Condition

Visceral leishmaniasis

Clinical trials and treatment information for Visceral leishmaniasis

200K

People Affected

Active Trials

80K

New Cases/Year

5,482

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Combination Therapies (e.g., Liposomal Amphotericin B + Miltefosine)

98% Effectiveness• 95% Confidence• 55% Safety• 25 trials• 2.5K participants

HIGH EvidenceExcellent ValueDose: Variable, e.g., L-AmB total 10-15 mg/kg + Miltefosine 7-14 days

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Days to 1 week

Duration

7-14 days

Response Rate

98%

Remission Rate

98%

Number Needed to Treat (NNT)

Common Side Effects:

Infusion-related reactions (fever, chills): 15%

Nausea/Vomiting/Diarrhea: 15%

Nephrotoxicity (creatinine elevation): 8%

Hypokalemia: 5%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$8,000

Side Effects

$1,000

Total Annual

$14,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.5

Cost per Remission

$14,286

Cost per Responder

$14,286

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+98%

Response Rate

+98%

Remission Rate

+98%

Common Side Effects

Infusion-related reactions (fever, chills)

+15%

Nausea/Vomiting/Diarrhea

+15%

Nephrotoxicity (creatinine elevation)

+8%

Clinical Trial Phases:

Phase 3Phase 4

Liposomal Amphotericin B

96% Effectiveness• 95% Confidence• 50% Safety• 18 trials• 5.5K participants

HIGH EvidenceGood ValueDose: 3-5 mg/kg daily or every other day for total 15-25 mg/kg

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

2-10 days (typically 5-7 days)

Response Rate

96%

Remission Rate

96%

Number Needed to Treat (NNT)

Common Side Effects:

Infusion-related reactions (fever, chills, rigors): 30%

Nephrotoxicity (creatinine elevation): 15%

Hypokalemia: 12%

Anemia: 8%

Annual Cost of Care

Drug Cost

$6,000

Monitoring

$10,000

Side Effects

$2,000

Total Annual

$18,000

Cost-Effectiveness

GOOD

QALYs Gained

1.2

Cost per Remission

$18,750

Cost per Responder

$18,750

Treatment Outcomes

Primary Outcomes

Parasite Load (spleen/bone marrow aspirate)3+ on a 0-4+ scale

-100% (-3+ (to 0+))

Spleen Size below costal margin7 cm

-86% (-6 cm)

Hemoglobin7.0 g/dL

+57% (+4.0 g/dL)

Platelet Count70 x 10^9/L

+186% (+130 x 10^9/L)

Secondary Benefits

Body Weight45 kg

+11% (+5 kg)

White Blood Cell Count2.0 x 10^9/L

+150% (+3.0 x 10^9/L)

C-Reactive Protein (CRP)75 mg/L

-93% (-70 mg/L)

Common Side Effects

Infusion-related reactions (fever, chills, rigors)

+30%

Nephrotoxicity (creatinine elevation)

+15%

Hypokalemia

+12%

Clinical Trial Phases:

Phase 4

Miltefosine

92% Effectiveness• 90% Confidence• 60% Safety• 12 trials• 3.5K participants

HIGH EvidenceGood ValueDose: Adults: 50 mg twice daily; Children: 2.5 mg/kg daily

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

28 days

Response Rate

92%

Remission Rate

92%

Number Needed to Treat (NNT)

Common Side Effects:

Nausea: 50%

Vomiting: 40%

Diarrhea: 15%

Abdominal pain: 10%

Teratogenicity: 0.1%

Annual Cost of Care

Drug Cost

$1,500

Monitoring

$2,000

Side Effects

$500

Total Annual

$4,000

Cost-Effectiveness

GOOD

QALYs Gained

Cost per Remission

$4,348

Cost per Responder

$4,348

Treatment Outcomes

Primary Outcomes

Parasite Load (Semi-Quantitative Grade)3/4 (positive for Leishmania amastigotes on 0-4 scale)

-100% (-3 units (from 3 to 0) on a 0-4 semi-quantitative scale)

Splenic Size (Palpable below Costal Margin)7 cm below costal margin

-85.7% (-6 cm below costal margin)

Days with Fever (per week)6 days per week

-100% (-6 days per week)

