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Miltefosine to treat leishmaniasis
1Office of Clinical and Regulatory Affairs, National Center For Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Suite 401, Bethesda, MD 20892, USA. Bermanjo@mail.nih.gov
Expert Opinion on Pharmacotherapy
|July 15, 2005
Summary
Miltefosine is a highly effective oral treatment for both visceral and cutaneous leishmaniasis, showing over 90% cure rates. Further trials will determine its suitability for widespread outpatient and population-level treatment.
Area of Science:
- Parasitology
- Pharmacology
- Tropical Medicine
Background:
- Leishmaniasis presents as visceral and cutaneous forms, posing a global health challenge.
- Existing treatments often require parenteral administration, limiting accessibility.
- Miltefosine emerges as a novel oral therapeutic option.
Purpose of the Study:
- To evaluate the efficacy and tolerability of miltefosine for leishmaniasis treatment.
- To explore the potential of miltefosine as a widely accessible oral medication.
Main Methods:
- Administration of miltefosine at approximately 2.5 mg/kg/day for 28 days.
- Clinical assessment of treatment outcomes in patients with visceral leishmaniasis in India and cutaneous leishmaniasis in Colombia.
Main Results:
- Miltefosine demonstrated over 90% curative efficacy for visceral leishmaniasis in India.
- Miltefosine achieved over 90% curative efficacy for cutaneous leishmaniasis in Colombia.
- The drug has a clinical half-life of approximately 7 days.
Conclusions:
- Miltefosine is the first oral agent with proven efficacy against both visceral and cutaneous leishmaniasis.
- Its mechanism of action involves inhibiting phosphatidylcholine biosynthesis in parasites.
- Further clinical trials are necessary to confirm its utility for widespread outpatient and population-level treatment.