Study of efficacy of miltefosine and allopurinol in dogs with leishmaniosis

Vet J. 2009 Dec;182(3):441-5. doi: 10.1016/j.tvjl.2008.08.009. Epub 2008 Sep 24.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Antiprotozoal Agents
  • Phosphorylcholine
  • miltefosine
  • Allopurinol