Favorable responses to treatment with 5 mg Sbv/kg/day meglumine antimoniate in patients with American tegumentary leishmaniasis acquired in different Brazilian regions.

Abstract

INTRODUCTION:

Favorable responses in American tegumentary leishmaniasis (ATL) patients to treatment with 5 mg Sbv/kg/day meglumine antimoniate (MA) has been reported in Rio de Janeiro, but little is known regarding the therapeutic response to low doses in patients from other locations.

METHODS:

A retrospective review of medical records was conducted to compare the therapeutic response to 5 mg Sbv/kg/day MA treatment among 36 patients who acquired ATL in Brazilian states other than Rio de Janeiro (OS group) and 72 patients from Rio de Janeiro (RJ group).

RESULTS:

One course of 5 mg Sbv/kg/day MA cured 72.8% of 81 cutaneous (CL) and 66.6% of 27 mucosal (ML) leishmaniasis-infected patients: 70% in the CL/RJ group, 81% in the CL/OS group, 50% in the ML/RJ group, and 80% in the ML/OS group. After up to two additional treatment courses at the same dose, 88.9% and 85.2% of the CL and ML patients were cured, respectively. Adverse events were observed in 40% of patients in the CL/RJ group, 57% of the CL/OS group, 58% of the ML/RJ group, and 80% of the ML/OS group. No significant differences were observed in the cure rates or adverse effects between the RJ and OS groups. No patients required permanent discontinuation of treatment due to adverse events.

CONCLUSIONS:

Patients with ATL acquired in both RJ and OS may respond to low-dose MA. While high-dose MA should remain the standard treatment for ATL, low-dose MA might be preferred when toxicity is a primary concern.

• Authors: Jamyra Iglesias Cataldo, Fátima Conceição-Silva, Liliane de Fátima Antônio, Armando de Oliveira Schubach, Mauro Célio de Almeida Marzochi, Cláudia Maria Valete-Rosalino, Maria Inês Fernandes Pimentel, Marcelo Rosandiski Lyra, Raquel de Vasconcellos Carvalhaes de Oliveira, Juliana Helena da Silva Barros, Raquel da Silva Pacheco, Maria de Fátima Madeira
• Journal: Revista da Sociedade Brasileira de Medicina Tropical (Rev Soc Bras Med Trop) 2018 Nov-Dec Vol. 51 Issue 6 Pg. 769-780 ISSN: 1678-9849 [Electronic] Brazil
• PMID: 30517530 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antiprotozoal Agents
• Meglumine Antimoniate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antiprotozoal Agents (therapeutic use)
• Brazil
• Child
• Child, Preschool
• Female
• Geography
• Humans
• Infant
• Infant, Newborn
• Leishmaniasis, Cutaneous (drug therapy, parasitology)
• Male
• Meglumine Antimoniate (therapeutic use)
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Young Adult