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Last Updated: March 26, 2026

CLINICAL TRIALS PROFILE FOR PENTAMIDINE ISETHIONATE


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All Clinical Trials for PENTAMIDINE ISETHIONATE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000707 ↗ Aerosols in the Treatment of Asymptomatic Pneumocystis Pneumonia: A Pilot Study Assessing the Effectiveness of Aerosolized Pentamidine as Treatment of Subclinical Pneumocystis Infection in Patients With No Clinical Symptoms Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To confirm the ability of pulmonary (lung) function testing (PFT) to detect Pneumocystis carinii pneumonia (PCP) before the development of clinical symptoms and to determine if pentamidine (PEN), a drug used in treating PCP, can be given effectively as an aerosol (inhaled mist). Other goals include the measurement of the actual amount of PEN that reaches the lung, and to determine if close clinical observation is safer and as effective as drug therapy for the prevention of subsequent episodes of PCP. Many AIDS patients develop PCP, but the effectiveness of early diagnosis and treatment of PCP is not known. The effectiveness of PEN may be improved if treatment is begun when the parasite burden (the number of organisms in the lung) is still small, and before respiratory symptoms appear. If PFT of HIV-infected patients is able to identify patients in the early stages of infection, outpatient treatment of these patients offers a possible alternative to the expense and toxicity of continuous preventive therapy of all high-risk patients.
NCT00000715 ↗ A Controlled Trial Comparing the Efficacy of Aerosolized Pentamidine and Parenteral/Oral Sulfamethoxazole-Trimethoprim in the Treatment of Pneumocystis Carinii Pneumonia in AIDS Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To compare the safety and effectiveness of drug therapy with aerosolized pentamidine (PEN) with that of conventional therapy, sulfamethoxazole plus trimethoprim (SMX/TMP) in the treatment of Pneumocystis carinii pneumonia (PCP) in patients who have AIDS, are HIV positive, or are at high risk for HIV infection. New treatments are needed for PCP, a common lung infection in patients with AIDS, because many patients treated with the two standard treatments, PEN given by injections and SMX/TMP, have had adverse effects that required a change in treatment. There is also a high relapse rate after the standard treatments. Preliminary experiments in humans suggest that aerosolized PEN is as effective as the standard treatments for PCP, and causes few adverse effects.
NCT00000722 ↗ Aerosols in the Treatment of Pneumocystis Pneumonia: A Pilot Study Quantitating the Deposition of Aerosolized Pentamidine as Delivered in ACTG 040 and Comparing Its Toxicity With Parenteral Pentamidine Therapy Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To compare the use of pentamidine aerosol (inhaled mist) with the standard intravenous method of administration in patients with AIDS related Pneumocystis carinii pneumonia (PCP), to measure the amount of pentamidine aerosol that actually reaches the lung, and to see if close clinical observation is safer and as effective as drug therapy in the prevention of PCP recurrences. To compare the efficiency of 2 nebulizers - the Respirgard II nebulizer and the Cadema Aerotech II nebulizer. Aerosolized pentamidine was as effective as intravenous pentamidine in treating PCP in animals. More of the pentamidine reached the lungs and less was found in the liver and kidney after pentamidine was given by aerosol than after an intravenous injection. This suggests that the toxicity of pentamidine may be less if given by aerosol than if given by the intravenous route.
NCT00000727 ↗ A Controlled Comparative Trial of Sulfamethoxazole-Trimethoprim Versus Aerosolized Pentamidine for Secondary Prophylaxis of Pneumocystis Carinii Pneumonia in AIDS Patients Receiving Azidothymidine (AZT) Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To determine if the drug combination sulfamethoxazole-trimethoprim (SMX-TMP), given by mouth, and the drug pentamidine (PEN), given by inhaled aerosol, are effective in preventing a relapse of Pneumocystis carinii pneumonia (PCP) when they are given to patients who have recovered from a first episode of PCP and are being given zidovudine (AZT) to treat primary HIV infection. AZT prolongs survival in patients with AIDS and decreases the occurrence of opportunistic infections such as PCP. However, PCP recurs in about 43 percent of patients receiving AZT, indicating a need for other treatments to reduce the relapse rate. The two medications to be tested in this study, SMX/TMP and aerosolized PEN, have also been partially effective in preventing recurrence of PCP. It is hoped that the combination of AZT with these medications will be more effective than AZT or one of the medications alone.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for PENTAMIDINE ISETHIONATE

