A pilot study comparing low‐dose liposomal amphotericin B with <i>N</i>‐methyl glucamine for the treatment of American cutaneous leishmaniasis

Motta, Jorgeth Oliveira Carneiro da; Sampaio, Raimunda Nonata Ribeiro

doi:10.1111/j.1468-3083.2011.04070.x

Cited by 28 publications

(23 citation statements)

References 26 publications

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“…For the treatment of the localized form of American cutaneous leishmaniasis, a study comparing lowdose liposomal amphotericin B (total dose of 7.5 mg/kg) with N-methyl glucamine showed that only 50% of patients achieved a clinical cure in the liposomal amphotericin B group, in comparison with a 100% clinical cure in the N-methyl glucamine group. 20 For the ML treatment, the World Health Organization guidelines recommend a total dose of 40-60 mg/kg, but we think that an intermediate dose can be used, according to our findings and the results reported in other studies. 15 We used a mean total dose of 32.5 mg/kg (range = 18.2-55.2 mg/kg) with a good cure rate.…”

Section: Discussionmentioning

confidence: 50%

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

Cunha¹,

Leão²,

Soler³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. The standard treatment of mucosal leishmaniasis (ML) is pentavalent antimonials, agents with serious adverse effects. Alternative agents include amphotericin B deoxycholate and liposomal amphotericin B. We performed a retrospective study including 29 patients treated with liposomal amphotericin B, most of whom had comorbidities, history of previous treatment of ML, and contraindications to the use of antimonial pentavalent or amphotericin B deoxycholate. We observed a cure rate of 93.1%. Kidney failure was the most important side effect, reported in five patients (17.2%). This study showed a good efficacy and safety profile of liposomal amphotericin B in patients with ML and contraindications to the use of other agents.

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Section: Discussionmentioning

confidence: 50%

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

Cunha¹,

Leão²,

Soler³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…The Leishmania species responsible for infection were identified in most studies (Table 1) [69]–[77], [81] The follow-up time ranged from 3 months to 1 year. Six references did not comply with eligibility criteria and were excluded [78]–[80], [82]–[84].…”

Section: Resultsmentioning

confidence: 99%

Interventions for American Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review Update

et al. 2013

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IntroductionLeishmaniasis is an important public health problem in the Americas. A Cochrane review published in 2009 analyzed 38 randomized controlled trials (RCT). We conducted a systematic review to evaluate the effects of therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis.MethodsAll studies were extracted from PubMed, Embase, Lilacs (2009 to July, 2012 respectively), the Cochrane Central Register of Controlled Trials (6-2012) and references of identified publications. RCTs’ risk of bias was assessed.ResultsWe identified 1865 references of interest; we finally included 10 new RCTs. The risk of bias scored low or unclear for most domains. Miltefosine was not significantly different from meglumine antimoniate in the complete cure rate at 6 months (4 RCT; 584 participants; ITT; RR: 1.12; 95%CI: 0.85 to 1.47; I2 78%). However a significant difference in the rate of complete cure favoring miltefosine at 6 months was found in L. panamensis and L. guyanensis (2 RCTs, 206 participants; ITT; RR: 1.22; 95%CI: 1.02 to 1.46; I2 0%). One RCT found that meglumine antimoniate was superior to pentamidine in the rate of complete cure for L. braziliensis (80 participants, ITT; RR: 2.21; 95%CI: 1.41 to 3.49), while another RCT assessing L. guyanensis did not find any significant difference. Although meta-analysis of three studies found a significant difference in the rate of complete cure at 3 months favoring imiquimod versus placebo (134 participants; ITT; RR: 1.45; 95%CI: 1.12 to 1.88; I2 0%), no significant differences were found at 6 and 12 months. Thermotherapy and nitric oxide were not superior to meglumine antimoniate.ConclusionTherapeutic interventions for American cutaneous and mucocutaneous leishmaniasis are varied and should be decided according to the context. Since mucosal disease is the more neglected form of leishmaniasis a multicentric trial should be urgently considered.

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“…Pentavalent antimonials (meglumine antimoniate and sodium estibogluconate), amphotericin B (AMB) and miltefosine are the main drugs used for treatment of leishmaniasis, and the pentavalent antimony is the more common leishmanicidal drug used nowadays. Its parenteral use and associated adverse reactions decrease therapy compliance, and failure to antimony treatment is on rise in ATL [ 14 – 16 ]. AMB is the most effective drug for the treatment of leishmaniasis but its adverse reactions, mainly kidney injury, limit its use [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Inhibitory activity of pentacyano(isoniazid)ferrate(II), IQG-607, against promastigotes and amastigotes forms of Leishmania braziliensis

et al. 2017

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M. tuberculosis and parasites of the genus Leishmania present the type II fatty acid biosynthesis system (FASII). The pentacyano(isoniazid)ferrate(II) compound, named IQG-607, inhibits the enzyme 2-trans-enoyl-ACP(CoA) reductase from M. tuberculosis, a key component in the FASII system. Here, we aimed to evaluate the inhibitory activity of IQG-607 against promastigote and amastigote forms of Leishmania (Viannia) braziliensis isolated from patients with different clinical forms of L. braziliensis infection, including cutaneous, mucosal and disseminated leishmaniasis. Importantly, IQG-607 inhibited the proliferation of three different isolates of L. braziliensis promastigotes associated with cutaneous, mucosal and disseminated leishmaniasis. The IC50 values for IQG-607 ranged from 32 to 75 μM, for these forms. Additionally, IQG-607 treatment decreased the proliferation of intracellular amastigotes in infected macrophages, after an analysis of the percentage of infected cells and the number of intracellular parasites/100 cells. IQG-607 reduced from 58% to 98% the proliferation of L. braziliensis from cutaneous, mucosal and disseminated strains. Moreover, IQG-607 was also evaluated regarding its potential toxic profile, by using different cell lines. Cell viability of the lineages Vero, HaCat and HepG2 was significantly reduced after incubation with concentrations of IQG-607 higher than 2 mM. Importantly, IQG-607, in a concentration of 1 mM, did not induce DNA damage in HepG2 cells, when compared to the untreated control group. Future studies will confirm the mechanism of action of IQG-607 against L. braziliensis.

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A pilot study comparing low‐dose liposomal amphotericin B with N‐methyl glucamine for the treatment of American cutaneous leishmaniasis

Abstract: Liposomal amphotericin B seems to be promising and safe for the treatment of American cutaneous leishmaniasis.

Cited by 28 publications

References 26 publications

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

Interventions for American Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review Update

Inhibitory activity of pentacyano(isoniazid)ferrate(II), IQG-607, against promastigotes and amastigotes forms of Leishmania braziliensis

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