3Arisa Kanaya4Ayumi Yamanaka5Manabu Fujimoto6Yoshiyuki Ishii7Aki Saito8Sae Inoue9Yasunari Mano10Tatsunori Suzuki11Rie Ozeki12Norihisa Ishii13Masayo Komoda14Faculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanDepartment of Materials Science and Technology Faculty of Industrial Science and Technology Tokyo University of Science Katsushika‐ku JapanDepartment of Biopharmaceutics Meiji Pharmaceutical University Kiyose JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba‐shi JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba‐shi JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba‐shi JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba‐shi JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanNational Sanatorium Tamazenshoen Higashimurayama JapanFaculty of Pharmaceutical Sciences Tokyo University of Science Noda‐shi JapanAbstract Objectives The combination therapy of phenothrin (PHT) and ivermectin (PI regimen) was effective for pyrethroid‐resistant head lice in Okinawa; however, further investigations have been required to improve the regimen. This study aimed to investigate the efficacy of the modified PI (mPI) regimen, which increased the maximum number of PHT treatments in the PI regimen by one, in Tsukuba, which has a low mutation rate compared to Okinawa. Methods An open‐label, uncontrolled, exploratory study was conducted at the Department of Dermatology, University of Tsukuba Hospital to investigate the treatment effect of mPI regimen. Genotypes were investigated for the knockdown (kdr) mutations at voltage‐sensitive sodium channel (VSSC) and glutamate‐gated chloride receptor‐encoding loci to identify their correlation with drug resistance. Results All the 8 patients treated with the mPI regimen resulted in lice free on day 29. Compared to baseline, the number of bodies, eggs, and itching grade significantly decreased on day 29. Mild erythema appeared after the second application of PHT on day 8 in one patient, persisted for 2 days, and recovered on day 15. No other adverse events were reported. Mutation rates were more than double in head lice collected from one patient for whom PHT was ineffective compared to those in lice from patients who responded to PHT. Furthermore, we identified four new haplotypes of VSSC loci in head lice. Conclusions The mPI regimen is a potential effective treatment for economically combating both PHT‐sensitive and resistant head lice.https://doi.org/10.1002/cia2.12149head liceivermectinkdr mutationphenothrinpyrethroid resistance |
| spellingShingle | Eiji Sato Masakazu Umezawa Atsushi Miyajima Noriko Koishi Arisa Kanaya Ayumi Yamanaka Manabu Fujimoto Yoshiyuki Ishii Aki Saito Sae Inoue Yasunari Mano Tatsunori Suzuki Rie Ozeki Norihisa Ishii Masayo Komoda Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan Journal of Cutaneous Immunology and Allergy head lice ivermectin kdr mutation phenothrin pyrethroid resistance |
| title | Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan |
| title_full | Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan |
| title_fullStr | Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan |
| title_full_unstemmed | Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan |
| title_short | Efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in Tsukuba, Japan |
| title_sort | efficacy and safety of a modified combination regimen of phenothrin and ivermectin lotion in patients with head lice in tsukuba japan |
| topic | head lice ivermectin kdr mutation phenothrin pyrethroid resistance |
| url | https://doi.org/10.1002/cia2.12149 |
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