New treatment for human parasitic infections shows high efficacy

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Male Trichuris trichiura. Credit: Leonardo M. Lustosa/Wikimedia Commons, CC BY-SA

Soil-borne helminthic infections are caused by various species of parasites such as whipworms, hookworms and roundworms. More than 1.5 billion people worldwide are infected with at least one soil-borne helminth, most of whom live in low- and middle-income countries.

Infected individuals may experience symptoms such as abdominal pain, diarrhea, and anemia, and severe infections can lead to malnutrition, failure to thrive, and impaired physical development. Severe cases can cause intestinal obstruction and may require surgery.

Safe drugs are available to treat soil-borne helminth infections, but their efficacy varies widely. The current treatments recommended by the World Health Organization (WHO) are albendazole and mebendazole. However, in the case of the whipworm Trichuris trichiura, a single dose of these agents cures only 17% of those infected, as shown in this study. Furthermore, new alternative therapies are urgently needed as drug resistance is increasing.

all patients were cured

To fill the anthelmintic pipeline, Swiss TPH researchers have now tested the drug emodepside for the first time in humans infected with soil-borne helminths in a Phase IIa trial.

“In this study, emodepside showed high cure rates against all three types of soil-borne helminths,” said Dr. Emmanuel Murimi. Candidate and first author of the study. At the lowest tested dose of Emodepside 5 mg, 83% of those infected with whipworm were cured. “When emodepside was increased to 15 mg, all were completely cured. Curing people infected with whipworm has never been achieved with current anthelmintic treatments.” A high effect was also observed.

“The drug has other important features: it was well tolerated and most adverse events in trials were mild,” Murimi said.The results were published in today’s article New England Journal of Medicine.

From innovation to application

Emodepside is an anthelmintic that has been used in veterinary medicine. “Drug repurposing is an important strategy in anthelmintic drug discovery and development research, but it is neglected and underfunded,” said Jennifer Kaiser, director of helminth drug development. “Most of the drugs used come from veterinary medicine.”

Switzerland’s TPH has already tested the drug in laboratory studies. “Based on our promising results in the lab, we now know that we may be able to treat patients infected with soil-borne helminths,” said Jennifer Kaiser. That is why the drug was developed. “The results of recent clinical trials are important and encouraging news in the field of neglected tropical diseases. No new anthelmintic drugs have been developed in the last decades. It’s a big milestone for

Switzerland’s TPH will now partner with life sciences company Bayer for further development of the drug. “The aim is to get it approved for human use and, in the future, to make it available to patients who need it,” Kaiser said.

For more information:
emodepside for Trichuris trichyura and hookworm infections, New England Journal of Medicine (2023). DOI: 10.1056/NEJ Moa2212825

Magazine information:
New England Journal of Medicine

Courtesy of the Swiss Institute of Tropical and Public Health

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