Visceral leishmaniasis relapse hazard is linked to reduced miltefosine exposure in patients from Eastern Africa: a population pharmacokinetic/pharmacodynamic study

by Dorlo TPC, Kip AE, Younis BM, Ellis SJ, Alves F, Beijnen JH, Njenga S, Kirigi G, Hailu H, Olobo J, Musa AM, Balasegaram M, Wasunna M, Karlsson MO and Khalil EAG. Journal of Antimicrobial Chemotherapy 2017, doi:10.1093/jac/dkx283.

Summary: Low miltefosine efficacy in the treatment of visceral leishmaniasis patients has been recently described in Eastern Africa. This study describes modelling  the pharmacokinetics of miltefosine in Eastern African patients, and establishes the pharmacokinetic/pharmacodynamic relationship between miltefosine exposure and effect on VL relapse. Relapse hazard was inversely linked to miltefosine exposure, the latter being significantly lower in children compared with adults, further emphasizing the need for implementation of dose adaptations in children.

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