title: Randomized, double-blind study of stibogluconate plus human granulocyte macrophage colony-stimulating factor versus stibogluconate alone in the treatment of cutaneous Leishmaniasis.
abstract: The response to recombinant human granulocyte macrophage colony-stimulating factor (GM-CSF) in the treatment of cutaneous leishmaniasis was evaluated. Twenty patients with cutaneous leishmaniasis who had lesions for 60 days were enrolled in a double-blind placebo trial of GM-CSF with standard parenteral sodium stibogluconate (20 mg/kg-1/day-1) for 20 days. Ten patients were randomized to receive intralesionally injected GM-CSF (200 microgram) at enrollment and 1 week after, and 10 patients received saline as placebo. GM-CSF- and antimony-treated patients healed faster than patients who received antimony alone (49+/-32.8 vs. 110+/-61.6 days, P<.05). Seven of 10 patients were healed of their lesions before 40 days after therapy in the GM-CSF group, compared with only 1 of 10 patients in the placebo group (relative risk, 7; 95% confidence interval, 1.04-47.00). Thus, GM-CSF plus antimony significantly increased the chance of lesion healing in 40 days.
authors.affiliation: Serviço de Imunologia do Hospital Universitário Prof. Edgard Santos, Salvador, Bahia, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Almeida
authors.forename: A
authors.initials: A
authors.lastname: D'Oliveira
authors.forename: P
authors.initials: P
authors.lastname: Machado
authors.forename: O
authors.initials: O
authors.lastname: Bacellar
authors.forename: A I
authors.initials: AI
authors.lastname: Ko
authors.forename: A R
authors.initials: AR
authors.lastname: de Jesus
authors.forename: N
authors.initials: N
authors.lastname: Mobashery
authors.forename: J
authors.initials: J
authors.lastname: Brito Santos
authors.forename: E M
authors.initials: EM
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000981:Antiprotozoal Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000967:Antimony Sodium Gluconate