A retrospective cohort study of the effectiveness and adverse events of intralesional pentavalent antimonials in the treatment of cutaneous leishmaniasis

Autor: Sofia Sales Martins, Cláudia Porto, Marina Freitas Ferreira, Jorgeth de Oliveira Carneiro da Motta, Carmen Déa Ribeiro de Paula, Ciro Martins Gomes, Bruna Côrtes Rodrigues, Raimunda Nonata Ribeiro Sampaio, Daniel Holanda Barroso
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
N-methyl glucamine
Meglumine antimoniate
030231 tropical medicine
Pentavalent antimonial
Antiprotozoal Agents
Leishmaniasis
Cutaneous
Context (language use)
Injections
Intralesional
Article
law.invention
lcsh:Infectious and parasitic diseases
Lesion
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Meglumine
Randomized controlled trial
law
Internal medicine
medicine
Organometallic Compounds
Humans
Pharmacology (medical)
lcsh:RC109-216
Prospective Studies
Adverse effect
New world leishmaniasis
Retrospective Studies
Pharmacology
Cutaneous leishmaniasis
Intralesional antimonial
business.industry
Retrospective cohort study
030104 developmental biology
Infectious Diseases
Treatment Outcome
chemistry
Intralesional therapy
Relative risk
Parasitology
Female
medicine.symptom
business
medicine.drug
Zdroj: International Journal for Parasitology: Drugs and Drug Resistance, Vol 14, Iss, Pp 257-263 (2020)
International Journal for Parasitology: Drugs and Drug Resistance
ISSN: 2211-3207
Popis: Introduction The standard therapy for American cutaneous leishmaniasis (ACL) is intravenous meglumine antimoniate (IV-MA). However, treatment interruptions due to adverse events (AEs) and non-adherence are frequent. Consequently, intralesional MA (IL-MA) was proposed. Objective This study examined the effectiveness of and AEs associated with IL-MA. Methods We performed a retrospective cohort study of 240 patients with ACL. We excluded patients with mucous lesions and disseminated leishmaniasis and those who received treatment in the previous 6 months. We considered protocol treatments as the main risk factors. IL-MA was performed using a subcutaneous injection of MA in a volume sufficient to elevate the lesion base (approximately 1 mL/cm2 of lesion area) once weekly for 1–8 weeks. IV-MA was performed via intravenous injections of MA at a dosage of 10–20 mg Sb5+/kg/day for 20 days. The primary outcome was defined as a lesion cure 3 months after treatment, and AEs were secondary outcomes. Results Seventy-three patients were included. The IL-MA group consisted of 21 patients, and the IV-MA group consisted of 52 patients. The IL-MA group was older, had more comorbidities and more previous unsuccessful treatment of ACL. The antimonial dose was significantly lower in this group. The cure rate for IL-MA was 66.7%, which was lower than that in the IV-MA group (relative risk (RR) = 0.68, 95% CI: 0.50–0.92, p
Graphical abstract Image 1
Highlights • Intralesional antimonials (IL-MA) had a 66.7% lower cure compared to systemic. • IL-MA group was older, had more comorbidities and unsuccessful previous treatment. • IL-MA was useful in this group, where worse clinical responses are expected. • Lesions larger than 3 cm did not have more chance of failure with IL-MA. • There was no mucous recurrence after IL-MA in an area of New World Leishmaniasis.
Databáze: OpenAIRE
Externí odkaz: