Preclinical Study of Single-Dose Moxidectin,a New Oral Treatment for Scabies: Efficacy,Safety,and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model

Background: scabies is one of the commonest dermatological conditions globally; however it is a largely underexplored and truly neglected infectious disease. foremost,improvement in the management of this public health burden is imperative. current treatments with topical agents and/or oral ivermectin (ivm) are insufficient and drug resistance is emerging. moxidectin (mox),with more advantageous pharmacological profiles may be a promising alternative. methodology/principal findings: using a porcine scabies model,12 pigs were randomly assigned to receive orally either mox (0.3 mg/kg once),ivm (0.2 mg/kg twice) or no treatment. we evaluated treatment efficacies by assessing mite count,clinical lesions,pruritus and elisa-determined anti-s. scabiei igg antibodies reductions. plasma and skin pharmacokinetic profiles were determined. at day 14 post-treatment,all four mox-treated but only two ivm-treated pigs were mite-free. mox efficacy was 100% and remained unchanged until study-end (d47),compared to 62% (range 26–100%) for ivm,with one ivm-treated pig remaining infected until d47. clinical scabies lesions,pruritus and anti-s. scabiei igg antibodies had completely disappeared in all mox-treated but only 75% of ivm-treated pigs. mox persisted ~9 times longer than ivm in plasma and skin,thereby covering the mite’s entire life cycle and enabling long-lasting efficacy. conclusions/significance: our data demonstrate that oral single-dose mox was more effective than two consecutive ivm-doses,supporting mox as potential therapeutic approach for scabies. © 2016 bernigaud et al.