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World J Biol Psychiatry. 2018 Nov 16:1-9. doi: 10.1080/15622975.2018.1523561. [Epub ahead of print]

Randomized crossover feasibility trial of helminthic Trichuris suis ova versus placebo for repetitive behaviors in adult autism spectrum disorder.

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a Autism and Obsessive-Compulsive Spectrum Program, and Anxiety and Depression Research Program Department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine , Montefiore Medical Center , Bronx , NY , USA.
b Charles E. Schmidt College of Medicine , Florida Atlantic University , Boca Raton , FL , USA.



Inflammatory mechanisms are implicated in the aetiology of autism spectrum disorder (ASD), and use of the immunomodulator Trichuris suis Ova (TSO) is a novel treatment approach. This pilot study determined the effect sizes for TSO versus placebo on repetitive behaviours, irritability and global functioning in adults with ASD.


A 28-week double-blind, randomised two-period crossover study of TSO versus placebo in ten ASD adults, aged 17-35, was completed, with a 4-week washout between each 12-week period at Montefiore Medical Center, Albert Einstein College of Medicine. Subjects with ASD, history of seasonal, medication or food allergies, Y-BOCS ≥6 and IQ ≥70 received 2,500 TSO ova or matching placebo every 2 weeks of each 12-week period.


Large effect sizes for improvement in repetitive behaviours (d = 1.0), restricted interests (d = 0.82), rigidity (d = 0.79) and irritability (d = 0.78) were observed after 12 weeks of treatment. No changes were observed in the social-communication domain. Differences between treatment groups did not reach statistical significance. TSO had only minimal, non-serious side effects.


This proof-of-concept study demonstrates the feasibility of TSO for the treatment of ASD, including a favourable safety profile, and moderate to large effect sizes for reducing repetitive behaviours and irritability. NCT01040221.


Autism spectrum disorder; Trichuris suis ova; cytokines; pharmacotherapy; repetitive behaviors

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