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New drug combination shows promise for African sleeping sickness
November 07, 2007A small clinical trial in Uganda, conducted within a long-established Médecins Sans Frontières (MSF) treatment program for African sleeping sickness, has found that a new combination treatment using the drugs nifurtimox and eflornithine holds promise and deserves further evaluation.
The parasitic disease African sleeping sickness (human African trypanosomiasis, or HAT) threatens millions across remote and conflict-affected regions of sub-Saharan Africa, and causes about 15 000 reported cases every year. Without treatment, HAT progresses from stage 1, infection of the blood and lymph, to stage 2, invasion of the central nervous system, and then to death.
There are few drugs available for treating stage 2. The historical mainstay, melarsoprol, is highly toxic and is ineffective in some areas due to parasite resistance. Eflornithine is the only viable alternative, already established as safe and efficacious, but it is difficult to administer-it is given intravenously and requires 24 hour nursing care, placing an additional workload on the already fragile health systems in HAT-endemic countries.
The new trial, by Gerardo Priotto (Epicentre, Paris, France) and colleagues at MSF and Epicentre, reports on a series of 48 patients treated with a novel combination of nifurtimox (a drug registered for Chagas disease) and eflornithine. Seventeen patients were recruited as part of a terminated randomized trial (previously published in PLoS Clinical Trials, at http://dx.doi.org/10.1371/journal.pctr.0010039), and 31 in a subsequent case series study.
Despite the low sample size, the findings were promising: no cases of treatment failure, no treatment terminations, and no HAT- or treatment-related deaths.
"Nifurtimox plus eflornithine may be the best treatment hope for stage 2 HAT patients in the next decade, while new drugs are developed," say the authors. "A larger, multi-centric trial of the combination is ongoing."
Public Library of Science
The new trial, by Gerardo Priotto (Epicentre, Paris, France) and colleagues at MSF and Epicentre, reports on a series of 48 patients treated with a novel combination of nifurtimox (a drug registered for Chagas disease) and eflornithine. Seventeen patients were recruited as part of a terminated randomized trial (previously published in PLoS Clinical Trials, at http://dx.doi.org/10.1371/journal.pctr.0010039), and 31 in a subsequent case series study.
Despite the low sample size, the findings were promising: no cases of treatment failure, no treatment terminations, and no HAT- or treatment-related deaths.
"Nifurtimox plus eflornithine may be the best treatment hope for stage 2 HAT patients in the next decade, while new drugs are developed," say the authors. "A larger, multi-centric trial of the combination is ongoing."
Public Library of Science
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A compound already used to treat pneumonia could become a new therapy for an inherited muscular wasting disease, according to researchers at the University of Oregon and the University of Rochester School of Medicine and Dentistry in New York.
How much is the world spending on neglected disease research and development?
The first comprehensive survey of global spending on neglected disease R&D, published in this week's PLoS Medicine, finds that just over $US 2.5 billion was invested into R&D of new products in 2007, with three diseases-HIV/AIDS, TB, and malaria-receiving nearly 80% of the total.
Scans show immune cells intercepting parasites
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DNA chunks, chimps and humans
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Death by hyperdisease
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'Deadly dozen' reports diseases worsened by climate change
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New UNC laboratory to help track and control tropical diseases
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Sleeping sickness finding could lead to earlier diagnosis
Sleeping sickness creates a metabolic 'fingerprint' in the blood and urine, which could enable a new test to be developed to diagnose the disease, according to new research published today in the journal Proceedings of the National Academy of Sciences.
Study finds multiple neglected tropical diseases effectively treated with drugs
The neglected tropical diseases are a group of 13 infectious diseases, including elephantiasis, hookworm, African sleeping sickness and trachoma, which affect more than 1 billion people worldwide, most of whom live in extreme poverty.
UGA researchers discover how human body fights off African parasite
Trypanosoma are a nasty class of single-celled parasites that cause serious, even fatal, diseases in human and animals.
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