A single oral dose of the drug acoziborol it could end up with a neglected tropical disease, which can be deadly if left untreated: sleeping sickness. The drug has been shown to be 95% effective at 18 months of treatment of sleeping sickness in adults and adolescents, regardless of the stage of the disease.
According to a study published in “The Lancet Infectious Diseases”, this treatment could help eliminate the transmission of the disease by 2030, the goal set by the WHO. Acoziborole, unlike current treatments for sleeping sickness, does not require several days of therapy, hospitalization, or highly trained healthcare personnel.
sleeping sickness, or human african trypanosomiasis (TAH), is a neglected tropical disease, found in all West and Central African countries, with the majority of cases in the Democratic Republic of the Congo.
Until 2019, treatment for patients in the early phase of the disease consisted of a daily injection for seven or more days and, for patients in the last phase of the disease, an intravenous drip for seven days, requiring hospitalization. Patients also had to undergo a lumbar puncture, in which fluid is collected from the spinal column, to diagnose the stage of sleeping sickness and determine the most appropriate treatment. Fexinidazole, a 10-day oral drug developed by the Drugs for Neglected Diseases initiative (DNDi) was introduced as first-line treatment for both stages of the disease in 2019, but its administration continues to require skilled personnel and often hospitalization.
“Sleeping sickness threatens millions of people in sub-Saharan Africa. Many of those at risk live in remote rural areas where there is little access to adequate healthcare, and where acoziborole has the potential to revolutionize the treatment of sleeping sickness. Delivered in a single dose, it is effective in all phases of the disease, removing the many barriers that currently exist for those most vulnerable to the disease, such as invasive treatments and long travel distances to a hospital. or clinic, and it opens the door to village-based screening and treatment approaches,” says Antoine Tarral, Head of the Human African Trypanosomiasis Clinical Program at DNDi, and lead author of the study.
Sleeping sickness threatens millions of people in sub-Saharan Africa
Antoine Tarral
Head of the Human African Trypanosomiasis Clinical Program at DNDi
During the study, which recruited patients from 10 hospitals in the Democratic Republic of the Congo and Guinea, a single 960 mg oral dose of acoziborole was administered to 208 patients; 167 diagnosed with TAH in the late phase and 41 with TAH-G in the initial or intermediate phase. Patients were followed up for 18 months to see if the treatment had been successful.
The investigators found that, 18 months after treatment, 95% (159/167) of the late-phase g-TAH patients treated with acoziborole were cured (there were no trypanosomes, the microscopic parasites that cause g-TAH, in bodily fluids). In patients in the initial and intermediate phase, 100% (41/41) were successfully treated. An analysis of the results revealed that they were similar to the success rate of the previous HAD treatment, nifurtimox and eflornithine combination therapy (NECT), of 94%.
«The World Health Organization has set a goal of eliminating TAH-g by 2030, interrupting the transmission of the disease. Although cases are declining across Africa, this will be challenging and we believe that the use of acoziborole could be a crucial tool in the future in efforts to reach our common goal of elimination,” said Victor Kande Betu Kumeso, Principal Investigator of the trial. .