Silva Rosiana Estéfane da, Toledo Antonio, Senna Maria Camilo, Rabello Ana, Cota Gláucia
Fundação Oswaldo Cruz, Centro de Pesquisas René Rachou, Centro de Referência em Leishmanioses, Pesquisas Clínicas e Políticas Públicas em Doenças Infecto-Parasitárias, Belo Horizonte, MG, Brasil.
Universidade José do Rosário Vellano, Faculdade de Medicina, Belo Horizonte, MG, Brasil.
Mem Inst Oswaldo Cruz. 2016 Aug;111(8):512-6. doi: 10.1590/0074-02760160183.
Although intralesional meglumine antimoniate (MA) infiltration is considered an option for cutaneous leishmaniasis (CL) therapy and is widely used in the Old World, there have been few studies supporting this therapeutic approach in the Americas. This study aims to describe outcomes and adverse events associated with intralesional therapy for CL. This retrospective study reviewed the experience of a Brazilian leishmaniasis reference centre using intralesional MA to treat 31 patients over five years (2008 and 2013). The median age was 63 years (22-86) and the median duration time of the lesions up to treatment was 16 weeks. In 22 patients (71%), intralesional therapy was indicated due to the presence of contraindications or previous serious adverse events with systemic MA. Other indications were failure of systemic therapy or ease of administration. Intralesional treatment consisted of one-six infiltrations (median three) for a period of up to 12 weeks. The initial (three months) and definitive (six months) cure rates were 70.9% and 67.7%, respectively. Most patients reported mild discomfort during infiltration and no serious adverse events were observed. In conclusion, these results show that the intralesional MA efficacy rate was very similar to that of systemic MA treatment, and reinforce the need for further studies with adequate design to establish the efficacy and safety of this therapeutic approach.
尽管病灶内注射葡甲胺锑酸盐（MA）被认为是治疗皮肤利什曼病（CL）的一种选择，且在旧大陆广泛使用，但在美洲支持这种治疗方法的研究很少。本研究旨在描述病灶内治疗CL的疗效和不良事件。这项回顾性研究回顾了巴西一家利什曼病参考中心在五年（2008年至2013年）内使用病灶内注射MA治疗31例患者的经验。中位年龄为63岁（22 - 86岁），治疗前病灶的中位持续时间为16周。在22例患者（71%）中，由于存在禁忌证或既往全身应用MA出现严重不良事件，而选择病灶内治疗。其他适应证为全身治疗失败或给药方便。病灶内治疗包括1至6次注射（中位3次），持续时间长达12周。初始（3个月）和最终（6个月）治愈率分别为70.9%和67.7%。大多数患者在注射期间报告有轻度不适，未观察到严重不良事件。总之，这些结果表明病灶内注射MA的有效率与全身应用MA治疗非常相似，并强调需要进行进一步设计合理的研究，以确定这种治疗方法的有效性和安全性。
