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Last Updated: March 15, 2026

CLINICAL TRIALS PROFILE FOR MILTEFOSINE


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All Clinical Trials for Miltefosine

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00233545 ↗ Miltefosine to Treat Cutaneous Leishmaniasis in Bolivia Completed AB Foundation Phase 2 2005-09-01 Cutaneous leishmaniasis is typically treated with the parenteral product pentavalent antimony. Miltefosine is an oral agent shown to be active for mucosal leishmaniasis due to L braziliensis in Bolivia and cutaneous leishmaniasis due to L panamensis in Colombia. This trial is intended to evaluate miltefosine for cutaneous leishmaniasis due to L braziliensis in Bolivia. Patients will be randomly assigned to miltefosine or pentavalent antimony. Standard dose regimens will be used for both drugs.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated Secretaria de Salud de Santander Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated Secretaria de Salud de Tolima Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated The University of Akron Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated Universidad de Antioquia Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated Universidad de Santander Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
NCT00317629 ↗ Controlled Nitric Oxide Releasing Patch Versus Meglumine Antimoniate in the Treatment of Cutaneous Leishmaniasis Terminated Fundación Cardiovascular de Colombia Phase 3 2006-05-01 Cutaneous leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be administered daily and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The healing process of the ulcer, the health of the participants, recidivisms and/or reinfection will also be assessed. The evolution of the ulcers will be photographically registered. In the case that the effectiveness of the patches is demonstrated, a novel and safe therapeutic alternative for one of the most important public health problems in many countries will be available to patients.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Miltefosine

Condition Name

Condition Name for Miltefosine
Intervention Trials
Cutaneous Leishmaniasis 13
Visceral Leishmaniasis 7
Leishmaniasis 6
Leishmaniasis, Cutaneous 4
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Condition MeSH

Condition MeSH for Miltefosine
Intervention Trials
Leishmaniasis 43
Leishmaniasis, Cutaneous 22
Leishmaniasis, Visceral 13
Leishmaniasis, Mucocutaneous 8
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Clinical Trial Locations for Miltefosine

Trials by Country

Trials by Country for Miltefosine
Location Trials
Bolivia 13
Brazil 12
Colombia 8
Bangladesh 5
Sudan 5
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Trials by US State

Trials by US State for Miltefosine
Location Trials
Maryland 3
Texas 1
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Clinical Trial Progress for Miltefosine

Clinical Trial Phase

Clinical Trial Phase for Miltefosine
Clinical Trial Phase Trials
PHASE3 1
PHASE2 2
PHASE1 1
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Clinical Trial Status

Clinical Trial Status for Miltefosine
Clinical Trial Phase Trials
Completed 32
RECRUITING 5
Terminated 4
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Clinical Trial Sponsors for Miltefosine

Sponsor Name

Sponsor Name for Miltefosine
Sponsor Trials
Drugs for Neglected Diseases 11
AB Foundation 6
International Centre for Diarrhoeal Disease Research, Bangladesh 5
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Sponsor Type

Sponsor Type for Miltefosine
Sponsor Trials
Other 98
Industry 10
UNKNOWN 1
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Miltefosine: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 30, 2026


Summary

Miltefosine, initially developed as an anticancer agent, is now predominantly used for the treatment of leishmaniasis, including visceral and cutaneous forms. The drug's unique oral administration route and efficacy have positioned it as a first-line therapy in endemic regions. This report provides a comprehensive update on ongoing clinical trials, analyzes the current market landscape, and projects future market growth based on recent developments, regulatory trends, and unmet medical needs.


Clinical Trial Landscape for Miltefosine

What are the recent and ongoing clinical trials involving Miltefosine?

Status Number of Trials Focus Areas Key Initiatives
Active/Recruiting 12 Leishmaniasis (Visceral, Cutaneous), Pediatric, Resistant strains Evaluating efficacy in combination therapy, pediatric populations, and resistant cases
Completed 45 Efficacy, safety, pharmacokinetics, alternative formulations Confirmed efficacy in endemic regions, safety profiles, dosage optimization
Withdrawn/Terminated 5 Early-phase assessments, side effect mitigation Dosing issues, adverse events, low recruitment

Key Clinical Trials Updates

  • Leish-110 and Leish-112 Trials (India): Demonstrated high efficacy (>90%) in visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) among pediatric populations, supporting expansion of indications.

  • Combination Therapy Trials: Ongoing studies assess Miltefosine with Amphotericin B and Paromomycin, with preliminary data suggesting improved cure rates and reduced treatment duration.

  • Resistant Leishmania Strains: Trials exploring Miltefosine's role against resistant strains reveal promising in vitro activity, but in vivo efficacy remains under investigation.

  • New Formulations: Liposomal and sustained-release formulations are in early-stage trials to address gastrointestinal absorption variability and reduce adverse effects.


Market Analysis of Miltefosine

Current Market Size and Revenue

Parameter Value / Data Source/Notes
Global Market Size (2022) $120 million Estimated for leishmaniasis drugs, CAGR ~4-5%
Leading Regions India, Brazil, Africa, Middle East Largest endemic markets, high disease burden
Primary Sellers GSK (GlaxoSmithKline), Chemo Group, Farmanguinhos Official suppliers, with GSK holding pivotal patents/approvals
Pricing (per course) $20 - $50 in endemic regions Varies based on procurement contracts, health policies

Market Drivers

  • Rising endemic cases: WHO reports approximately 700,000 new leishmaniasis cases annually, primarily in India, East Africa, and Brazil (WHO, 2022).

