The World Health Organization (WHO) released updated treatment guidelines for visceral leishmaniasis (VL, also known as kala-azar) and post-kala-azar dermal leishmaniasis (PKDL) for eastern Africa and South-East Asia. This marks a significant shift in patient care. who.int +1
The major innovation is that WHO now recommends SSG-free (sodium stibogluconate-free) regimens for the first time. Previously, treatment in Africa often relied on SSG, which required lengthy courses of painful daily injections and caused severe side effects.
- For eastern Africa: The new recommendation for VL is a combination of oral miltefosine with injectable paromomycin. This regimen is over 90% effective, reduces the number of injections from 34 to 14, shortens hospitalization, and also helps lower the risk of developing PKDL.
- For South-East Asia: New, shorter, and safer options for PKDL include liposomal amphotericin B alone or in combination with a limited course of miltefosine. This approach reduces reliance on long, toxic treatment courses. who.int +1
- Additionally, the guidelines provide updated recommendations for managing relapses of VL in South-East Asia and include a revised safety profile for miltefosine, with measures to minimize ocular adverse events.
Many of these new therapies were developed by the non-profit organization Drugs for Neglected Diseases initiative (DNDi) and partners. Countries affected by these diseases are expected to incorporate the new recommendations into their national treatment protocols soon.
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