Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 June 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Oral miltefosine for Indian visceral leishmaniasis

Oral miltefosine is an effective and safe treatment for Indian visceral leishmaniasis, find researchers in the latest issue of the New England Journal of Medicine.

News image

fiogf49gjkf04

There are approximately 500,000 cases per year of visceral leishmaniasis.

These occur primarily in the Indian subcontinent.

Almost all untreated patients die, and all the effective treatment agents are parenteral.

However, miltefosine is an oral agent that has a favorable therapeutic index for Indian visceral leishmaniasis, in small numbers of patients

6 months later, 94% of the miltefosine group and 97% of the amphotericin B group had not relapsed.
New England Journal of Medicine

In this study, a team of international researchers performed a clinical trial in India, comparing miltefosine with the most effective standard treatment, amphotericin B.

The team orally administered miltefosine (50 or 100 mg [approximately 2.5 mg per kilogram of body weight] daily for 28 days) to 299 patients, 12 years or older.

In addition, 99 patients received intravenously administered amphotericin B (1 mg per kilogram, every other day for a total of 15 injections).

The groups were well matched in terms of age, weight, proportion with previous failure of treatment for leishmaniasis, parasitologic grade of splenic aspirate, and splenomegaly.

At the end of treatment, the researchers obtained splenic aspirates from 293 patients in the miltefosine group, and from 98 patients in the amphotericin B group.

The team did not identify any parasites, and determined and an initial cure rate of 100%.

By 6 months after the completion of treatment, 94% of patients in the miltefosine group and 97% of patients in the amphotericin B group had not had a relapse. The researchers classified these patients as cured.

However, a greater number of patients in the miltefosine group experienced vomiting (38%) and diarrhea (20%), lasting 1 to 2 days.

Dr Shyam Sundar's team concluded, "Oral miltefosine is an effective and safe treatment for Indian visceral leishmaniasis".

"Miltefosine may be particularly advantageous because it can be administered orally."

"It may also be helpful in regions where parasites are resistant to current agents."

In related editorial in the same publication, Dr Henry Murray also discusses visceral leishmaniasis, or kala-azar, and its prevalence in India, Nepal, Bangladesh, Brazil, and Sudan.

Dr Murray concludes that visceral leishmaniasis "remains a neglected disease".

"The biggest problem today is no longer a lack of basic research, epidemiological work, or clinical investigation into diagnosis and treatment."

"Instead the real obstacle now…is proper translation, distribution, and expansion of the advances that have been made."

N Engl J Med 2002; 347(22): 1739-46. 1793-4
02 December 2002

Go to top of page Email this page Email this page to a colleague

 31 May 2018 
Diagnostic for NAFLD  
 31 May 2018 
Bile acids and the risks for hepatotoxicity
 31 May 2018 
Rectal cancer female sexuality score
 30 May 2018 
Fungal dysbiosis in cirrhosis
 30 May 2018 
Placebo rates in ulcerative colitis trials
 30 May 2018 
Follow-up testing and colorectal cancer mortality
 29 May 2018 
Organ transplantation donors
 29 May 2018 
Novel therapies for IBD
 29 May 2018 
Helicobacter pylori infection to stomach cancer
 28 May 2018 
Mesalazine in ulcerative colitis
 28 May 2018 
Technology and management of digestive diseases
 28 May 2018 
Therapeutic strategies for HCV
 25 May 2018 
Post‐operative complications in elderly IBD
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Colorectal cancer–specific mortality
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
New therapies for CDI
 15 May 2018 
Hep B in the Grey Zone
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Chronic Hep B
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Symptom assessment in cirrhotic ascites
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
European guidelines on pancreatic cystic neoplasms

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us