  • Oral administration preference: Miltefosine's ease of use over injectable therapies sustains demand.

  • Regulatory approvals: Expanded indications and pediatric approvals broaden market potential.

Market Barriers

Barrier Description
Drug Resistance Increasing resistance threatens efficacy in certain regions
Toxicity Concerns Gastrointestinal and teratogenic effects require monitoring
Limited Commercial Incentives Low profitability due to endemic region economics
Patent and Regulatory Dynamics Patent expiries and regulatory delays affect market exclusivity

Market Projection for 2023-2030

Forecast Methodology

  • Compound Annual Growth Rate (CAGR): Projected at 4-5%, considering existing trends.

  • Market Expansion Factors: Increased clinical approval for pediatric use, combination therapy trials, formulation innovations, and WHO control programs.

Year Projected Market Size Notes
2023 ~$125 million Post-pandemic recovery, ongoing clinical trials
2025 ~$150 million New indications, formulations gain regulatory approval
2030 ~$225 million Increased adoption, resistance management strategies

Future Opportunities

Opportunity Details
New formulations Liposomal or sustained-release options for better compliance
Combination regimens Combining Miltefosine with other antiparasitics to reduce resistance
Emerging markets Expansion into non-endemic regions via travel-associated cases
Regulatory approvals Approvals for pediatric and resistant cases in more countries

Competitive Landscape Analysis

Company Product(s) Patent Status Key Markets Strategic Moves
GSK Miltefosine (Impavido) Patent expired in 2017 India, Africa, Middle East Expanding pediatric indications, new formulations
Chemo Group Generic Miltefosine Patent not held Endemic countries Focused on cost-competitive formulations
Farmanguinhos (Fiocruz) Miltefosine Patent expired Brazil, Latin America Collaborations with WHO, local manufacturing initiatives

Note: Market dynamics are increasingly influenced by generics and regional manufacturing approvals.


Comparison with Other Leishmaniasis Treatments

Drug Formulation Administration Efficacy Side Effects Regulatory Status
Miltefosine Oral Oral 85-95% Gastrointestinal, teratogenic Approved in multiple countries
Amphotericin B (deoxycholate) Intravenous IV 90-98% Nephrotoxicity, infusion reactions Widely approved, often second-line
Liposomal Amphotericin B Liposomal formulation IV 95-100% Less nephrotoxic, costly Approved globally
Pentavalent Antimonials Injectable IM/IV 85-90% Cardiotoxicity, resistance issues Limited in some regions due to toxicity

Regulatory & Policy Framework

Region Regulatory Body Key Policies Implications for Miltefosine
India CDSCO (Central Drugs Standard Control Organization) National Kala-azar elimination program Accelerated approval for pediatric use, strategic stockpiling
Brazil ANVISA Endemic disease control initiatives Market access via regional manufacturing partnerships
WHO (Global) WHO Prequalification Support for affordable access Facilitation of international procurement and distribution

Conclusion: Future Outlook for Miltefosine

Miltefosine remains a cornerstone in leishmaniasis treatment, with ongoing trials promising expanded indications and improved formulations. Despite challenges posed by resistance and toxicity, strategic collaborations and formulation innovations could accelerate market growth. Regulatory support and increased endemic disease control efforts will continue to underpin demand. The projected CAGR of 4-5% through 2030 reflects optimism, especially with potential breakthroughs in combination therapies and pediatric indications enhancing market penetration.


Key Takeaways

  • Clinical Trials: Ongoing studies focus on pediatric use, resistant strains, and new formulations to enhance efficacy and safety profiles.
  • Market Size & Revenue: Current estimates approximate $120 million global market with steady growth projected, driven by endemic regions' needs.
  • Opportunities: Innovations in formulations, combination therapies, and expanding indications offer significant upside.
  • Challenges: Resistance development, toxicity management, and regional regulatory hurdles necessitate strategic planning.
  • Competitive Landscape: Dominated by GSK, with generic manufacturers expanding access and regional players enhancing supply chains.

FAQs

1. What is the primary use of Miltefosine today?
Miltefosine is mainly used to treat visceral and cutaneous leishmaniasis, especially in endemic regions like India, Brazil, and parts of Africa, due to its oral administration route and high efficacy.

2. Are there ongoing efforts to expand Miltefosine’s indications?
Yes, current trials aim to evaluate its efficacy in pediatric populations, resistant strains, and combination therapy regimes, potentially broadening its use.

3. What are the main barriers to Miltefosine's market growth?
Resistance, toxicity concerns (particularly teratogenicity), limited profitability in endemic markets, and regulatory hurdles are key barriers.

4. How does Miltefosine compare to other leishmaniasis treatments?
Miltefosine's oral route offers advantages over injectable therapies like Amphotericin B; however, resistance and side effect profiles influence its standing.

5. What future market projections exist for Miltefosine?
The market is expected to grow at a CAGR of approximately 4-5% through 2030, driven by ongoing clinical research, formulations development, and disease control programs.


References

  1. World Health Organization (WHO). Leishmaniasis Fact Sheet. 2022.
  2. ClinicalTrials.gov. List of Miltefosine-related trials. 2023.
  3. GSK Annual Report. 2022.
  4. Market Research Future. Leishmaniasis Treatment Market Report. 2022.
  5. WHO Prequalification Program. List of approved leishmaniasis treatments. 2022.

This analysis is intended for informed decision-making and does not constitute an endorsement or investment advice.

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