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Effective oral treatment for kala azar

According to a recent Indian study, a drug originally used to treat cancer has proved to be an easy and effective way to fight kala azar or visceral leishmaniasis, a parasitic disease that infects approximately 5,00,000 people in 88 countries each year around the globe. In India, the country hardest hit by visceral leishmaniasis, up to 60% of people with the disease harbour infections that are resistant to available drugs.

Effective oral treatment for kala azar

According to a recent Indian study, a drug originally used to treat cancer has proved to be an easy and effective way to fight kala azar or visceral leishmaniasis, a parasitic disease that infects approximately 5,00,000 people in 88 countries each year around the globe. In India, the country hardest hit by visceral leishmaniasis, up to 60% of people with the disease harbour infections that are resistant to available drugs.

The illness is spread by sand flies that carry the disease causing parasite, Leishmania donovani, from person to person. There are four major forms of leishmaniasis, with the visceral variety being the most severe. Visceral leishmaniasis attacks the liver, spleen and lymph nodes, resulting in weight loss and is fatal if left untreated. Current treatment by using the drug amphotericin B for the disease is less than ideal. In addition to requiring injections or intravenous treatment, it is toxic with serious side-effects.

Researchers from the Banaras Hindu University (BHU) in Varanasi, India, looked at the safety and effectiveness of miltefosine in 299 patients over the age of 12 with visceral leishmaniasis. The group was compared with 99 similarly infected patients who received intravenous doses of a drug known as amphotericin B. Six months after the treatment, 94% of those who received miltefosine and 96% of the patient, in the other group who received amphotericin B were considered to have been cured of the disease.

Miltefosine was approved for use in India earlier this year. This study shows that oral miltefosine is an effective and safe treatment for Indian visceral leishmaniasis in patients 12 years of age and older with healthy immune systems. This is an improvement over current therapies because it can be taken in an oral form, as capsules, hence the patient does not require hospitalisation for treatment.

NEJM November 2002, Vol. 347 (22)
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