by Chu W-Y, Verrest L, Younis BM, Musa AN, Mbui J, Mohammed R, Olobo J, Ritmeijer K, Monnerat S, Wasunna M, Roseboom IC, Solomos A, Huitema ADR, Alves F, Dorlo TPC. The Journal of Infectious Diseases 2024, 230(6): e1375–e1384. doi:10.1093/infdis/jiae413
Summary: Since the pharmacokinetics of paromomycin and miltefosine have not been studied in patients with post-kala-azar dermal leishmaniasis (PKDL), the treatment regimen is typically extrapolated from that used for visceral leishmaniasis (VL). However, there are marked differences in disease presentation and physiological status between VL and PKDL patients, which could result in variations in the pharmacokinetics of antileishmanial drugs and the relationships between drug exposure and response. The authors of this study identified clinically relevant differences in drug exposure and pharmacokinetics parameters for paromomycin and miltefosine between PKDL and VL patients in eastern Africa, highlighting the challenges of directly extrapolating dosing regimens from one leishmaniasis presentation to another.