Hemoglobin8.0 g/dL

+37.5% (+3.0 g/dL)

Secondary Benefits

Body Weight35 kg

+14.3% (+5 kg)

Platelet Count90,000 /uL

+66.7% (+60,000 /uL)

Karnofsky Performance Status Score40/100 (requires considerable assistance)

+75% (+30 points on a 0-100 scale)

Common Side Effects

Nausea

+50%

Vomiting

+40%

Diarrhea

+15%

Clinical Trial Phases:

Phase 4

Paromomycin

85% Effectiveness• 80% Confidence• 65% Safety• 11 trials• 1.5K participants

MODERATE EvidenceGood ValueDose: 15 mg/kg/day intramuscularly for 21 days

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-3 weeks

Duration

21 days

Response Rate

85%

Remission Rate

80%

Number Needed to Treat (NNT)

Common Side Effects:

Injection site pain: 30%

Nephrotoxicity (creatinine elevation): 10%

Ototoxicity (hearing loss, tinnitus): 3%

Annual Cost of Care

Drug Cost

$800

Monitoring

$4,000

Side Effects

$1,000

Total Annual

$5,800

Cost-Effectiveness

GOOD

QALYs Gained

0.8

Cost per Remission

$7,250

Cost per Responder

$6,824

Treatment Outcomes

Primary Outcomes

Spleen Palpability Below Costal Margin7 cm

-71.4% (-5 cm)

Hemoglobin Level8.5 g/dL

+17.6% (+1.5 g/dL)

White Blood Cell Count3.0 x 10^9/L

+66.7% (+2.0 x 10^9/L)

Fever Resolution (days with fever)Average 10 days with fever in last 14 days

-90% (-9 days)

Secondary Benefits

Body Weight45 kg

+8.9% (+4 kg)

Platelet Count100 x 10^9/L

+40% (+40 x 10^9/L)

Health-Related Quality of Life40 points (out of 100)

+50% (+20 points)

Common Side Effects

Injection site pain

+30%

Nephrotoxicity (creatinine elevation)

+10%

Ototoxicity (hearing loss, tinnitus)

+3%

Clinical Trial Phases:

Phase 4

Sodium Stibogluconate (SSG)

88% Effectiveness• 75% Confidence• 45% Safety• 5 trials• 6K participants

MODERATE EvidenceModerate ValueDose: 20 mg/kg/day intravenously or intramuscularly for 28 days

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

3-4 weeks

Duration

28 days

Response Rate

88%

Remission Rate

85%

Number Needed to Treat (NNT)

Common Side Effects:

Cardiotoxicity (ECG changes, QT prolongation): 30%

Pancreatitis (elevated amylase/lipase): 20%

Arthralgia/Myalgia: 25%

Hepatotoxicity (elevated liver enzymes): 10%

Nephrotoxicity: 5%

Annual Cost of Care

Drug Cost

$1,000

Monitoring

$6,000

Side Effects

$2,000

Total Annual

$9,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.8

Cost per Remission

$10,588

Cost per Responder

$10,227

Treatment Outcomes

Primary Outcomes

Parasite Clearance (Splenic Aspirate)Parasites present (e.g., Grade 3+)

-100% (Cleared (to Grade 0))

Spleen Size Reduction (below costal margin)10 cm below costal margin

-80% (-8 cm (from 10 cm to 2 cm))

Resolution of Fever (Days with Fever per week)7 days/week

-100% (-7 days/week (to 0))

Hemoglobin Level8.0 g/dL

+50% (+4.0 g/dL (from 8.0 to 12.0 g/dL))

Secondary Benefits

Body Weight45 kg (for average adult)

+10% (+4.5 kg (from 45 kg to 49.5 kg))

Serum Albumin2.5 g/dL

+40% (+1.0 g/dL (from 2.5 to 3.5 g/dL))

Activity Level (Karnofsky Performance Status)KPS: 50/100 (considerable assistance needed)

+60% (+30 points (from 50 to 80))

Common Side Effects

Cardiotoxicity (ECG changes, QT prolongation)

+30%

Pancreatitis (elevated amylase/lipase)

+20%

Arthralgia/Myalgia

+25%

Clinical Trial Phases:

Phase 4