Study of efficacy of miltefosine and allopurinol in dogs with leishmaniosis.

Abstract

Visceral leishmaniosis is a life-threatening disease of medical, social and economic importance in endemic areas. It is an opportunistic infection in immunocompromised patients, including human immunodeficiency virus-positive subjects. Dogs are the main reservoir of Leishmania infantum. The aim of this study was to evaluate the efficacy of miltefosine and allopurinol for the control of human leishmaniosis using the dog as a model. The study included 28 sick dogs treated with miltefosine (2 mg/kg/day PO) administered concurrently with allopurinol (10 mg/kg/day, PO) for 30 days, and then with allopurinol alone, at the same dosage, for 1 year. Eight dogs (four of which relapsed) received a second cycle of miltefosine within 6 months of the first cycle. Efficacy was measured by real-time polymerase chain reaction assay on whole blood samples and lymph node aspirates, collected at baseline and every 3 months for 12 months. Of the total number of animals (28), two showed renal insufficiency and died after the start of therapy with miltefosine. Two other dogs presented some side effects to treatment, such as nausea, vomiting and reduction in white and red blood cell counts, and these animals were excluded from the follow-up. The results showed that the first cycle of therapy with miltefosine and allopurinol induced a drastic and progressive reduction of L. infantum load in lymph node aspirates but the second cycle did not eliminate the parasite.

• Authors: Laura Manna, Fabrizio Vitale, Stefano Reale, Esther Picillo, Gianluca Neglia, Francesco Vescio, Angelo Elio Gravino
• Journal: Veterinary journal (London, England : 1997) (Vet J) Vol. 182 Issue 3 Pg. 441-5 (Dec 2009) ISSN: 1532-2971 [Electronic] England
• PMID: 18818112 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiprotozoal Agents
• Phosphorylcholine
• miltefosine
• Allopurinol

Topics

• Allopurinol (adverse effects, therapeutic use)
• Animals
• Antiprotozoal Agents (adverse effects, therapeutic use)
• Disease Models, Animal
• Disease Reservoirs (parasitology, veterinary)
• Dog Diseases (drug therapy, parasitology, prevention & control, transmission)
• Dogs
• Drug Therapy, Combination
• Female
• Humans
• Leishmania infantum (pathogenicity)
• Leishmaniasis, Visceral (drug therapy, prevention & control, transmission, veterinary)
• Male
• Phosphorylcholine (adverse effects, analogs & derivatives, therapeutic use)
• Recurrence
• Treatment Outcome
• Zoonoses