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Intralesional meglumine antimoniate for cutaneous leishmaniasis: Evidence from a prospective real-world study in the
João Guilherme Pontes Lima Assy1, Olivia Campos Pinheiro Berretta2, Nara Karyne Del Ducke Feitosa3
1Secretaria Municipal de Saúde de Santarém: Avenida Mendonça Furtado, Santarém, Pará, Brazil; Universidade do Estado do Pará - Campus XII: Avenida Plácido de Castro, Santarém, Pará, Brazil; Faculdade de Medicina da Universidade de São Paulo-Núcleo de Medicina Tropical: Av. Dr. Enéas de Carvalho Aguiar, São Paulo, São Paulo, Brazil; Programa de Pós-Graduação em Doenças Infecciosas e Saúde Global, Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Background:
Evidence on local therapy for cutaneous leishmaniasis (CL) in the Amazon remains limited, particularly in areas where multiple Leishmania species other than Leishmania braziliensis are prevalent.
Methodology:
In this prospective, single-arm study, patients with localized CL were treated with a three-dose schedule intralesional meglumine antimoniate (IL-MA) at a referral center in Santarém, Pará, Brazil. Follow-up and outcome assessment also involved the use of mHealth tools.
Results:
Between 2022 and 2024, 127 patients were enrolled. Treatment effectiveness at day 120 ranged from 69.3% (intention-to-treat) to 76.8% (per-protocol) after the initial regimen. Following an additional IL cycle, effectiveness increased to 85.6%. One serious adverse event required brief hospitalization.
Conclusion:
IL-MA demonstrated favorable safety and moderate-to-high effectiveness, supporting its use as a pragmatic therapeutic option for CL in the Amazon region. The integration of mHealth tools proved valuable for remote monitoring and minimizing loss to follow-up, offering a promising approach for patient management and the generation of real-world evidence in endemic settings.
