Comparative study on the short term efficacy and adverse effects of miltefosine and meglumine antimoniate in dogs with natural leishmaniosis

Abstract

The aim of this study was to compare the efficacy and safety of oral administration of miltefosine (Milteforan) at 2 mg/kg/day for 28 days (Group M; n = 60) with a subcutaneous administration of meglumine antimoniate (Glucantime) at 50 mg/kg/12 h or at 100 mg/kg/day for 28 days (Group G; n = 59) in the treatment of canine leishmaniosis in dogs. Out of 119 dogs included in the study, 90 could be used for efficacy assessment and 112 for safety assessment. Treated dogs were followed up for 6 weeks, with re-checks every 14 days. The mean total clinical scores significantly decreased throughout the study in both treatment groups. The evolution of parasitological results after treatment (D42) shows a high percentage of dogs with negative bone marrow smears, 90% and 91.3% in groups M and G respectively, and did not significantly differ between groups (p = 0.8066). Out of the 112 dogs used for the safety assessment, only 26 dogs (23.2%) presented product-related adverse events concerning the gastrointestinal tract. These results showed that miltefosine at 2 mg/kg once daily can be safely used over a 28-day period in the treatment of canine leishmaniosis and provides both a steadily increasing improvement of the clinical signs and a good leishmanicidal efficacy.

Intra-abdominal Aspergillosis due to Aspergillus fumigatus in a Dog

“…Prednisolone administration for 6 weeks along with canine monocytic ehrlichiosis and leishmaniosis may have resulted in a suppression of cellular immunity (De Luna et al, 1999, Harrus et al, 2003, Saridomichelakis, 2009) that permitted uninhibited fungal invasion of abdominal organs. Negative PCR for Leishmania may be attributed to previous treatment with miltefosine that reduces tissue parasitic load (Manna et al, 2008, Mateo et al, 2009, Andrade et al, 2011 and to PCR examination of kidney tissue which is not optimal for the detection of the parasite (Costa et al, 2003, Plevraki et al, 2006.…”

Canine leishmaniosis: in vitro efficacy of miltefosine and marbofloxacin alone or in combination with allopurinol against clinical strains of Leishmania infantum

“…According to Luz et al (2009), miltefosine shows excellent in vitro efficacy against Leishmania donovani even on strains isolated from relapsed or non-responder patients. By contrast, some studies describing its clinical efficacy are available (Manna et al 2009;Mateo et al 2009;Mirò et al 2009). …”

“…Therefore investigations are still in progress to discover new antileishmanial drugs (Bianciardi et al 2004;Pujals et al 2008;Zhang et al 2010). Recently miltefosine has been registered for use in dogs and different studies have demonstrated its leishmanicidal effect (Mirò et al 2009). Moreover, it has been suggested that fluoroquinolones, compared to standard chemotherapeutic agents, coul d be an effective and pragmatic alternative to treat CVL (Raether et al 1989;Vouldoukis et al 2006).…”

Aktuelle Kenntnisse zu Therapie und Prävention der kaninen Leishmaniose

“…The action mechanism of miltefosine is not clearly understood and multiple mechanisms are proposed (7), the most recent of which being parasite calcium homeostasis (45). This can reduce the parasite burden and improve clinical signs, although relapses have been reported when miltefosine has been administered alone, and therefore combination with allopurinol is preferable (27,28,32). Miltefosine has shown greater efficacy than drugs such as marbofloxacin, whether alone or in combination with allopurinol (10).…”

“…Meglumine antimonate can cause nephrotoxicity, cellulitis and abscesses, whereas milteforan can lead to vomiting and diarrhoea (39). Nevertheless, beyond these side effects, the short-time efficacy of these drugs is similar (28).…”