Efficacy and safety of miltefosine in treatment of post-kala-azar dermal leishmaniasis.

Shyam Sundar,Anup Singh,Jaya Chakravarty,Madhukar Rai

doi:10.1155/2015/414378

Abstract

Background. Long regimens for the treatment of post-kala-azar dermal leishmaniasis (PKDL) result in noncompliance. A safe, effective, and acceptable regimen for the treatment of PKDL is still to be developed. Miltefosine has been found to be effective in the treatment of Visceral Leishmaniasis (VL). Hence, its efficacy was tested in patients of PKDL. Methods. In this exploratory study, 33 patients with PKDL aged 10 years and above were administered miltefosine (50 mg for those weighing <25 kg or 100 mg in divided doses for those ≥25 kg and 2.5 mg per kg for children) for 12 weeks and followed up for one year to find out the efficacy. Results. Out of 33 patients, 3 patients withdrew consent. Treatment was stopped due to adverse effect in 1 patient. 28 (96.6%) got cured with complete disappearance of lesion while 1 patient (3.4%) failed treatment by protocol analysis. Conclusion. Miltefosine was found to be effective and safe in the treatment of PKDL.

Highlights

Post-kala-azar dermal leishmaniasis (PKDL) cases serve as a reservoir of Leishmania infection in the population and should be diagnosed and treated effectively
Thirty-three patients with post-kala-azar dermal leishmaniasis (PKDL) were included in the study out of which two patients had no history of prior episode of Visceral Leishmaniasis (VL)
Amongst the previously treated patients for VL, 18 patients were treated with sodium stibogluconate (SSG), 10 patients were treated with paromomycin, and 1 patient was treated with each of miltefosine, liposomal amphotericin B, and amphotericin B

Summary

Background

Long regimens for the treatment of post-kala-azar dermal leishmaniasis (PKDL) result in noncompliance. A safe, effective, and acceptable regimen for the treatment of PKDL is still to be developed. Miltefosine has been found to be effective in the treatment of Visceral Leishmaniasis (VL). Its efficacy was tested in patients of PKDL. In this exploratory study, 33 patients with PKDL aged 10 years and above were administered miltefosine (50 mg for those weighing

Introduction

Material and Methodology

Results

Discussion