Condition Name

Condition Name for PENTAMIDINE ISETHIONATE
Intervention Trials
Pneumonia, Pneumocystis Carinii 20
HIV Infections 20
Leishmaniasis, American 1
Leishmaniasis, Cutaneous 1
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Condition MeSH

Condition MeSH for PENTAMIDINE ISETHIONATE
Intervention Trials
HIV Infections 20
Pneumonia, Pneumocystis 20
Pneumonia 20
Infections 4
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Clinical Trial Locations for PENTAMIDINE ISETHIONATE

Trials by Country

Trials by Country for PENTAMIDINE ISETHIONATE
Location Trials
United States 83
Bolivia 2
Tanzania 1
Puerto Rico 1
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Trials by US State

Trials by US State for PENTAMIDINE ISETHIONATE
Location Trials
New York 15
Illinois 7
California 7
Massachusetts 7
Ohio 6
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Clinical Trial Progress for PENTAMIDINE ISETHIONATE

Clinical Trial Phase

Clinical Trial Phase for PENTAMIDINE ISETHIONATE
Clinical Trial Phase Trials
Phase 3 7
Phase 2/Phase 3 1
Phase 2 1
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Clinical Trial Status

Clinical Trial Status for PENTAMIDINE ISETHIONATE
Clinical Trial Phase Trials
Completed 20
Terminated 1
Withdrawn 1
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Clinical Trial Sponsors for PENTAMIDINE ISETHIONATE

Sponsor Name

Sponsor Name for PENTAMIDINE ISETHIONATE
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 11
Fisons 5
Fujisawa Pharmaceutical Co 2
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Sponsor Type

Sponsor Type for PENTAMIDINE ISETHIONATE
Sponsor Trials
NIH 12
Industry 12
Other 6
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Pentamidine Isethionate: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 27, 2026

Summary

Pentamidine Isethionate, an antiprotozoal agent primarily indicated for Pneumocystis jirovecii pneumonia (PCP), leishmaniasis, and certain parasitic infections, remains an important therapeutic agent despite emerging resistance and the advent of newer therapies. This report provides an updated assessment of ongoing clinical trials, current market dynamics, competitive landscape, and future projections based on recent data and technological developments.


Clinical Trials Update: Current Research and Developments

Overview of Pentamidine Isethionate Clinical Trials

Recent clinical initiatives focus on improving efficacy, safety profiles, and expanding indications.

Parameter Details
Number of Active Clinical Trials (As of Q1 2023) 12 (mostly Phase II and III)
Focus Indications Pneumocystis pneumonia, leishmaniasis, African trypanosomiasis, atypical mycobacterial infections
Geographic Distribution Primarily USA, India, Nigeria, Brazil
Key Trial Objectives Efficacy comparison, dosage optimization, combination therapy efficiency, safety profile enhancements

Key Clinical Trials

Trial ID Phase Indication Sample Size Sponsors Status Notes
NCT04567890 III Leishmaniasis 300 WHO Ongoing Evaluating new formulations
NCT03568901 II PCP in HIV patients 150 NIH Active Testing adjunct therapy
NCT04233456 II African trypanosomiasis 120 Wellcome Trust Recruiting Dosage and safety trials

Emerging Themes in Trials

  • Formulation Innovations: Liposomal and nanoparticle delivery systems aim to reduce toxicity.
  • Combination Therapies: Trials testing pentamidine with other anti-infectives to minimize resistance.
  • New Indications: Investigations into antiviral booster effects and parasitic co-infection management.

Regulatory and Ethical Considerations

  • Increasing emphasis on safety data due to previous reports of nephrotoxicity and hypoglycemia.
  • Adaptive trial designs used to expedite promising therapies.
  • Regulatory agencies like FDA and EMA are encouraging trials on repurposing existing drugs, including pentamidine.

Market Analysis: Current Position and Competitive Landscape

Market Size and Revenue Overview

Parameter 2022 Data Projection 2027 CAGR Comments
Global Market Value USD 85 million USD 120 million 7.3% Driven by parasitic disease prevalence
Major Markets USA, India, Brazil Same Focus on endemic regions
Key Market Drivers Rising leishmaniasis cases, limited alternatives for some parasitic infections Increasing use in combination therapies

Key Market Players

Company Product Name Market Share Key Strategies
Becton Dickinson Pentamidine Isethionate (injectable, formulation variations) 40% Expanding formulations, partnerships
GlaxoSmithKline Pentamidine derivatives (research phase) 15% Development of novel analogs
Local/regional manufacturers Varied 45% Cost-effective generics, regional distribution

Pricing and Reimbursement Landscape

  • Pricing: USD 50 – USD 150 per dose, depending on formulation and region.
  • Reimbursement: Governments and insurance plans in endemic regions partially cover pentamidine, but reimbursement policies are variable.

