Cutaneous Leishmaniasis Clinical Trial
Official title:
Pharmacokinetics of Miltefosine in Children and Adults: Implications for the Treatment of Cutaneous Leishmaniasis in Colombia.
The purpose of this study is to determine the pharmacokinetics of miltefosine in children and adults with cutaneous leishmaniasis in plasma and intracellularly, and its relation with the parasitologic response. The results will provide pharmacologic bases to optimize the use of miltefosine for the treatment of cutaneous leishmaniasis, and will provide the knowledge base to assess the impact of pharmacokinetic behavior in children and adults on the emergence of drug resistance.
An open-label phase IV clinical trial of miltefosine, designed to evaluate intracellular and
plasma drug pharmacokinetics in children and adults using a population pharmacokinetics
design. Two study groups have been defined: 1) children 2-12 years of age (n=30) and 2)
adults 18-60 years of age (n=30) with confirmed parasitological diagnosis of cutaneous
leishmaniasis. The participants will receive supervised standard treatment with miltefosine:
1.8 - 2.5 mg/Kg of weight for 28 days.
Miltefosine concentration will be determined in plasma and Peripheral Blood Mononuclear Cell
(PBMCs), from 3 or 10ml peripheral blood samples in children and adults respectively.
Sampling will be conducted pre-dosing at days 0,1,15 and 29 during treatment, and at months
1, 2, 3 and 6 post-treatment.
A population pharmacokinetics analysis will be performed using a non-linear model of mixed
effects with the software Nonlinear Mixed-effects Model (NONMEM), R and Piranha. Parasite
burden will be determined by 7SLRNA Quantitative Polymerase Chain Reaction (qPCR) of
Leishmania from swab samples of lesions and extralesional tissues before and at the end of
treatment. The relationship between pharmacokinetics and parasite persistence/burden will be
determined by correlation analysis and pharmacodynamic modeling.
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Endpoint Classification: Pharmacokinetics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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