Inefficacy of Allopurinol as Monotherapy for Colombian Cutaneous Leishmaniasis

Vélez, Iván Darío; Agudelo, Sonia; Hendrickx, Erik; Puerta, Juan Alberto; Grögl, Max; Modabber, Farrohk; Berman, Jonathan

doi:10.7326/0003-4819-126-3-199702010-00010

Cited by 94 publications

(73 citation statements)

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“…The drug was not effective when used alone [93]; however, in association with a low dose of antimonials, treatment achieved similar results to those obtained using full-dose antimonials [94].…”

Section: Alternative Drugssupporting

confidence: 62%

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Goto¹,

Lindoso

2010

Expert Review of Anti-infective Therapy

369

364

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Section: Alternative Drugssupporting

confidence: 62%

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Goto¹,

Lindoso

2010

Expert Review of Anti-infective Therapy

369

364

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“…In the search for therapeutic alternatives, various oral medications have been evaluated, such as dapsone 18 , ketoconazole 12,21 , mefloquine 9 , and allopurinol 31 , none of which were shown to be adequately effective. An additional difficulty in the interpretation of results of clinical trials is the lack of methodological unity, which hinders their comparison 3,8 .…”

Section: Introductionmentioning

confidence: 99%

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

López

Cruz

Godoy

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIn Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems), cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145) or a thermotherapy (Thermomed ® ) application of 50 ºC for 30 seconds over the lesion and surrounding area (n = 149). Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients) and 69% (85/145 patients), respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol) between the two treatments. ClinicalTrials.gov: NCT00471705.

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“…En la actualidad, cada vez son más los estudios que reportan el hallazgo de Leishmania spp. resistente al antimonio pentavalente alrededor del mundo y en Colombia (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Como tratamientos de segunda línea se utilizan la anfotericina B, la pentamidina y la miltefosina, que son medicamentos efectivos contra la leishmaniasis, pero, debido a sus altos costos y los efectos secundarios que pueden ocasionar, estos son poco utilizados (18).…”

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