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River blindness is caused by the parasitic worm Onchocerca volvulus, which is transmitted from person to person by black flies that breed in fast flowing rivers in sub-Saharan Africa, Yemen and small foci in South and Central America.
Moxidectin is a macrocyclic lactone anthelmintic medicine that selectively binds to the parasite’s glutamate-gated chloride ion channels. These channels are vital to the function of invertebrate nerve and muscle cells.
Moxidectin has activity against O. volvulus microfilariae but does not kill adult O. volvulus parasites. Patients with river blindness administered moxidectin experienced adverse events consistent with those associated with efficacy. The nature and severity of adverse events in moxidectin recipients was similar to ivermectin.
The most common adverse reactions (incidence > 10%) were: eosinophilia, pruritus, musculoskeletal pain, headache, lymphopenia, tachycardia, rash, abdominal pain, hypotension, pyrexia, leukocytosis, influenza-like illness, neutropenia, cough, lymph node pain, dizziness, diarrhea, hyponatremia and peripheral swelling.
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