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Successful results with new worm treatment

23 Oct 2008

Paul Chinnock

Source: PLoS Neglected Tropical Diseases (see original article)

Researchers have reported positive results from the first safety and efficacy study of tribendimidine, a broad-based treatment for intestinal worm infections. The group’s results demonstrate the success of the new drug from China versus that of the standard albendazole for the treatment of hookworm, large roundworm, whipworm, tapeworm and, for the first time, threadworm. The study was jointly implemented by researchers from the Swiss Tropical Institute in Basel, the National Institute of Parasitic Diseases (IPD) in Shanghai, the Yunnan Institute of Parasitic Diseases in Simao, China, and the Jiangsu Institute of Parasitic Diseases in Wuxi, China. The trial has been published in the open-access journal PLoS Neglected Tropical Diseases.

Globally, more than one billion people are infected with intestinal worms. These chronic infections negatively impact on child and maternal health, nutritional status, physical performance and cognitive development. The current control strategy relies on drugs to reduce morbidity, ideally complemented by provision of safe water and sanitation to curb transmission. Only four drugs are currently recommended by the World Health Organization for treating soil-transmitted helminth infections, making the potential development of drug resistance a concern. Tribendimidine belongs to a different chemical class than current worm treatments. The drug had been developed at IPD and Shandong Xinhua Pharmaceutical, and was approved by the China State Food and Drug Administration in 2004.

The community-based study involved 123 individuals who were screened for intestinal helminth infections, and randomly allocated to tribendimidine or the widely used albendazole treatment. Only four study participants harbored no intestinal worms. The researchers’ administration of a single oral dose of tribendimidine cured up to 92% of the common soil-transmitted helminth infections in humans in a highly endemic setting in China.

Encouraging results were also found against threadworm and tapeworm infections. After treatment, these two parasites were absent in 55% and 67% of those initially infected, respectively. Albendazole was more efficacious against large roundworms and whipworms. The infection intensity of large roundworms and hookworms was significantly reduced by both drugs, and no adverse treatment-related events were noted among the final study cohort.

The obtained results need to be validated in larger patient cohorts and different epidemiological settings, and repeated dosing should be tested to further improve treatment outcomes.