Critically Appraised Topic on Canine Leishmaniosis : Does Treatment with Antimonials and Allopurinol Have the Same Clinical and Clinicopathological Efficacy as Treatment with Miltefosine and Allopurinol, after One Month of Treatment?

To treat canine leishmaniosis, two medication combinations are used: meglumine antimoniate with allopurinol, or miltefosine with allopurinol. This study compared the clinical effectiveness of both options after one month of treatment. The results showed a significantly higher rate of complete clinical cure in the meglumine antimoniate and allopurinol group. Most dogs in both groups improved after one month of treatment. There were no significant differences in the presence of the Leishmania parasite between the groups after treatment. The humoral immune response could not be compared due to insufficient data. Overall, meglumine antimoniate and allopurinol seem more effective in treating canine leishmaniosis compared to miltefosine and allopurinol. The treatment of canine leishmaniosis commonly involves meglumine antimoniate with allopurinol or miltefosine with allopurinol. This study aims to compare the clinical and clinicopathological efficacy at 28-30 days of conventional dosing regimens for both treatments using the critically appraised topic methodology. A comprehensive search across three databases (PubMed, CAB Abstracts, and Web of Science) from March 2004 to September 2023 yielded 16 relevant articles, encompassing 325 ogs treated with meglumine antimoniate and allopurinol, and 273 dogs treated with miltefosine and allopurinol. The findings indicated a significantly higher rate of complete clinical cure in the group treated with meglumine antimoniate and allopurinol. Most dogs in both groups exhibited improvement in clinicopathological alterations after one month of treatment. No significant difference was observed in the number of dogs that showed a negative Leishmania qPCR between the two groups, one month post-treatment. However, quantitative serology results were not commonly reported in the available data and therefore this aspect could not be compared.