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Purpose of Review <p>To determine the safety and efficacy of intralesional versus systemic (intramuscular/endovenous) application of meglumine antimony (MA) in cutaneous leishmaniasis (CL).</p> Recent Findings <p> The search was conducted in CENTRAL, Pubmed, LILACS, Web of Science, Embase and Google Scholar. We included randomized clinical trials (RCTs) or non-randomized intervention studies (NIS), in any language, with patients with a laboratory diagnosis of CL; excluding: extracutaneous involvement, comorbidities, previous treatment with MA, pregnant or breastfeeding women. The GRADE system was used for the assessment of certainty of evidence (CoE). A total of 4 studies were included (2 RCTs and 2 NISs). Intralesional therapy showed greater efficacy than systemic therapy, with 14% more complete cures (RR=1.14; CoE: very low). Cure was 16 days faster with intralesional, but not statistically significant (95% CI -33 to 0.35; p=0.05; CoE: very low). There were no recurrences in either group. The intralesional route had fewer adverse events (RR=0.67; p&lt;0.05 CoE: very low): clinical (RR=0.57; CoE: very low), laboratory (RR=0.36; CoE: low), electrocardiographic (RR=0.35; CoE: very low) and severe (RR=0.09; CoE: very low).</p> Summary <p> Current evidence shows uncertainty regarding the efficacy and safety of intralesional administration of meglumine antimoniate compared to the systemic route in the treatment of cutaneous leishmaniasis.</p> Registration <p> CRD42024628935 (PROSPERO).</p>

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Efficacy and Safety in the Treatment of Patients with Cutaneous Leishmaniasis of Intralesional Compared to Intramuscular or Intravenous Administration of Meglumine Antimony: a Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年10月25日

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  • Frydda Catacora-Zamalloa,
  • Vanessa Cruzado-Maldonado,
  • Akemi Toyama-Tena,
  • Diego Urrunaga-Pastor,
  • Milton A. Romero-Robles

摘要

Purpose of Review

To determine the safety and efficacy of intralesional versus systemic (intramuscular/endovenous) application of meglumine antimony (MA) in cutaneous leishmaniasis (CL).

Recent Findings

The search was conducted in CENTRAL, Pubmed, LILACS, Web of Science, Embase and Google Scholar. We included randomized clinical trials (RCTs) or non-randomized intervention studies (NIS), in any language, with patients with a laboratory diagnosis of CL; excluding: extracutaneous involvement, comorbidities, previous treatment with MA, pregnant or breastfeeding women. The GRADE system was used for the assessment of certainty of evidence (CoE). A total of 4 studies were included (2 RCTs and 2 NISs). Intralesional therapy showed greater efficacy than systemic therapy, with 14% more complete cures (RR=1.14; CoE: very low). Cure was 16 days faster with intralesional, but not statistically significant (95% CI -33 to 0.35; p=0.05; CoE: very low). There were no recurrences in either group. The intralesional route had fewer adverse events (RR=0.67; p<0.05 CoE: very low): clinical (RR=0.57; CoE: very low), laboratory (RR=0.36; CoE: low), electrocardiographic (RR=0.35; CoE: very low) and severe (RR=0.09; CoE: very low).

Summary

Current evidence shows uncertainty regarding the efficacy and safety of intralesional administration of meglumine antimoniate compared to the systemic route in the treatment of cutaneous leishmaniasis.

Registration

CRD42024628935 (PROSPERO).