Antihelminthic Therapy for Neurocysticercosis

To the Editor. —Sotelo et al 1,2 report clinical trials comparing albendazole with praziquantel as therapy for neurocysticercosis. In a trial of very similar design, Alarcon et al 3 compared two dosing schedules of albendazole. These trials randomly allocated 25 1 or 23 2 subjects to one of three groups. The active drug treatment groups were of equal size in both trials, with 10 1 or nine 2 subjects in each treatment group, and the control (no treatment) group had five subjects in each trial. The outcome variable evaluated was the change in cyst size as demonstrated by computed tomography. These reports are illustrative of the ills replicated in clinical trials touting various pharmacologic regimens in the treatment of neurocysticercosis. In these and other putatively seminal clinical trials in this disorder, several easily identified problems limit the utility of the data. The interpretation of these trials is particularly important, given