Leishmaniasis--oral treatment with hexadecylphosphocholine

Abstract

Hexadecylphosphocholine (HDPC, Miltefosine, Impavido) was synthesized at the Max-Planck-Institut für Biophysikalische Chemie in Göttingen, Germany and successfully used for the therapy of cancer metastases. At the Institute of General and Tropical Hygiene of Göttingen University the antiparasitic efficacy--earlier mentioned by Croft et al. (1987)--could be established for the first time in animals after oral administration. In India Impavido has been recently registered for the treatment of visceral leishmaniasis as the first oral medication in this indication. Clinical studies in India--actually a phase IV study is running--and Columbia (cutaneous leishmaniosis) demonstrated the excellent efficacy of this oral treatment also in patients with Antimon resistance. The cure rates are above 90% with low side effects (Impavido twice 50 mg capsules daily over 28 days).