Clinical and parasitological impact of short-term treatment using miltefosine and allopurinol monotherapy or combination therapy in canine visceral leishmaniasis.

Canine visceral leishmaniasis is an endemic zoonosis in Brazil. Dogs are the main hosts in urban environments. The treatment has gained popularity since the Brazilian government authorized miltefosine for canine treatment. The aim of this study was to investigate the clinical and parasitological impact of short-term treatment with miltefosine and allopurinol, alone and in combination. We evaluated the ability of pharmacotherapy to reduce clinical signs of disease, antibody levels using the indirect fluorescence antibody test (IFAT) and skin parasite load via qPCR after 28 days of treatment. The therapeutic protocols promoted a significant decline in clinical signs and in the skin parasite load in dogs (p < 0.01). We observed a moderate correlation between the skin parasite load and the clinical score in all three treatment groups (r > 0.5) Antibody levels did not decrease in this short period. It was concluded that the treatment with allopurinol reduced the number of parasites in the skin of dogs with visceral leishmaniasis in the short term. However, its efficiency is potentiated when associated with miltefosine.

Clinical and parasitological impact of short-term treatment using miltefosine and allopurinol monotherapy or combination therapy in canine visceral leishmaniasis / Impacto clínico e parasitológico do tratamento de curta duração com miltefosina e alopurinol em monoterapia ou terapia combinada na leishmaniose visceral canina

Canine visceral leishmaniasis is an endemic zoonosis in Brazil. Dogs are the main hosts in urban environments. The treatment has gained popularity since the Brazilian government authorized miltefosine for canine treatment. The aim of this study was to investigate the clinical and parasitological impact of short-term treatment with miltefosine and allopurinol, alone and in combination. We evaluated the ability of pharmacotherapy to reduce clinical signs of disease, antibody levels using the indirect fluorescence antibody test (IFAT) and skin parasite load via qPCR after 28 days of treatment. The therapeutic protocols promoted a significant decline in clinical signs and in the skin parasite load in dogs (p < 0.01). We observed a moderate correlation between the skin parasite load and the clinical score in all three treatment groups (r > 0.5) Antibody levels did not decrease in this short period. It was concluded that the treatment with allopurinol reduced the number of parasites in the skin of dogs with visceral leishmaniasis in the short term. However, its efficiency is potentiated when associated with miltefosine.(AU)

A leishmaniose visceral canina é uma zoonose endêmica no Brasil. Os cães são os principais hospedeiros em ambientes urbanos. O tratamento ganhou popularidade desde que o governo brasileiro autorizou a miltefosina para tratamento canino. O objetivo deste estudo foi investigar o impacto clínico e parasitológico do tratamento a curto prazo com miltefosina e alopurinol, isoladamente e/ou em combinação. Foi avaliada a capacidade da farmacoterapia em reduzir os sinais clínicos da doença e também os níveis de anticorpos, usando-se o teste de anticorpos de fluorescência indireta (RIFI) e a carga parasitária na pele, via qPCR, após 28 dias de tratamento. Os protocolos terapêuticos promoveram declínio significativo dos sinais clínicos e da carga parasitária na pele dos cães (p < 0,01). Foi observada uma correlação moderada entre a carga parasitária da pele e o escore clínico em todos os três grupos de tratamento (r > 0,5). Já os níveis de anticorpos não diminuíram nesse curto período. Concluiu-se que o tratamento com alopurinol, em curto prazo, reduziu a quantidade de parasitos na pele dos cães com leishmaniose visceral. No entanto, sua eficiência é potencializada quando associada a miltefosina.(AU)