Methisoprinol for children with early phase dengue infection: a pilot study

Abstract

Background Dengue fever is associated with many healthcomplications and medical costs. Furthermore, there is currentlyno approved dengue antiviral medication or vaccine. Empiricevidence has suggested that patients who received supplementalmethisoprinol therapy had faster recovery times and fewercomplications .Objective To detennine the effects of oral methisoprinol on theclinical course and laboratory findings of children with early phasedengue infection.Methods We conducted a randomized, double-blind study fromJune to September 2012 on 22 children aged 2.7-16.8 years withlaboratory-confirmed early dengue infection. Subjects had notpreviously received antithrombotic agents, nor did they havebleeding disorders or immunodeficiency. We randomized thesubjects to receive either oral methisoprinol (100 mg/kg BW/day,divided into four doses) or placebo for 72 hours, with 11 subjectsper group. The primary endpoint was fever clearance time (FCT),and secondary endpoints were platelet nadii; white blood cell(WBC) nadii; maximum hemoconcentration, length of hospitalstay, and development of complications .Results The mean decrease in WBC count was less withmethisoprinol than with placebo [1.14 (SD 0.84) vs 2.60 (SD 3.12)x [09 /L; P = 0.004]. In addition, the mean decrease in platelet countwas less in patients on methisoprinol [38.36 (SD 58.3) vs. 50.46 (SD73.42) x 109/L; P=0.046]. No significant differences between thetwo groups were found for FCT (P=0.158), length ofhospital stay(P=0.511), hemoconcentration, or dengue complications.Conclusion Methisoprinol initiated at an early phase in dengueinfection reduced the anticipated leukopenia by 56% andthrombocytopenia by 24%. Hence it can be used along withstandard approved fluid and antipyretic therapy.