Towards personalized treatment of alveolar echinococcosis: a pilot study measuring levels of albendazole-sulfoxide in a cohort of patients in Slovakia

Introduction: Albendazole is still considered a cornerstone in the treatment of alveolar echinococcosis (AE). Its parasitostatic effect, together with variable individual plasma concentration, can be considered a therapeutic problem. For this reason, the measurement of the plasma concentration of its active metabolite, albendazole sulfoxide is important in optimizing treatment and minimizing toxicity. Aim: The aim of the study is to present preliminary data from Slovakia and to demonstrate the feasibility and applicability of albendazole sulfoxide (ASOX) levels in clinical practice. Methods: Determination of plasma concentrations of ASOX was performed in 19 patients with confirmed AE. The data were evaluated through a basic statistical analysis. A literature review supporting the applicability of monitoring therapeutic levels of ASOX (TDM) was carried out. Results: ASOX concentrations ranged from 1.18 to 12.10 μmol/ l (mean 4.11 μmol/ l), with some values exceeding the recommended therapeutic interval. Conclusion: Our conclusions confirm the technical and clinical feasibility of implementing TDM for ASOX and reflect the step towards personalized AE treatment in Slovakia Keywords alveolar echinococcosis, albendazol, albendazole-sulfoxide, TDM