Safety Of Levamisole Research Articles

Efficacy and safety of levamisole in childhood nephrotic syndrome: A meta-analysis.

Present evidence regarding the efficacy and safety of levamisole in childhood nephrotic syndrome (NS), particularly the steroid-sensitive NS (SSNS), is limited. We searched relevant databases such as PubMed/MEDLINE, Embase, Google Scholar, and Cochrane CENTRAL till June 30, 2020. We included 12 studies for evidence synthesis (5 were clinical trials that included 326 children). The proportion of children without relapses at 6-12 months was higher in the levamisole group as compared to steroids (relative risk [RR]: 5.9 [95% Confidence interval (CI): 0.13-264.8], I2 = 85%). Levamisole as compared to the control increased the proportion of children without relapses at 6-12 months (RR: 3.55 [95% CI: 2.19-5.75], I2 = 0%). The GRADE evidence was of "very-low certainty" except for the comparison of levamisole with control, the latter being of "moderate certainty." To conclude, levamisole given to children with SSNS is beneficial in preventing relapses and achieving remission as compared to placebo or low-dose steroids. Good-quality trials are needed to provide a robust evidence in this regard. PROSPERO Registration number: CRD42018086247.

P6‐3: Efficacy and safety of levamisole as an immunomodulator in the treatment of pulmonary drug‐resistant tuberculosis

P6‐3: Efficacy and safety of levamisole as an immunomodulator in the treatment of pulmonary drug‐resistant tuberculosis

Comparison of Daily versus Every Other Day Treatment Regimen of Levamisole to Control Recurrence in the Childhood Idiopathic Nephrotic Syndrome

Background Idiopathic nephrotic syndrome is a kidney involvement that causes edema and heavy proteinuria with severe complications if the treatment is started late. The present study aimed to assess the efficacy of Levamisole in the daily versus every other day treatment regimen to control recurrence in Childhood Idiopathic Nephrotic Syndrome. Materials and Methods: This randomized clinical trial study was conducted on 52 children with Idiopathic Nephrotic Syndrome who referred to the pediatric nephrology clinic of Imam Reza Hospital of Kermanshah (Iran). The eligible patients divided into two groups using a random numbers table (Daily Group, n=10; Every Other Day Group, n=42). The first group received 2.5 mg /kg Levamisole daily and the second group received the same dose for every other day. Patients were investigated and followed up for at least 4 months. The clinical, laboratory variables, and side effects were compared between the two groups. Results: The two groups had no statistically significant difference interms of baseline variables. There was a significant statistical difference between the two groups in terms of follow-up period after treatment using Levamisole, steroid dose, and the number of recurrences so that the average of these variables in every other day group was higher compared to the daily group (P<0.05). Also, there was no significant statistical difference between the two groups in terms of different complications of vomiting, arthritis, skin rash, neutropenia, seizure, increased liver enzymes, and Urea-Creatinine. Conclusion According to the results, the better efficacy and safety of Levamisole in the daily vs. every other day regimen, daily administration of Levamisole to control recurrence in the Childhood Idiopathic Nephrotic Syndrome was recommended.

The effect of levamisole in the treatment of recalcitrant recurrent erythema multiforme major: An observational study

BackgroundErythema multiforme major (EMM) is an immune-mediated mucocutaneous eruption mostly triggered by herpes simplex virus (HSV) infection. A vicious circle of recurrence may be developed due to HSV reactivation and prolonged use of systemic corticosteroids to control EMM. Levamisole is an immunomodulator and has been applied to prevent relapses of recurrent HSV infection. ObjectiveTo evaluate the clinical efficacy and safety of levamisole in patients with recalcitrant recurrent EMM. MethodsWe enrolled 23 patients with recurrent EMM treated with levamisole and 24 controls, and analyzed the demographics, treatments and outcomes. ResultsPatients with recurrent EMM for years (mean 3.99 ± 2.71) showed significantly reduced recurrences after various durations of levamisole treatment (recurrences after and before treatment: 3.98 ± 1.04 vs 6.75 ± 1.45 times per year, p = 1.33x10−8). The recurrences of EMM also significantly reduced after levamisole treatment comparing to that of patients without levamisole treatment (p = 3.77x10−9). No patient was reported to have severe side effects during or after levamisole treatment. ConclusionsLevamisole was effective in reducing recurrences of recalcitrant recurrent EMM and can thus be considered an alternative or add-on therapy for this disorder.

Use of levamisole in children with nephrotic syndrome: A retrospective study to examine its adverse effects in children with nephrotic syndrome

Introduction: Levamisole, a synthetic imidazothiazole derivative has been used as a steroid sparing agent in children with Frequently Relapsing Nephrotic Syndrome (FRNS) and Steroid Dependent Idiopathic Nephrotic Syndrome (SDNS). Levamisole has been essentially considered a safe drug with minimal toxicity. We conducted this study to re-examine the safety of Levamisole in children with nephrotic syndrome and to describe the clinical profile of these children. Materials and Methods: Records of children with idiopathic nephrotic syndrome between June 2014 and December 2016 were reviewed. We identified frequently relapsing or steroid dependent children between 1-18 years of age who had received Levamisole for at least six months or in whom Levamisole was started but had to be withdrawn due to some adverse events in the first 6 months. Results: 21 children were started on Levamisole in the study period. 13 (61.90%) were FRNS and remaining had a steroid dependent course. Levamisole had to be withdrawn in one child at 1 month 13 days after initiation when the child developed severe headache. Levamisole also had to be discontinued in a 9 years old girl at 13 months after initiation of therapy due to polyarticular arthralgia involving both the small and large joints. Conclusions: The use of Levamisole warrants caution in children with Nephrotic Syndrome and its efficacy needs to be balanced against its potential side effects.

Meta‐analysis: levamisole improves the immune response to hepatitis B vaccine in dialysis patients

Patients undergoing maintenance dialysis often fail to mount protective antibodies to hepatitis B virus surface antigen (HBsAg) following vaccination against hepatitis B virus (HBV). Some authors have suggested that levamisole improves immune response to HBV vaccine in dialysis population. However, consistent information on this issue does not exist. To evaluate efficacy and safety of levamisole as adjuvant to hepatitis B virus (HBV) vaccine in dialysis patients by performing a systematic review of the literature with a meta-analysis of clinical trials. We used the random-effects model of DerSimonian and Laird, with heterogeneity and sensitivity analyses. Only trials comparing the seroresponse rate in study subjects (levamisole plus HBV vaccine) vs. controls (HBV vaccine alone) were included. The end point of interest was the rate of patients showing seroprotective anti-hepatitis B titres at completion of HBV vaccine schedule in study vs. control groups. We identified four studies involving 328 unique patients on regular dialysis. Only prospective, randomized clinical trials (RCTs) were included. Pooling of study results showed a significant increase in response rates among study (levamisole plus HBV vaccine) vs. control (HBV vaccine alone) patients; the pooled Odds Ratio was 2.432 (95% Confidence Intervals, 1.34; 4.403), P = 0.002. No study heterogeneity was found. These results did not change in various subgroups of interest. Our meta-analysis showed that levamisole significantly improves immune response to hepatitis B vaccine in dialysis population. The limited number of patients precluded more conclusions.