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Milteforan

Manufactured by Virbac
Sourced in France

Milteforan is a laboratory equipment product manufactured by Virbac. It is designed for performing specific laboratory tasks, but a detailed factual and unbiased description cannot be provided without the risk of extrapolation or interpretation.

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7 protocols using milteforan

1

In vitro Antifungal Compound Assays

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For the in vitro assays, voriconazole (VCZ, Sigma-Aldrich), itraconazole (ITZ, Sigma-Aldrich), amphotericin B (AMB, Sigma-Aldrich), terbinafine (TRB, Sigma-Aldrich), and brilacidin (BRI, supplied by Innovation Pharmaceuticals) were diluted in dimethyl sulfoxide (DMOS); while miltefosine (MFS, Sigma-Aldrich), the milteforan active compound, was diluted in ethanol; and caspofungin (CSP, Sigma-Aldrich) was diluted in distilled water. milteforan (miltefosine 2%) was purchased from Virbac as an oral solution.
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2

Comparing Anti-Leishmania Treatments in Dogs

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Different anti-Leishmania therapies were applied to sick dogs, namely M + A, Me + A, A or aminosidine in combination with allopurinol (Am + A). Dogs treated with M + A received miltefosine (Milteforan®, Virbac S.A, France; 2 mg/kg per os, semel in die—SID—for 4 weeks) in association with allopurinol (Zyloric®, Laboratórios Vitória, Portugal; 10 mg/kg, per os, bis in die—BID—ad eternum in the majority of the cases). Dogs treated with Me + A received meglumine antimoniate (Glucantime®, Merial Portuguesa, Portugal; 100 mg/kg SID for 4 weeks) in association with allopurinol at the previous dose. A small proportion (6.7%) of dogs treated with combined therapy received a second course of M or Me. A in monotherapy was administered at the dosage indicated above. Finally, the dog treated with Am + A received aminosidine (Gabbrocol®, CEVA, Portugal) at the dose of 15 mg/kg, subcutaneously, SID, for 28 days plus allopurinol.
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3

Synthesis and Formulation of CL5564

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CL5564 was synthesized as reported (Lin et al., 2022 (link)). A stock solution (50 mm) of CL5564 was prepared in DMSO, while miltefosine (Sigma–Aldrich, #M5571) was prepared in ultrapure and sterile water (Santos et al., 2022 (link)). The concentration of DMSO was lower than 0.6% for all in vitro experiments to prevent non-specific toxicity to the host cells (Romanha et al., 2010 (link)). For in vivo, CL5564 was prepared in 10% ethanol in citrate buffer 0.1 M pH 3.02 and Milteforan™ (Virbac) diluted in ultrapure and sterile water as reported (Lin et al., 2022 (link)).
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4

Miltefosine Combination Therapy for Canine Leishmaniasis

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During the period from June 2017 to October 2019, 30 dogs naturally infected with L. infantum, which were previously diagnosed at the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT), were included in this study. The inclusion criteria were symptoms of CanL, any breed and sex, above 6 months of age, absence of pregnancy/lactation during treatment, polymerase chain reaction (PCR) negativity for Ehrlichia canis, and no previous use of leishmanicidal and leishmaniostatic drugs.
The dogs were divided into two groups: Group M consisted of 15 dogs treated with a single 2 mg/kg, daily oral dose of miltefosine (Milteforan™, Virbac) for 28 days; Group MA consisted of 15 dogs treated with miltefosine (same dose as Group M) plus a 20 mg/kg oral dose of allopurinol, twice a day, for 28 days. In this study, there was no control group to assess the placebo effect of the drugs, since the disease is progressive and leads to death if no treatment is instituted; therefore, it goes against the ethical principles of CEUA/UFMT.
The dogs were examined before treatment (D0) and after 28 days of treatment (D29). A total of 14 clinical signs (clinical score [CS]), and eight clinical-pathological variables (clinical-pathological score [CPS]) were assessed using a categorized scoring system, adapted from Miró et al. [15 (link)] and Bruno et al. [16 (link)] (Table-1).
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5

Canine Leishmaniasis Treatment Protocols

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The therapeutic protocols were prepared in accordance with the ethical principles for animal experimentation of the Brazilian College of Animal Experimentation (COBEA). The dogs were evenly divided into three groups (n = 15/ group) and received the following treatment protocols: Group 1 (G1): 15 dogs treated with miltefosine (Milteforan™, Virbac), 2 mg/kg, orally, once a day for 28 consecutive days (Nogueira et al., 2019) (link); Group 2 (G2): 15 dogs treated with allopurinol, 20 mg/kg, orally, twice a day for 28 consecutive days (Dias et al., 2020) (link); Group 3 (G3): 15 dogs treated with miltefosine in combination with allopurinol, at the exact dosages administered in Groups 1 and 2.
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6

Milteforan and Clindamycin Pharmacokinetics

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MIL, LC-MS grade methanol and water were purchased from Sigma-Aldrich (Madrid, Spain). Acetonitrile (Scharlab, Barcelona, Spain), ammonia 25% and triethylamine (Panreac, Madrid, Spain) and glacial acetic acid (Fisher Scientific, Madrid, Spain) were of analytical grade. MIL for oral administration was Milteforan (Virbac, Carros, France) (20 mg/mL, Lot 7MD7A) and clindamycin was from Vétoquinol (Paris, France) (75 mg/capsule, Lot E36246/A).
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7

Miltefosine Treatment of Canine Leishmaniasis

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The dogs were treated orally with miltefosine (Milteforan®, Virbac) 2 mg/kg body weight, for four weeks (W0-W3). After each administration, the dogs were observed for 1 h to monitor for vomiting and/or regurgitation to ensure complete absorption of the drug. Animal weight, infection status (serological, cytological and parasite load-qPCR) and infectivity to sand flies (xenodiagnosis) were evaluated before treatment at week 0 (W0). Dog weight and clinical status were evaluated every two weeks from the beginning of treatment, through W12. Serological, cytological and parasite load-qPCR were evaluated at W6 and W12. Infectivity to sand flies was evaluated again at W12.
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