Intralesional meglumine antimoniate for cutaneous leishmaniasis: Evidence from a prospective real-world study in the Brazilian Amazon.

BACKGROUND

Evidence on local therapy for cutaneous leishmaniasis (CL) in the Amazon remains limited, particularly in areas where multiple Leishmania species other than Leishmania braziliensis are prevalent.

METHODOLOGY: In this prospective, single-arm study, patients with localized CL were treated with a three-dose schedule intralesional meglumine antimoniate (IL-MA) at a referral center in Santarém, Pará, Brazil. Follow-up and outcome assessment also involved the use of mHealth tools.

RESULTS

Between 2022 and 2024, 127 patients were enrolled. Treatment effectiveness at day 120 ranged from 69.3% (intention-to-treat) to 76.8% (per-protocol) after the initial regimen. Following an additional IL cycle, effectiveness increased to 85.6%. One serious adverse event required brief hospitalization.

CONCLUSION

IL-MA demonstrated favorable safety and moderate-to-high effectiveness, supporting its use as a pragmatic therapeutic option for CL in the Amazon region. The integration of mHealth tools proved valuable for remote monitoring and minimizing loss to follow-up, offering a promising approach for patient management and the generation of real-world evidence in endemic settings.