| dc.description.abstract | Canine Leishmaniasis is a vector-borne disease caused by the intracellular protozoa Leishmania
infantum, which continues to be a difficult and challenging disease to effectively treat and cure.
Among variable antileishmanial drugs, the use of miltefosine appeared to be safe and effective for
treatment of canine Leishmaniasis and is nowadays widely used in veterinary medicine. This study
was aimed to evaluate the use of miltefosine in Dutch veterinary first-line practice, a non-endemic
country, by assessing survival, efficacy of a first miltefosine therapy cycle as measured by recovery of
clinical signs and clinicopathological parameters, and side effects as outcome parameters. Patient
files of dogs with a confirmed diagnosis and treated with miltefosine in 2014, 2015, 2016 and 2017,
were retrospectively reviewed. Survival analysis and assessment of side effect was performed on the
complete dataset (n=53), while the efficacy of therapy was assessed only on a subset (n=25) of
included dogs (“Inclusion T0-T1”). A survival probability of 78% and 71%, three-years from diagnosis
and commencement of the first miltefosine therapy cycle, respectively, was shown. Gastrointestinal
side effects were reported in 23% of treatments. For the efficacy of the first miltefosine therapy
cycle, the clinical signs lymphadenomegaly and scaling skin, and the laboratory parameters
hematocrit, thrombocytes, total protein, globulins, albumin, and A/G-ratio improved significantly
after treatment. Administration of allopurinol was very common and may have had a positive effect
on the outcome. This study provides an accurate overview of the use of miltefosine in Dutch
veterinary first-line practice and therewith provided useful and promising results. | |
