Last Updated: June 9, 2026

CLINICAL TRIALS PROFILE FOR MILTEFOSINE


✉ Email this page to a colleague

« Back to Dashboard


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.
>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
[disabled in preview] 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Condition MeSH

Condition MeSH for miltefosine
Intervention Trials
Leishmaniasis 43
Leishmaniasis, Cutaneous 22
Leishmaniasis, Visceral 13
Leishmaniasis, Mucocutaneous 8
[disabled in preview] 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Locations for miltefosine

Trials by Country

Trials by Country for miltefosine
Location Trials
Bolivia 13
Brazil 12
Colombia 8
India 5
Bangladesh 5
This preview shows a limited data set
Subscribe for full access, or try a Trial

Trials by US State

Trials by US State for miltefosine
Location Trials
Maryland 3
Texas 1
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Progress for miltefosine

Clinical Trial Phase

Clinical Trial Phase for miltefosine
Clinical Trial Phase Trials
PHASE3 1
PHASE2 2
PHASE1 1
[disabled in preview] 15
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Status

Clinical Trial Status for miltefosine
Clinical Trial Phase Trials
Completed 32
Recruiting 5
Terminated 4
[disabled in preview] 5
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Sponsors for miltefosine

Sponsor Name

Sponsor Name for miltefosine
Sponsor Trials
Drugs for Neglected Diseases 11
AB Foundation 6
Knight Therapeutics (USA) Inc 5
[disabled in preview] 10
This preview shows a limited data set
Subscribe for full access, or try a Trial

Sponsor Type

Sponsor Type for miltefosine
Sponsor Trials
Other 98
Industry 10
UNKNOWN 1
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Miltefosine: Clinical Trial Update, Market Analysis, and Projection

Last updated: May 5, 2026

What is the current clinical-trial status for miltefosine?

Miltefosine is a first-in-class oral alkylphosphocholine with established labels across multiple endemic parasitic diseases. In the current trial landscape, the strongest activity is in (1) leishmaniasis subtypes and (2) combination regimens, with additional studies focused on safety, pharmacokinetics, and special populations.

Recent and ongoing study themes

Across registered interventional studies, miltefosine trial designs cluster into four operational buckets:

  1. Visceral leishmaniasis (VL)
    • Comparators against standard-of-care (SOC) amphotericin regimens or paromomycin-containing strategies.
    • Regimen optimization studies for oral dosing duration and treatment adherence.
  2. Cutaneous leishmaniasis (CL)
    • Studies targeting early disease, lesion burden stratification, and combination approaches to improve cure rates.
  3. Mucosal leishmaniasis (ML) and species-specific responses
    • Small cohort trials assessing efficacy signals by Leishmania species.
  4. Real-world-adjacent endpoints
    • PK, safety monitoring, and adherence programs used to support use in routine care settings.

Trial update signals to track

For investment and R&D planning, the key items in the miltefosine trial pipeline are:

  • Ongoing combination regimens (especially those that reduce parenteral burden).
  • End-of-treatment cure plus relapse-free follow-up (relapse rates drive net clinical value in leishmaniasis).
  • Safety in at-risk populations, particularly pregnancy risk management (miltefosine is teratogenic, and many programs integrate structured pregnancy prevention and monitoring pathways).

No new, single definitive phase-transition milestone is identifiable from the information provided in this request alone. The actionable view is that trial activity remains anchored to regimen optimization and use-case refinement rather than a single late-stage global pivot.


What is the market landscape for miltefosine?

Miltefosine’s market is dominated by endemic-disease demand rather than growth driven by new label expansion. Pricing power is constrained by:

  • Government and donor procurement frameworks
  • Competitive oral or parenteral antiparasitics in overlapping geographies
  • Generic availability in multiple markets

Primary demand drivers

  • Endemic burden of leishmaniasis (VL and CL).
  • Oral route advantage relative to IV or hospital-administered alternatives.
  • Health-system preference for outpatient-capable regimens.
  • Programmatic procurement that favors drugs with established supply chains.

Competitive set and substitution pressure

Miltefosine faces substitution from:

  • Liposomal amphotericin B (where budgets and supply permit, and where hospitalization is acceptable)
  • Paromomycin (topical or systemic in specific CL or VL strategies)
  • Miltefosine competitors in oral regimens where available locally (often country-specific)
  • Combination protocols that re-balance the role of miltefosine within standard-of-care pathways

Where miltefosine holds strategic value

The practical positioning is:

  • Patients who cannot access parenteral therapies easily
  • Outpatient or resource-limited settings
  • Health systems seeking to reduce hospitalization and infusion capacity constraints

How should you forecast miltefosine demand and revenue?

A decision-grade projection requires explicit baselines (current patient numbers, pricing, and procurement volumes). This request does not include those inputs, and the instruction constraints require a complete and accurate response. No quantified revenue or market-size forecast can be produced from the information provided here without risking incorrect numbers.

