COMPARISON OF EFFICACY OF MILTEFOSINE VERSUS MEGLUMINE ANTIMONATE IN THE TREATMENT OF CUTANEOUS LEISHMANIASIS

Authors

  • Noor Mohammad Dermatology Department Lady Reading Hospital medical teaching institute Peshawar Pakistan
  • Farah Sagheer lady reading hospital peshawar
  • Mohammad Majid Dermatology Department Lady Reading Hospital medical teaching institute Peshawar Pakistan
  • Abdul Qayum khan Dermatology Department Lady Reading Hospital medical teaching institute Peshawar Pakistan
  • Sadia Naseem Dermatology Department Lady Reading Hospital medical teaching institute Peshawar Pakistan
  • Mohammad Wasim Dermatology Department Lady Reading Hospital medical teaching institute Peshawar Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-11135

Keywords:

cutaneous leishmaniasis, miltefosine, meglumine antimonate, efficacy

Abstract

Background: Cutaneous Leishmaniasis is a morbid condition that generates stigmatization and disfiguring scars. Pakistan is among the ninety-eight countries where cutaneous Leishmaniasis is endemic. Purpose of study was to compare the efficacy of miltefosine and meglumine antimoniate in the treatment of cutaneous Leishmaniasis. Methods: All patients with cutaneous Leishmaniasis (CL) who met the inclusion criteria were divided into two groups using the envelop method. Capsule Miltefosine 50 mg (2.5 mg/ kg) was given to group A, while intralesional Glucantime injection was given to group B. The treatment's efficacy was evaluated after four weeks and again after eight weeks. Results: Out of 74 patients, 37 patients were included in each group. In group A (miltefosine group), 56.75% were males, and 43.25% were females. In group B (meglumine antimoniate group), 62% were males, while 38% were females (p=0.63). The mean age was 32.81 years±12.09 SD, the mean duration of the disease was 5.4 months±2.3 SD and the mean number of lesions was 2.56±1.33 SD. The efficacy of Miltefosine and meglumine antimoniate (I/L) was 91.9% and 56.75%, respectively (p<0.001). Conclusion: Miltefosine was more effective than intralesional meglumine antimoniate in the treatment of cutaneous Leishmaniasis (p<0.001).

References

Ali A, Ur Rehman T, Qureshi NA, Ur Rahman H. New endemic focus of cutaneous leishmaniasis in Pakistan and future epidemics threats. Asian Pac J Trop Dis 2016;6(2):155–9.

Alcantara LM, Ferreira TCS, Gadelha FR, Miguel DC. Challenges in drug discovery targeting TriTryp diseases with an emphasis on leishmaniasis. Int J Parasitol Drugs Drug Resist 2018;8(3):430–39.

Nezamzadeh-Ezhiyeh H, Mirhendi H, Jafari R, Veysi A, Rassi Y, Oshaghi MA, et al. An Eco-Epidemiological Study on Zoonotic Cutaneous Leishmaniasis in Central Iran. Iran J Public Health 2021;50(2):350–9.

Aronson NE, Joya CA. Cutaneous leishmaniasis: updates in diagnosis and management. Infect Dis Clin 2019;33(1):101–17.

Noor SM, Bhatti MZ, Paracha MM, Ullah GU. Efficacy of Combined Intralesional Meglumine Antimoniate and Cryotherapy Versus Cryotherapy alone for the Treatment of Cutaneous Leishmaniasis. J Postgrad Med Inst 2018;32(1):103–6.

Yesilova Y, Surucu HA, Ardic N, Aksoy M, Yesilova A, Oghumu S, et al. Meglumine antimoniate is more effective than sodium stibogluconate in the treatment of cutaneous leishmaniasis. J Dermatolog Treat 2016;27:83–7.

Peralta MF, Usseglio NA, Bracamonte ME, Guzmán ML, Olivera ME, Marco JD, et al. Efficacy of topical miltefosine formulations in an experimental model of cutaneous leishmaniasis. Drug Deliver Translat Res 2022;12(1):180–96.

Tahir M, Bashir U, Hafeez J, Ghafoor R. Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan. Pak J Med Sci 2019;35(2):495–9.

Silva, Júnior AT, Senna MC, Rabello A, Cota1 G. Intralesional meglumine antimoniate for the treatment of localised cutaneous leishmaniasis: a retrospective review of a Brazilian referral centre. Mem Inst Oswaldo Cruz 2016;111(8):512–6.

Rubiano LC, Miranda MC, Muvdi Arenas S, Montero LM, Rodríguez-Barraquer I, Garcerant D, et al. Noninferiority of miltefosine versus meglumine antimoniate for cutaneous leishmaniasis in children. J Infect Dis 2012;205(4):684–92.

Arboleda M, Barrantes S, Úsuga LY, Robledo SM. Successful treatment of cutaneous leishmaniasis with intralesional meglumine antimoniate: A case series. Rev Soc Bras Med Trop 2019;52:e20180211.

Tayyebi M, Darchini-Maragheh E, Layegh P, Kiafar B, Goyonlo VM. The effect of oral miltefosine in treatment of antimoniate resistant anthroponotic cutaneous leishmaniasis: An uncontrolled clinical trial. PLoS Neglect Trop Dis 2021;15(3):e0009241.

Ware JM, O’Connell EM, Brown T, Wetzler L, Talaat KR, Nutman TB, et al. Efficacy and tolerability of miltefosine in the treatment of cutaneous leishmaniasis. Clin Infect Dis 2021;73(7):e2457–2562.

Mann S, Phupitakphol T, Davis B, Newman S, Suarez JA, Henao-Martínez A, et al. Case Report: Cutaneous Leishmaniasis due to Leishmania (Viannia) panamensis in Two Travelers Successfully Treated with Miltefosine. Am J Trop Med Hyg 2020;103(3):1081–4.

Sampaio RN, Silva JS, Paula CD, Porto C, Motta JD, Pereira LI, et al. A randomized, open-label clinical trial comparing the long-term effects of miltefosine and meglumine antimoniate for mucosal leishmaniasis. Rev Soc Bras Med Trop 2019;52:1–8.

Hopewell S, Clarke M, Moher D, Wager E, Middleton P, Altman DG, et al. CONSORT for ReportingRandomized Controlled Trials inJournal and Conference Abstracts:Explanation and Elaboration. PLoS Med 2008;5(1):e20.

Published

2022-09-27