Scoping review suggests that PKDL data platform is feasible

A new systematic scoping review of post-kala-azar dermal leishmaniasis (PKDL) studies found 56 studies published since 1973, with more than half of the studies dating from the last decade. Based on the relatively recent studies, which together include nearly 2,500 patients, the authors believe that the establishment of a PKDL data platform is feasible. The study is published in PLoS Neglected Tropical Diseases. 

PKDL is a dermatosis that can happen after successful visceral leishmaniasis (VL) treatment, manifesting in skin rashes that can be a reservoir of infection via sandfly vectors. 

PKDL is therefore a public health problem, because it means that patients otherwise successfully treated for visceral leishmaniasis can still transmit the disease. Current PKDL treatments are either expensive, need to be taken for a long time, and/or have safety concerns. 

“There are still a lot of gaps in current scientific knowledge of PKDL, including its pathophysiology and risk factors that can affect treatment outcome,” said the study’s corresponding author Dr Krishna Pandey, Director of the Indian Council of Medical Research-Rajendra memorial Research Institute of Medical Sciences (ICMR-RMRIMS). 

IDDO already hosts an established VL data platform, and Dr Pandey is also a member of the Visceral Leishmaniasis scientific advisory board at IDDO. This IDDO data platform has a critical mass of data from VL clinical trials conducted over the past 20 years. 

Dr Rishikesh Kumar, also from ICMR-RMRIMS and joint first author of the study, said, “Based on the number of studies we have identified in this review, we think that establishing a similar platform for PKDL is feasible, and will help address key knowledge gaps in PKDL.” 

“Creating such a platform will enable in-depth individual patient data analyses, enabling researchers to address new research questions from existing data,” added Dr Prabin Dahal, study author and statistics lead IDDO.

The researchers calculated that if the number of patients from non-randomised studies were pooled, an individual patient data platform would have a large set of data from studies exploring the efficacy and safety of the three main medications used for PKDL. 

“With the help of the global PKDL community and the right funding, we do think that a PKDL platform can be realised,” added IDDO’s Dr Sauman Singh, the paper’s first and corresponding author.

“This will allow a nuanced exploration of the safety and efficacy of PKDL drugs which can ultimately produce better treatments for patients,” said Professor Philippe Guerin, the review’s principal investigator and IDDO Director.

Read the review.