What can be produced as a projection framework (usable for modeling) is the demand logic that drives miltefosine share within leishmaniasis treatment algorithms:

Demand model structure

  1. Incidence and treatment eligibility
    • VL: treatment initiation depends on diagnostic access and clinical staging.
    • CL: lesion count, species, and local guideline adoption influence miltefosine use.
  2. Guideline adoption of miltefosine-containing regimens
    • Combination protocols can either expand or narrow miltefosine utilization depending on cure and relapse outcomes.
  3. Regimen duration and adherence feasibility
    • Oral regimens can increase uptake but also face adherence variation.
  4. Pricing and procurement cycles
    • Donor or government procurement can cause step-function changes in volumes.
  5. Safety and risk management requirements
    • Teratogenicity and pregnancy prevention programs can constrain prescriber adoption in some jurisdictions.

Share-and-risk levers for investors

  • If combination trials improve relapse-free outcomes, miltefosine use can expand within treatment pathways where relapse management is prioritized.
  • If safety or adherence challenges are emphasized in post-market experience, share can erode in favor of more logistically controlled alternatives.
  • If generic supply is stable and procurement is predictable, revenue can remain stable even when clinical usage share shifts modestly.

What patent and commercial constraints shape the outlook?

Miltefosine’s commercial and competitive dynamics are driven by long availability and generic penetration in most markets. In practical terms:

  • Near-term commercial upside depends on formulation, regimen inclusion in guidelines, and contracted procurement, not on exclusive IP rights.
  • R&D value concentrates on new combinations, improved endpoints, and better safety positioning.

Clinical endpoints that determine commercial value in leishmaniasis

When miltefosine is evaluated in trial settings, commercial relevance concentrates on endpoints that translate into procurement decisions:

  • Primary cure at end-of-treatment
  • Relapse-free survival at set follow-up timepoints
  • Species and geography-adjusted efficacy
  • Safety profile including GI adverse events
  • Pregnancy prevention compliance metrics where the regimen is used in women of childbearing potential

Key Takeaways

  • Miltefosine clinical activity is concentrated on leishmaniasis regimen optimization, with emphasis on cure and relapse-free outcomes and on operational feasibility for oral therapy.
  • The market is driven by endemic demand and procurement frameworks, where oral administration can be decisive but generic competition limits pricing power.
  • A quantified market projection cannot be produced accurately from the information provided in this request; the usable path is a model grounded in incidence, eligibility, guideline adoption, adherence, procurement cadence, and safety-driven prescribing constraints.

FAQs

1) What diseases drive miltefosine demand?
Visceral leishmaniasis and cutaneous leishmaniasis are the central clinical use-cases that structure procurement and clinical-trial activity.

2) Why does miltefosine remain relevant versus infusion-based alternatives?
Its oral route reduces hospitalization and infusion capacity constraints, which can support outpatient use in resource-limited settings.

3) What endpoints most affect leishmaniasis procurement decisions?
End-of-treatment cure and relapse-free follow-up are the dominant decision endpoints, supplemented by species- and geography-adjusted performance and safety.

4) Does miltefosine have a patent-driven growth runway?
Commercial exclusivity is constrained by long market presence and generic penetration; growth tends to come from guideline inclusion and regimen optimization rather than new exclusivity.

5) What safety factor most constrains clinical adoption?
Teratogenicity and pregnancy prevention requirements affect prescriber comfort and program implementation.


References

[1] WHO. (2020). Leishmaniasis: a guide to global control and surveillance. World Health Organization. https://www.who.int/teams/control-of-neglected-tropical-diseases/leishmaniasis
[2] Drugs@FDA. (n.d.). Miltefosine (Impavido) prescribing information and safety labeling. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cder/daf/
[3] EMA. (n.d.). Impavido (miltefosine): product information. European Medicines Agency. https://www.ema.europa.eu/
[4] ClinicalTrials.gov. (n.d.). Miltefosine studies (interventional trials) and results. U.S. National Library of Medicine. https://clinicaltrials.gov/

More… ↓

⤷  Start Trial

Make Better Decisions: Try a trial or see plans & pricing

Drugs may be covered by multiple patents or regulatory protections. All trademarks and applicant names are the property of their respective owners or licensors. Although great care is taken in the proper and correct provision of this service, thinkBiotech LLC does not accept any responsibility for possible consequences of errors or omissions in the provided data. The data presented herein is for information purposes only. There is no warranty that the data contained herein is error free. We do not provide individual investment advice. This service is not registered with any financial regulatory agency. The information we publish is educational only and based on our opinions plus our models. By using DrugPatentWatch you acknowledge that we do not provide personalized recommendations or advice. thinkBiotech performs no independent verification of facts as provided by public sources nor are attempts made to provide legal or investing advice. Any reliance on data provided herein is done solely at the discretion of the user. Users of this service are advised to seek professional advice and independent confirmation before considering acting on any of the provided information. thinkBiotech LLC reserves the right to amend, extend or withdraw any part or all of the offered service without notice.