first-line therapy for human cutaneous leishmaniasis in peru using the tlr7 agonist imiquimod in combination with pentavalent antimony一线治疗人类皮肤利什曼病在秘鲁使用tlr7兴奋剂咪喹莫特结合五价锑.pdfVIP
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first-line therapy for human cutaneous leishmaniasis in peru using the tlr7 agonist imiquimod in combination with pentavalent antimony一线治疗人类皮肤利什曼病在秘鲁使用tlr7兴奋剂咪喹莫特结合五价锑
First-Line Therapy for Human Cutaneous Leishmaniasis
in Peru Using the TLR7 Agonist Imiquimod in
Combination with Pentavalent Antimony
1 1 2 3
Cesar Miranda-Verastegui , GianFranco Tulliano , Theresa W. Gyorkos , Wessmark Calderon , Elham
2 2,4 3 1 4
Rahme , Brian Ward , Maria Cruz , Alejandro Llanos-Cuentas , Greg Matlashewski *
1 Universidad Peruana Cayetano Heredia, Lima, Peru, 2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada,
3 Social Security Hospital ESSALUD-Cusco, Lima, Peru, 4 Department of Microbiology and Immunology, McGill University, Montreal, Canada
Abstract
Background: Current therapies for cutaneous leishmaniasis are limited by poor efficacy, long-term course of treatment, and
the development of resistance. We evaluated if pentavalent antimony (an anti-parasitic drug) combined with imiquimod (an
immunomodulator) was more effective than pentavalent antimony alone in patients who had not previously been treated.
Methods: A randomized double-blind clinical trial involving 80 cutaneous leishmaniasis patients was conducted in Peru. The
study subjects were recruited in Lima and Cusco (20 experimental and 20 control subjects at each site). Experimental arm:
Standard dose of pentavalent antimony plus 5% imiquimod cream applied to each lesion three times per week for 20 days.
Control arm: Standard dose of pentavalent antimony plus placebo (vehicle cream) applied as above. The primary outcome
was cure defined as complete re-epithelization with no inflammation assessed during the 12 months post-treatment period.
Results: Of the 80 subjects enroll
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