Foto: Marcello Casal jr/Agência Brasil

With information from Cristina Indio do Brasil, from Agência Brasil

New treatment against leishmaniasis has been tested by Dr. Jackson Mauricio Lopes Costa’s Leishmaniasis Reference Center in the Corte de Pedra district of Presidente Tancredo Neves, Bahia. From next year begins the third phase of the tests, made in partnership with the University Hospital Júlio Muller, Cuiabá, Mato Grosso.

The program is part of the Medicines for Neglected Diseases (DNDi) initiative, a nonprofit drug research and development organization.

The goal is to test the treatment that combines a single 50 degree heat therapy session with a 21-day intake of one pill of the drug Miltefosine, used to treat leishmaniasis and free-living amoeba infections. The drug is effective in treating cutaneous, mucocutaneous and visceral leishmaniasis.

The results showed that the combination has a cure rate of approximately 80% and is more effective than heat and meglubin antimoniate injections separately.

In phase 3, the Brazilian centers will work in conjunction with laboratories in Bolivia, Peru and Panama. This step complements the study, which brings together researchers from Peru and Colombia. The project was developed with 130 patients to treat cutaneous leishmaniasis.

The result was first presented at the Brazilian Congress of Tropical Medicine, ChagaLeish and Parasitology, by the program director Byron Arana, in Belo Horizonte (MG). According to the researcher, the studies began three years ago and the treatment gives more security to patients with higher cure rates.

Perfect combination

“A protocol was approved for Colombia and Peru to include a relatively small group of patients in the studies, 130 people, divided into two treatment groups. One received only thermotherapy and the other received thermotherapy and miltefosine. What we found was that the combination is much more effective than just heat therapy, ”Arana told Agência Brasil.

According to the researcher, the treatment also brings more comfort to the patient, since they do not need to go to health facilities for injections. There were also no side effects. “It’s 20 days of injectable treatment,” said DNDi clinical research manager Marina Boni.

According to the Pan American Health Organization of the World Health Organization (PAHO / WHO), leishmaniasis are vector-borne diseases and are part of the neglected infectious disease group. They are considered as such because they spread in poorer regions and reach more vulnerable populations, which suffer from difficulties in accessing health services.

Although there are records in many parts of the world, most cases occur in Africa, Asia and the Americas.

“WHO estimates there are between 600,000 and 1.9 million new cases each year. It is a problem that most often affects migrant populations. At present the problem is serious in Syria as a result of the war; in Pakistan, with migrants in conflict areas; and in Latin American countries, such as Brazil, which reports approximately 17,000 new cases per year. It is a country that contributes 70%, 80% of cases in Latin America, ”he said.

“There is tremendous concern in countries, because the disease is reporting more and more cases each year. Everyone is worried, but there is not much to do, because the medicine we are using is old, ”he said. He added that there is little support for the development of treatments.

The researcher also warned of the segregation that many patients face because of skin wounds. “It is a mental burden that the disease causes. In recent years the problem has begun to be quantified more systematically. Previously, nothing was noted and it was not known how much this represents. Today there are already studies in women and children showing the impact on their quality of life, ”he noted.

Brazil

DNDi clinical research manager Marina Boni said that the intention to include Brazilian centers in phase 3 of the studies is to change the treatment recommendation pathways in Brazil, which would be less long and less toxic.

“Currently, the disease is still treated with very old, long and injectable medicines from 40 to 60 years ago. With the new studies, we want to bring scientific evidence of efficacy that will translate into quality of life for neglected patients, ”he told Agência Brasil.

According to the researcher, the Northeast and Midwest regions are the most endemic in Brazil.

Marina Boni pointed out that in order to get more realistic notifications, one has to follow what is called good clinical practice. “We have centers like Cuiabá, which receives patients from all over the region. So we need researchers to follow the rules of good clinical practice, ”he said, noting that the patient with cutaneous leishmaniasis may have a cure for the skin lesion, but as it will remain with circulating parasites in the body, the ulcers cannot be ruled out. and even evolution to the mucous membranes.

Americas

According to WHO, leishmaniasis is present in 18 countries of the Americas and the most common clinical form is cutaneous leishmaniasis (LC). Between 2001 and 2017, there were a total of 940,396 new cases of cutaneous leishmaniasis (LC) and mucosa (ML) that were reported by 17 of the 18 endemic countries in this region, with an annual average of 55,317 cases.

In 2017, the Pan American Health Organization (SisLeish – PAHO / WHO) reported 49,959 cases in 17 endemic countries, as French Guiana reports data to France.