Intralesional meglumine antimoniate for the treatment of localised cutaneous leishmaniasis: a retrospective review of a Brazilian referral centre

Abstract

Although intralesional meglumine antimoniate (MA) infiltration is considered an option for cutaneous leishmaniasis (CL) therapy and is widely used in the Old World, there have been few studies supporting this therapeutic approach in the Americas. This study aims to describe outcomes and adverse events associated with intralesional therapy for CL. This retrospective study reviewed the experience of a Brazilian leishmaniasis reference centre using intralesional MA to treat 31 patients over five years (2008 and 2013). The median age was 63 years (22-86) and the median duration time of the lesions up to treatment was 16 weeks. In 22 patients (71%), intralesional therapy was indicated due to the presence of contraindications or previous serious adverse events with systemic MA. Other indications were failure of systemic therapy or ease of administration. Intralesional treatment consisted of one-six infiltrations (median three) for a period of up to 12 weeks. The initial (three months) and definitive (six months) cure rates were 70.9% and 67.7%, respectively. Most patients reported mild discomfort during infiltration and no serious adverse events were observed. In conclusion, these results show that the intralesional MA efficacy rate was very similar to that of systemic MA treatment, and reinforce the need for further studies with adequate design to establish the efficacy and safety of this therapeutic approach.

Successful Treatment with Intralesional Meglumine Antimoniate in Recurrent Cutaneous Leishmaniasis: Case Report

“…Although some studies report a lower cure rate, such as the intralesional application of meglumine antimoniate in Iran for L. major, with a low cure rate of 56% [20], other studies, particularly in Latin America, report cure rates that exceed 70% with similar efficacy to the systemic Glucantime, without showing statistically significant differences [7]. In Brazil, Vasconcellos et al reported a healing rate close to 80% in patients who received intralesional therapy, considerably reducing adverse effects and therapeutic expenditure [8].…”

“…There are cases and series of cases in the literature of cutaneous leishmaniasis treated with intralesional antimonials showing divergent results, some with satisfactory results, with cure rates as high as 70-80% [7,8] and others with poor cure rates [9,10].…”

Intralesional treatment with meglumine antimoniate in three patients with New World cutaneous leishmaniasis and large periarticular lesions with comorbidities

“…Specific treatment is thus almost mandatory. Patients with contraindications to systemic treatment, however, can benefit from IL MA treatment 3,8 . Recently, Soto et al 9 found that treatment with IL MA has comparable efficacy to treatment with IL pentamidine in Bolivian patients with cutaneous leishmaniasis caused by L. braziliensis.…”

Intralesional Infiltration with Meglumine Antimoniate for the Treatment of Leishmaniasis Recidiva Cutis in Ecuador

“…The evaluation of direct parasitological cure has ethical implications and is not considered safe. 19 Ethics. This study was approved by the Human Research Ethics Committee of the Pontificia Universidad Católica del Ecuador (CEISH-057-2016) and the Ministerio de Salud Publica del Ecuador (MSP-DIS-2015-0011-O).…”

“…15,16 In Brazil, studies reported a cure rate of 80%, 83.3%, and 77.7% in patients with the ulcerative variant of CL. [17][18][19] Reported here are the results of a study conducted in the subtropical region of the province of Pichincha of Ecuador where 21 patients with LRC lesions were treated IL with MA.…”