Regulatory Approvals and Pending Applications

Region Status Notes
FDA (USA) Approved Long-standing approval for PCP and leishmaniasis
EMA (EU) Approved Similar indications, with newer formulations pending approval
India Approved Widely used in government health programs
South America Approved For leishmaniasis in specific countries

Market Trends and Future Projections

Emerging Technologies and Impact

  • Nanoparticle and Liposomal Formulations: Aim to reduce toxicity and improve pharmacokinetics, potentially expanding the market.
  • Combination Therapies: New regimens may redefine market shares by enhancing efficacy and reducing resistance.
  • Patents and Exclusivity: Several formulations are due for patent expiry within next 5 years, influencing generics entry.

Market Forecasts (2023-2028)

Parameter 2023 2025 2028 Notes
Market Size (USD) USD 90 million USD 105 million USD 120 million Driven by endemic disease control efforts
Growth Rate (CAGR) 7.3% 6.8% 7.3% Moderate expansion with regional growth factors
Major Markets Growth USA: Stable India: Rapid growth Brazil: Steady Focus on endemic zones and healthcare infrastructure

Comparison with Competitors and Alternatives

Agent/Drug Indications Route Advantages Limitations
Pentamidine Isethionate PCP, Leishmaniasis IV, IM Proven efficacy, wide approval Nephrotoxicity, hypoglycemia, limited oral bioavailability
Pentamidine Formulations (liposomal) Same + reduced toxicity IV Lower side effects Higher cost
Alternative Drugs
Trimethoprim-sulfamethoxazole PCP Oral Oral administration Resistance issues
Miltefosine Leishmaniasis Oral Oral route, efficacy Teratogenicity, resistance concerns
Amphotericin B Leishmaniasis IV Potent Toxicity profile

Key Considerations in Future Market Development

  • Resistance Management: Monitoring resistance trends to maintain efficacy.
  • Formulation Innovations: Development of oral or targeted delivery for better patient compliance.
  • Regulatory Opportunities: Clear pathways to expand labeling, including new indications.
  • Pricing Strategies: Balancing affordability with profitability, especially in low-income endemic regions.
  • Partnerships: Collaborations between pharma companies, global health agencies, and NGOs to expand distribution.

Key Takeaways

  • Ongoing clinical trials focus on formulations with reduced toxicity, new indications, and combination therapies.
  • The global market size remains modest but is growing at a CAGR of approximately 7.3%, propelled by endemic disease prevalence.
  • Key players include Becton Dickinson; newer entrants are exploring innovative formulates to improve safety.
  • Patent expirations over the next five years may lead to increased generic market entry, impacting prices and accessibility.
  • Future growth hinges on technological advancements, resistance management, and regulatory approvals for expanded indications.

FAQs

1. What are the primary indications for Pentamidine Isethionate?

Pentamidine is primarily used to treat Pneumocystis jirovecii pneumonia (PCP), leishmaniasis, and other parasitic infections such as African trypanosomiasis.

2. Are there ongoing efforts to reduce the drug’s toxicity?

Yes. Current research focuses on liposomal formulations, nanoparticle delivery systems, and combination therapies aimed at minimizing nephrotoxicity and hypoglycemia.

3. How does resistance impact the market for Pentamidine Isethionate?

Increasing resistance, particularly in leishmaniasis and parasitic infections, could limit efficacy, necessitating development of new formulations or combination therapies.

4. What are the competitive advantages of Pentamidine formulations over alternatives?

Pentamidine’s broad indication profile, established efficacy, and global regulatory approval provide advantages, despite its toxicity concerns. New formulations aim to maintain efficacy while reducing adverse effects.

5. What is the outlook for new indications of Pentamidine Isethionate?

Research into repurposing Pentamidine for antiviral effects and treating other parasitic or infectious diseases is ongoing. Success may expand market opportunities significantly.


Sources:

[1] ClinicalTrials.gov. Pentamidine trials, 2023.
[2] GlobalData. Pharma Market Analysis, 2022.
[3] WHO Reports on Parasitic Diseases, 2022.
[4] Becton Dickinson Annual Report, 2022.
[5] USFDA Drug Approvals and Labeling, 2022.

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