Abstract
IntroductionThe usual treatment of American Cutaneous Leishmaniasis is based on intravenous drugs of the 1940s and causes adverse events, having as first choice pentavalent antimonials that require clinical and laboratory follow-up in the hospital setting. The present study aimed to identify potentially more effective and safe oral therapies, applying Technological Horizon Scanning.MethodsThe searches were divided into three blocks: clinical trials through the Clinical Trials Registry Platform on the WHO search portal; searches in the PubMed, Embase, Cochrane Library, Lilacs and Center for Reviews and Dissemination databases; and search for patents in the Orbit base. The searches aimed at identifying drugs, authors, institutions and therapeutic classes in order to proceed with scanning process.ResultsWe found 197 studies and selected 33 in the Americas region. Of these, seventeen (51%) investigated miltefosine, six (18%) had azithromycin, four (12%) Fluconazole, two (6%) pentoxifylline, two (6%) allopurinol and one (3%) terbinafine. Of the 26 clinical studies, twelve presented positive results for oral medications, six related to miltefosine, two to fluconazole, two to pentoxifylline, one to azithromycin and one to allopurinol. Through the analysis of patents, 35 documents involving 32 institutions and 134 inventors were identified. Of the 32 institutions that registered patent documents, Novartis is the one with the highest number of inventors.ConclusionsMiltefosine is in the incorporation phase in the Brazilian health system, evaluating its performance and effectiveness in the services. Pentoxifylline was recently incorporated as a coadjuvant to the treatment, and Fluconazole presented positive results, however with a small number of patients and uncertain outcomes. It is recommended to carry out more research directed to the drug association, since the studies indicate the possibility of decreasing occurrence of relapses, dosages and treatment time, increasing adherence to treatment.
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