Efficacy and Safety of Single, Double and Triple Dose Pentamidine (7mg/kg) for Patients With Cutaneous Leishmaniasis Caused by L. Guyanensis: a Pilot Study
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 159
- 主要终点
- Number of patients with reduction in 50% in the diameters of the ulcers and lesions skin
研究概览
简要总结
Introduction: Up to the present, have been few studies with pentamidine in the Americas; and there is no consensus regarding the dose used.
Objectives: To evaluate the use of pentamidine in single dose, double and triplo in the treatment of cutaneous leishmaniasis.
Methods: Clinical trial of phase II pilot study with 159 patients. Pentamidine will be used at a dose of 7 mg/kg, in three arms: single dose, double dose and triple dose. They will be also assessed the safety and adverse effects. The sic will be reviewed one, two and six months after the end of the treatments.
详细描述
This is a phase II pilot study comprising 159 patients. The sample size was calculated for a study using a test of difference between proportion considering alpha and beta errors . With an estimated curing ratio of 80 % for group 3 Pentamidine applications 7 mg / kg group and the pentamidine at a dose of 7 mg / kg 58.1 % cure rate, with a significance level 95 % and a 80 % test power .
Clinical and laboratory workup: Full body skin examination will be performed. Ulcerated lesions will be measured and pictured before treatment. Follow-up measurements and pictures were also taken one week, one, two and six months after treatment. Species identification was made through polymerase chain reaction (PCR) as described elsewhere. Two months after treatment, additional smears will be obtained from lesions that were not completely healed and/or showed an increase of, at least, 50% of its original dimensions.
Other laboratory exams included complete blood count, sugar, AST, ALT, urea, creatinine and amylase blood levels, stool parasite examination, routine urine examination and rapid test for HIV.
Drug administration: PI (300mg) was diluted in 5 ml of saline solution and a single IM injection (7 mg/kg) was administered at the outpatient unit of the FMT-HVD.
Patients were given a carbohydrate enriched meal before treatment to prevent hypoglycemia and were kept at rest and under close clinical observation until one hour after medication. Rescue treatment with IV injections of antimonials (15 mg/kg every 20 days) was prescribed for those who fail to improve.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 64 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Newly diagnosed cutaneous leishmaniasis (untreated) with localized lesions ( without maximum 6 injuries ) and Direct Examination positive : amastigotes display in tissue samples ;
- •Age: 16-64 years;
- •Sex: male and female patients to eligible ;
- •Disease Clinical Evolution not longer than 3 months .
排除标准
- •AST > 3 times the upper limit of normal;
- •ALT > 3 times the upper limit of normal;
- •Alkaline phosphatase > 3 times the upper limit of normal;
- •Serum creatinine and urea > 1.5 times the upper limit of normality;
- •Blood glucose above 110 mg / dl;
- •Evidence of serious underlying disease ( heart , kidney , liver or lung);
- •protein and / or caloric severe malnutrition;
- •Any uncompensated or uncontrolled condition like active tuberculosis, malignant disease , severe malaria , HIV, leprosy , systemic fungal disease (histoplasmosis, paracoccidioidomycosis) or any other infectious disease;
- •Pregnant women or who are breastfeeding;
- •Lack of ability or willingness to provide informed consent (patient and / or parent / legal representative); lack of availability for the visits or to comply with study procedures.
研究组 & 干预措施
Single dose of Pentamidine
Fifty three patients using Pentamidine at a dose of 7 mg/kg will be included, in a single dose.
干预措施: Single dose of Pentamidine (Drug)
Two doses of Pentamidine
Fifty three patients using Pentamidine at a dose of 7 mg/kg, in a weekly dose, during two weeks.
干预措施: Two doses of Pentamidine (Drug)
Three doses of Pentamidine
Fifty three patients using Pentamidine at a dose of 7 mg/kg, in a weekly dose, during three weeks.
干预措施: Three doses of Pentamidine (Drug)
结局指标
主要结局
Number of patients with reduction in 50% in the diameters of the ulcers and lesions skin
时间窗: Two months after the end of the treatment
次要结局
- Number of patients with complete healing in the diameters of the ulcers and lesions skin(Six months after the end of the treatment)