Safety and Efficacy of Azithromycin to Treat Cutaneous Leishmaniasis

Cutaneous Leishmaniasis Clinical Trial

— PCL01  

Official title:

Open Label Randomized Study to Assess Safety and Efficacy of Azithromycin Versus Meglumine Antimoniate to Treat Cutaneous Leishmaniasis

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00682656
• Other study ID #: CEPSH/CPqRR 21/2006
• Status: Terminated
• Phase: Phase 2/Phase 3
• First received: May 20, 2008
• Last updated: October 16, 2014
• Start date: June 2008
• Est. completion date: September 2012

Study information

• Verified date: July 2011
• Source: Oswaldo Cruz Foundation
• Contact: n/a
• Is FDA regulated: No
• Health authority: Brazil: National Health Surveillance Agency
• Study type: Interventional

Clinical Trial Summary

The adequate treatment of the American tegumentary leishmaniasis is crucial since the disease, differently from the caused by the Old World species, is painful and not self-healing and may lead to the disfiguring mucosal involvement. So far, pentavalent antimony compounds have been considered the treatment of choice for cutaneous leishmaniasis (CL), however, these drugs present high frequency of side effects and important disadvantages as parenteral administration and need for careful renal and cardiac monitoring. Azithromycin is a macrolide antibiotic, non-expensive, largely commercially available that has shown in-vitro and in vivo activity against different species of Leishmania.

The main objective of this study is to evaluate the efficacy and safety of oral azithromycin for the treatment of CL. The efficacy of oral treatment of azithromycin 500 mg/day for 20 days is going to be compared with the standard treatment of intramuscular injections of 20 mg/Kg/day of pentavalent antimonials (Glucantime®) for 20 days in patients with CL from two endemic regions of Brazil: the metropolitan region of Belo Horizonte and Montes Claros (MG)in the southeast Brazil and in Corte de Pedras (Bahia), Northeastern Brazil. The patients follow up lasts for 12 months.

Description:

Included a new site (University Estadual de Montes Claros - UNIMONTES) in 7 June 2010. The site was included due the need to achieve more patients. The ANVISA (National Agency of Sanitary Surveillance) approved these site in March 2011 and the start of activities is planned for June 2011.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 48
• Est. completion date: September 2012
• Est. primary completion date: December 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 14 Years to 65 Years

Eligibility

Inclusion Criteria:

• Patients older than 14 and younger than 65 years old

• Skin lesions with clinical suggestion of cutaneous leishmaniasis and positive leishmanin skin test(Montenegro test)or parasitological (direct observation of leishmania amastigotes, leishmania in vitro culture from aspirates, histopathological) and molecular(Polymerase Chain Reaction - PCR)samples.

• No use of oral potentially antileishmanial drugs, or topics throughout the term of the current injury.

• Absence of disseminated leishmaniasis.

• Absence of mucosal involvement.

• Agreement to participate in the study and signed the informed consent.

Exclusion Criteria:

• Diabetes mellitus, kidney diseases, liver or cardiac diseases, tuberculosis, malaria.

• Pregnancy

• lactating mothers

• Breast feeding

• Cutaneous lesion with bacterial infection for which antibiotics need to be prescribed

• More than six cutaneous lesions

• Previous history of cutaneous or mucosal leishmaniasis

• Use of drugs with potential pharmacological interactions with antimonials as anti-arrhythmic or tricycle anti-depressives

• Previous intolerance to azithromycin or other macrolides or N-methylglucamine

• Abusive alcohol ingestion according to the CAGE questionnaire

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Cutaneous Leishmaniasis
• Leishmaniasis
• Leishmaniasis, Cutaneous

Intervention

Drug:
• Glucantime®
15mg Sb+5/Kg/day, during 20 days. Maximum dose:15ml/day
• Zithromax ®
Zithromax ®/ Pfizer, 500 mg - 1x day, during 20 days

Locations

Country	Name	City	State
Brazil	Centro de Pesquisas René Rachou - Fiocruz	Belo Horizonte	Minas Gerais
Brazil	University Estadual de Montes Claros	Montes Claros	MG
Brazil	Núcleo de Medicina Tropical University of Brasília - Health Center Corte de Pedras	Presidente Tancredo Neves	Bahia

Sponsors (2)

Lead Sponsor	Collaborator
Ana Rabello	Conselho Nacional de Desenvolvimento Científico e Tecnológico

Country where clinical trial is conducted

Brazil, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of clinically cured patients	A cure was defined as complete lesion healing and re-epithelialization without inflammatory infiltration and erythema until 90 days after the treatment ended.	at the third month after treatment	No
Secondary	Proportion of patients with failure and cured	Proportion of cured patients at 1, 2, 3, 6, 9 and 12 follow-up after completion of treatment. Mean time to healing.	twelve months after treatment	No
Secondary	Occurrence of mucosal lesions after treatment	Proportion of patients with relapsed or mucosal lesion in 6 months, 9 and 12 follow-up after completion of treatment.	twelve months after treatment	No
Secondary	Proportion of patients presenting new lesions	Proportion of patients with new lesions at 1, 2, 3, 6, 9 and 12 follow-up after completion of treatment.	1st 2nd 3rd 6th 12th month after treatment	No
Secondary	Proportion of adverse events on each treatment group	Proportion of patients clinical, electrocardiographic and laboratory adverse events.	1st 2nd 3rd 6th 12th month after treatment.	Yes