<html>
<head>
<style><!--
.hmmessage P
{
margin:0px;
padding:0px
}
body.hmmessage
{
font-size: 10pt;
font-family:Verdana
}
--></style>
</head>
<body class='hmmessage'>
Date: Fri, 12 Feb 2010 22:09:54 -0800<br>From: aranjan30@yahoo.com<br>Subject: Re: [Leish-l] FW: Single-Dose Therapy for Visceral Leishmaniasis<br>To: jayusp@hotmail.com<br><br>
<style>
.ExternalClass DIV
{;}
</style><div style="font-family: times new roman,new york,times,serif; font-size: 12pt;"><div>Dear All,</div>
<div>This should be considered as a landmark in the field of anti-leishmanial trial - certainly going to be proved as a boon for the poor patients in Indian Sub-continent where the cost of VL treatment is very high and beyond reach of the general mass. In context of the public health benefits, this has immense potential to reduce the economic burden both at micro as well as macro level. </div>
<div>Alok Ranjan,</div>
<div>Scientist 'C',</div>
<div>Division of Epidemiology and Biostatistics,</div>
<div>RMRIMS, ICMR, Patna, India.</div>
<div style="font-size: 12pt; font-family: times new roman,new york,times,serif;"><br>
<div style="font-size: 12pt; font-family: times new roman,new york,times,serif;"><font size="2" face="Tahoma">
<hr size="1">
<b><span style="font-weight: bold;">From:</span></b> jeffrey shaw <jayusp@hotmail.com><br><b><span style="font-weight: bold;">To:</span></b> Leish-L <leish-l@lineu.icb.usp.br><br><b><span style="font-weight: bold;">Sent:</span></b> Fri, February 12, 2010 4:08:10 PM<br><b><span style="font-weight: bold;">Subject:</span></b> [Leish-l] FW: Single-Dose Therapy for Visceral Leishmaniasis<br></font><br>
<style>
.ExternalClass .ecxhmmessage P
{padding:0px;}
.ExternalClass body.ecxhmmessage
{font-size:10pt;font-family:Verdana;}
</style>
<br>
<hr id="ecxstopSpelling">
Date: Thu, 11 Feb 2010 22:58:51 -0800<br>From: s_bashaye@yahoo.com<br>Subject: Re: [Leish-l] Single-Dose Therapy for Visceral Leishmaniasis<br>To: jayusp@hotmail.com; leish-l@lineu.icb.usp.br<br><br>
<style>
.ExternalClass DIV
{;}
</style>
<div style="font-size: 12pt; font-family: arial,helvetica,sans-serif;">
<div>Dear all,</div>
<div> </div>
<div>
<p class="ecxecxMsoNormal" style="text-align: justify;"><span style="color: black; font-family: 'Arial','sans-serif';">It is good news to Developing countries like Ethiopia. We opt for short course therapies in that it minimizes time for admission which is related again to many interrelated costs, Problems related to treatment cost should of course be. Is there a need of conducting related trial in Africa including Ethiopia?</span></p>
<p class="ecxecxMsoNormal" style="text-align: justify;"><span style="color: black; font-family: 'Arial','sans-serif';">Seife Bashaye,</span></p>
<p class="ecxecxMsoNormal" style="text-align: justify;"><span style="color: black; font-family: 'Arial','sans-serif';">RTI /PMI, Ethiopia</span></p></div>
<div style="font-size: 12pt; font-family: arial,helvetica,sans-serif;"><br>
<div style="font-size: 12pt; font-family: times new roman,new york,times,serif;"><font size="2" face="Tahoma">
<hr size="1">
<b><span style="font-weight: bold;">From:</span></b> jeffrey shaw <jayusp@hotmail.com><br><b><span style="font-weight: bold;">To:</span></b> Leish-L <leish-l@lineu.icb.usp.br><br><b><span style="font-weight: bold;">Sent:</span></b> Thu, February 11, 2010 8:07:55 AM<br><b><span style="font-weight: bold;">Subject:</span></b> [Leish-l] Single-Dose Therapy for Visceral Leishmaniasis<br></font><br>
<style>
.ExternalClass .ecxhmmessage P
{padding:0px;}
.ExternalClass body.ecxhmmessage
{font-size:10pt;font-family:Verdana;}
</style>
<p style="font-size: 11px; margin-bottom: 5px;">Summary and Comment</p>
<h3 style="font-weight: bold; font-size: 15px; margin-bottom: 2px;">Single-Dose Therapy for Visceral Leishmaniasis</h3>
<p style="font-size: 12px; margin-bottom: 10px;"><em>A single infusion of liposomal amphotericin B was not inferior to a 15-dose regimen of amphotericin B deoxycholate.</em></p>
<div style="font-size: 12px; margin-bottom: 7px;">Despite impressive cure rates for several antileishmanial agents, lengthy treatment courses limit the appeal of these therapies. In recent clinical trials, high cure rates have been seen with a 5-day course of liposomal amphotericin B. This finding, coupled with a price reduction for this antimicrobial in developing countries, prompted evaluation of even shorter courses of therapy.<br>In an open-label trial, 410 patients with visceral leishmaniasis, or kala-azar, were randomized to receive a single infusion of liposomal amphotericin B (10 mg/kg) or 15 alternate-day infusions of amphotericin B deoxycholate (1 mg/kg; conventional therapy). The trial was conducted in northeastern India, which is home to approximately 50% of such patients worldwide. Participants — aged 2 to 65 years — were evaluated at 30 days postenrollment for apparent cure (i.e., absence of fever, clinical improvement, reduction in
spleen size, and a splenic-aspirate score of 0) and then at 6 months for cure (being healthy, with no signs or symptoms of relapse).<br>All 304 patients in the liposomal-therapy group and 106 (98%) of 108 in the conventional-therapy group had apparent cure at 30 days postenrollment. At 6 months, cure rates were similar between groups: 95.7% (95% confidence interval, 93.4%–97.9%) and 96.3% (95% CI, 92.6%–99.9%), respectively. No serious adverse events were reported in either group. The estimated treatment costs were higher for amphotericin B deoxycholate than for liposomal amphotericin B (US$436 vs. $162).<br><b>Comment:</b> The availability of a new preferential price agreement for liposomal amphotericin B in developing countries was key in the decision to conduct this trial. The results are impressive and should prompt a reevaluation of current treatment strategies for kala-azar.<br><b><i>— <a href="http://infectious-diseases.jwatch.org/misc/board_about.dtl?q=etoc_jwid#aBaddour" rel="nofollow">Larry M. Baddour, MD</a></i></b><br><i>Published in</i> <a href="http://infectious-diseases.jwatch.org/" rel="nofollow">Journal Watch Infectious Diseases</a> <i>February 10, 2010</i><br></div>
<p style="font-weight: bold; font-size: 11px; margin-bottom: 5px;">Citation(s):</p><a rel="nofollow" name="ref"></a>
<p style="font-size: 11px; margin-bottom: 2px;">Sundar S et al. Single-dose liposomal amphotericin B for visceral leishmaniasis in India. <em>N Engl J Med</em> 2010 Feb 11; 362:504.</p></div></div></div><br></div></div></div><br> </body>
</html>