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Last Updated: February 7, 2025

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.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Miltefosine

Condition Name

Condition Name for Miltefosine
Intervention Trials
Cutaneous Leishmaniasis 12
Visceral Leishmaniasis 7
Leishmaniasis 6
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Condition MeSH

Condition MeSH for Miltefosine
Intervention Trials
Leishmaniasis 41
Leishmaniasis, Cutaneous 20
Leishmaniasis, Visceral 13
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Clinical Trial Locations for Miltefosine

Trials by Country

Trials by Country for Miltefosine
Location Trials
Bolivia 12
Brazil 8
Colombia 6
Sudan 5
India 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
Phase 4 2
Phase 3 13
Phase 2/Phase 3 1
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Clinical Trial Status

Clinical Trial Status for Miltefosine
Clinical Trial Phase Trials
Completed 30
Terminated 4
Recruiting 4
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Clinical Trial Sponsors for Miltefosine

Sponsor Name

Sponsor Name for Miltefosine
Sponsor Trials
Drugs for Neglected Diseases 10
AB Foundation 6
Knight Therapeutics (USA) Inc 5
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Sponsor Type

Sponsor Type for Miltefosine
Sponsor Trials
Other 91
Industry 9
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Miltefosine: A Comprehensive Overview of Clinical Trials, Market Analysis, and Projections

Introduction to Miltefosine

Miltefosine, also known as hexadecylphosphocholine (HePC), is a significant drug in the treatment of leishmaniasis, a neglected parasitic disease. Originally developed for breast cancer and other solid tumors, miltefosine has become the first and only oral drug licensed for treating visceral and cutaneous leishmaniasis[3].

Clinical Trials Update

Phase II and Phase III Trials for Cutaneous Leishmaniasis

Recent clinical trials have focused on optimizing the treatment regimen for cutaneous leishmaniasis. A Phase II study demonstrated that combining thermotherapy with a shorter course of oral miltefosine achieves significantly better results than thermotherapy alone[1].

In the ongoing Phase III trial, initiated in 2021, 182 patients were enrolled across five study sites in Bolivia, Brazil, Panama, and Peru. The trial compares the efficacy of a combination therapy (thermotherapy and miltefosine) against the standard treatment (meglumine antimoniate). Despite challenges posed by the COVID-19 pandemic, the trial has progressed, with no serious adverse events recorded during the initial year[1].

Pilot Randomized Clinical Trial: Miltefosine and Pentoxifylline

A pilot randomized clinical trial assessed the efficacy and adverse events associated with the oral combination of miltefosine and pentoxifylline. The trial found that this combination yielded similar cure rates to the standard antimonial treatment but with a lower risk of adverse events. This study highlights the potential of miltefosine-based combination therapies as safer alternatives to traditional treatments[4].

Mechanism of Action and Pharmacology

Miltefosine is an alkylphosphocholine drug that inhibits the Akt signaling pathway, which is crucial for the survival of Leishmania parasites. Its long residence time in the body and extensive drug accumulation during treatment contribute to its therapeutic efficacy. However, its teratogenic potential is a significant concern, limiting its widespread use[5].

Market Analysis

Global Market Size and Growth

The global miltefosine market has been expanding steadily. As of 2018, the market size was valued at a significant figure, and it is projected to grow at a compound annual growth rate (CAGR) from 2019 to 2025. The market is driven by increasing demand for effective treatments for leishmaniasis, particularly in endemic regions[2].

Market Competition and Consumption

The market competition is analyzed by country, with key players operating in the USA, EU, Japan, and China. The consumption of miltefosine is evaluated by application, with a focus on its use in treating cutaneous and visceral leishmaniasis. The market forecast from 2024 to 2029 indicates continued growth, driven by increasing production capacity and consumption volumes[2].

Economic Impact and Industry Chain

The global and Chinese macroeconomic environments significantly influence the miltefosine market. The industry chain analysis includes upstream raw materials, manufacturing processes, and downstream applications. The economic impact section discusses the effects of global and Chinese economic trends on the miltefosine market, highlighting opportunities and challenges[2].

Market Projections

Future Growth and Production

From 2024 to 2029, the global and Chinese miltefosine markets are expected to see significant growth in production capacity, production value, and consumption volumes. The market share of key manufacturers is anticipated to shift, with emerging players potentially entering the market. The import and export dynamics of miltefosine are also expected to evolve, influenced by global demand and supply chains[2].

Market Opportunities and Challenges

The miltefosine market faces both opportunities and challenges. The growing need for effective treatments for leishmaniasis, especially in endemic regions, presents a significant opportunity. However, challenges include the drug's teratogenic potential, the need for combination therapies to mitigate adverse effects, and the impact of global economic trends on market stability[2][5].

Key Takeaways

  • Clinical Trials: Ongoing Phase III trials are evaluating the combination of thermotherapy and miltefosine for cutaneous leishmaniasis, showing promising results.
  • Market Growth: The global miltefosine market is projected to grow at a steady CAGR from 2019 to 2025, driven by increasing demand for leishmaniasis treatments.
  • Pharmacology: Miltefosine's mechanism of action and pharmacokinetics make it an effective but complex drug, with considerations needed for its teratogenic potential.
  • Market Projections: Future growth is anticipated in production capacity, consumption volumes, and market share, with potential shifts in the industry landscape.

FAQs

What is miltefosine used for?

Miltefosine is used for the treatment of leishmaniasis, specifically cutaneous and visceral leishmaniasis. It is the first and only oral drug licensed for this purpose[3].

What are the side effects of miltefosine?

Miltefosine is generally well-tolerated but can cause mild gastrointestinal side effects. Its teratogenic potential is a significant concern, limiting its use in certain populations[5].

How does miltefosine work?

Miltefosine inhibits the Akt signaling pathway, which is crucial for the survival of Leishmania parasites. It is an alkylphosphocholine drug with a long residence time in the body[5].

What are the current clinical trials on miltefosine?

Current clinical trials include a Phase III study comparing the combination of thermotherapy and miltefosine against the standard treatment (meglumine antimoniate) for cutaneous leishmaniasis[1].

What is the market forecast for miltefosine?

The global miltefosine market is projected to grow at a steady CAGR from 2019 to 2025, with continued growth anticipated from 2024 to 2029 in production capacity, production value, and consumption volumes[2].

Sources

  1. DNDi: Miltefosine + thermotherapy for cutaneous leishmaniasis.
  2. Prof-Research: Miltefosine Market Size, Share, Trend and Forecast to 2025.
  3. Ozmosi: Miltefosine Drug Profile.
  4. Frontiers in Cellular and Infection Microbiology: A Pilot Randomized Clinical Trial: Oral Miltefosine and Pentoxifylline.
  5. Journal of Antimicrobial Chemotherapy: Miltefosine: a review of its pharmacology and therapeutic efficacy in leishmaniasis.

More… ↓

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