There is no licensed treatment for Dirofilariasis in Humans. The only 100% cure is based on arsenic and no doctor would ever prescribe this for a patient that they can not even prove is sick with any particular disease. The second best drug is Diethylcarbamazine Citrate (DEC), which the FDA has pulled from the market in the US due to many adverse reactions (Mazzotti reaction) while there is no perceived risk of filarial diseases here in the US.

There are many complications to consider when any treatment is proposed:

Filaria are very hard to kill and any drug that can kill them is likely very toxic to the patient as well. It may be better if a combination of drugs are used which utilize multiple molecular pathways and by weakening the parasite prior to treatment. If the Wolbachia are killed first then the filaria that require them become weaker and may be more prone to die from other follow on treatments.

Any drug that kills too many filara too fast will likely trigger an over active immune response (cytokine storm) to the dying filaria, and may result in the death of the patient. The patients own immune system has been shut down in certain ways and may begin waking up when the filaria die.

When dogs are treated for heartworm they are usually confined to a small cage to prevent the heart rate from rising too high due to activity. If the heart rate rises too high it is likely that the dead filaria will be swept downstream, through the heart, and then get lodged in the arteries of the lungs where necrosis of lung tissues will result.

We need to focus on medications and treatments that will kill the filaria more gradually to avoid any life threatening complications.