Cortisone and Prednisone in the Suppression of Allergic Reactions to Diethylcarbamazine Treatment of Onchocerciasis

SummaryDiethylcarbamazine treatment in onchocerciasis results in destruction of microfilariae in the subcutaneous tissues, but is frequently accompanied by severe allergic reactions in heavily infected persons. Preliminary trials of cortisone suggested that this drug might prove effective in suppression of such allergic reactions; further trials were then made with prednisone. Simultaneous diethyl-carbamazine-prednisone treatment was given to half of the individuals in a group of 40 persons heavily infected with Onchocerca, as judged by skin biopsies, and to a group of 20 persons with negative skin biopsies from the same plantation. The other half of each group was treated with diethylcarbamazine and a placebo. In both cases, there were very few reactions in the prednisone-treated groups, and these reactions were generally mild in nature, while the control groups suffered from large numbers of severe reactions.