Miltefosine to treat leishmaniasis.
Leishmaniasis exists in both visceral and cutaneous forms, and miltefosine is the first oral agent with demonstrable efficacy against both types of this disease. At a dose of approximately 2.5 mg/kg/day for 28 days, miltefosine is > 90% curative for visceral disease in India and cutaneous disease in Colombia. Miltefosine is a lecithin analogue and its mechanism may be to inhibit phosphatidylcholine biosynthesis in the causative parasites. The clinical half-life of miltefosine is approximately 7 days. Whether or not miltefosine can be used for widespread out-patient treatment of individuals and whole populations depends on whether its efficacy and tolerability can be maintained in further treatment trials.
Berman
Jonathan
J
Office of Clinical and Regulatory Affairs, National Center For Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Suite 401, Bethesda, MD 20892, USA. Bermanjo@mail.nih.gov
D000284:Administration, Oral; D000818:Animals; D000981:Antiprotozoal Agents / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000378:metabolism; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000378:metabolism; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine