A single-group trial of end-stage patients with anthroponotic cutaneous leishmaniasis: Levamisole in combination with Glucantime in field and laboratory models

Bamorovat, Mehdi; Sharifi, Iraj; Fekri, Alireza; Keyhani, Alireza; Aflatoonian, Mohammad Reza; Heshmatkhah, Amireh; Oliaee, Razieh Tavakoli; Khosravi, Ahmad; Naderi, Afsaneh; Parizi, Maryam Hakimi; Mostafavi, Mahshid; Varma, Rajender S.

doi:10.1016/j.micpath.2018.12.040

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…To control the disease, chemotherapy is therefore the only measure needed at present. The development of superior and more efficient ACL treatment drugs is highly required to diminish infections in endemic areas (Bamorovat et al, 2019b).…”

Section: Discussionmentioning

confidence: 99%

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Determinants of Unresponsiveness to Treatment in Cutaneous Leishmaniasis: A Focus on Anthroponotic Form Due to Leishmania tropica

et al. 2021

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Cutaneous leishmaniasis (CL) is a curable disease; however, due to various risk factors, unresponsiveness to CL treatments is inevitable. The treatment of CL has been firmly correlated with multiple determinants, such as demographical, clinical, and environmental factors, the host’s immune response, poor treatment adherence, the parasite’s genetic make-up, and Leishmania RNA virus. This study primarily focuses on the risk factors associated with different therapeutic outcomes following meglumine antimoniate (MA; Glucantime®) treatment and policy approaches to prevent unresponsiveness in CL patients with a focus on anthroponotic form (ACL). Findings suggest that effective preventive and therapeutic measures should be more vigorously implemented, particularly in endemic areas. Accordingly, extensive training is essential to monitor drug unresponsiveness regularly, especially in tropical regions where the disease is prevalent. Since humans are the fundamental reservoir host of ACL due to L. tropica, prompt detection, early diagnosis, and timely and effective treatment could help control this disease. Furthermore, major challenges and gaps remain: efficacious vaccine, new tools, and expert staff are crucial before CL can be definitively controlled.

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Section: Discussionmentioning

confidence: 99%

“…For instance, a leishmanicidal drug with either anti-inflammatory or immunomodulatory effects could be efficient in the treatment of CL. A previous study on combination therapy for ACL indicated that combining the first-line and secondline drugs could improve their efficacy (Croft et al, 2006;Bamorovat et al, 2019b).…”

Section: Discussionmentioning

confidence: 99%

Determinants of Unresponsiveness to Treatment in Cutaneous Leishmaniasis: A Focus on Anthroponotic Form Due to Leishmania tropica

et al. 2021

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“…Combination therapy is now being recommended for many infectious diseases, including ACL. This modality offers the potential of preventing drug resistance, because organisms resistant to one of the drugs may be susceptible to the other drug; and also the potential to diminish drug therapy duration and thus side effects [42].…”

Section: Discussionmentioning

confidence: 99%

Associated-risk determinants for anthroponotic cutaneous leishmaniasis treated with meglumine antimoniate: A cohort study in Iran

et al. 2019

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Background The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment. Methodology/Principal findings This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079–2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075–2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008–2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204–3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906–3.936, p≤0.001). Conclusions/Significance The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L . tropica .

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“…In Kerman, average annual precipitation is low (140-150 mm), and maximum rain falls in winter. One of Iran's well-known ACL focal points is Kerman's county (Aflatoonian et al, 2019;Bamorovat et al, 2019bBamorovat et al, , 2019aBamorovat et al, 2018bBamorovat et al, , 2018aSharifi et al, 2015) (Fig. 1).…”

Section: Design and Study Sitementioning

confidence: 99%

Prophylactic effect of cutaneous leishmaniasis against COVID-19: a case-control field assessment

Bamorovat

Sharifi

Aflatoonian

et al. 2022

International Journal of Infectious Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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A single-group trial of end-stage patients with anthroponotic cutaneous leishmaniasis: Levamisole in combination with Glucantime in field and laboratory models

Cited by 16 publications

References 39 publications

Determinants of Unresponsiveness to Treatment in Cutaneous Leishmaniasis: A Focus on Anthroponotic Form Due to Leishmania tropica

Determinants of Unresponsiveness to Treatment in Cutaneous Leishmaniasis: A Focus on Anthroponotic Form Due to Leishmania tropica

Associated-risk determinants for anthroponotic cutaneous leishmaniasis treated with meglumine antimoniate: A cohort study in Iran

Prophylactic effect of cutaneous leishmaniasis against COVID-19: a case-control field assessment

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