Oral Pentoxifylline Associated with Pentavalent Antimony: A Randomized Trial for Cutaneous Leishmaniasis

AbstractCutaneous leishmaniasis (CL) by is associated with decreasing cure rates in Brazil. Standard treatment with pentavalent antimony (Sb ) cures only 50-60% of the cases. The immunopathogenesis of CL ulcer is associated with high interferon-γ and tumor necrosis factor (TNF) production. Pentoxify...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2017-05, Vol.96 (5), p.1155-1159
Main Authors: Brito, Graça, Dourado, Mayra, Guimarães, Luiz Henrique, Meireles, Everson, Schriefer, Albert, de Carvalho, Edgar Marcelino, Machado, Paulo Roberto Lima
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antimony - therapeutic use
Antiprotozoal Agents - therapeutic use
Brazil
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Interferon-gamma - antagonists & inhibitors
Interferon-gamma - biosynthesis
Interferon-gamma - immunology
Leishmania braziliensis - drug effects
Leishmania braziliensis - growth & development
Leishmania braziliensis - pathogenicity
Leishmaniasis, Cutaneous - drug therapy
Leishmaniasis, Cutaneous - immunology
Leishmaniasis, Cutaneous - parasitology
Leishmaniasis, Cutaneous - pathology
Male
Middle Aged
Pentoxifylline - therapeutic use
Treatment Outcome
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Tumor Necrosis Factor-alpha - biosynthesis
Tumor Necrosis Factor-alpha - immunology
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Summary:AbstractCutaneous leishmaniasis (CL) by is associated with decreasing cure rates in Brazil. Standard treatment with pentavalent antimony (Sb ) cures only 50-60% of the cases. The immunopathogenesis of CL ulcer is associated with high interferon-γ and tumor necrosis factor (TNF) production. Pentoxifylline, a TNF inhibitor, has been successfully used in association with Sb in mucosal and cutaneous leishmaniasis. This randomized, double-blind, and placebo-controlled trial aimed to evaluate the efficacy and safety of oral pentoxifylline plus Sb versus placebo plus Sb in patients with CL in Bahia, Brazil. A total of 164 patients were randomized in two groups to receive the combination or the monotherapy. Cure rate 6 months after treatment was 45% in the pentoxifylline group and 43% in the control group. There was also no difference between the groups regarding the healing time (99.7 ± 66.2 days and 98.1 ± 72.7 days, respectively). Adverse events were more common in the pentoxifylline group (37.8%), versus 23% in the placebo group. This trial shows that Sb combined therapy with pentoxifylline is not more effective than Sb monotherapy in the treatment of CL caused by .
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.16-0435