Therapy Analysis - Malaria
Malaria - current research
In response to the rise in malaria infections over the past few decades, a number of major worldwide programmes have been launched in order to develop new, effective treatments for the disease. Pharmaprojects' Trend Analysis data shows a clear rise the development of antimalarial drugs during the past decade.
There are several families of drugs currently available for the treatment and prophylaxis of malaria. In regions that are still sensitive, chloroquinine is used; however in resistant parts of the world the WHO recommends the use of artemisinin-based combination therapies (ACT) as the first-line treatment for malaria. Artemisinin is derived from the Chinese medicinal plant Artemisia annua, and is believed to disrupt the parasitic DNA by adding alkyl organic groups. Currently the demand for artemisinin outstrips supply, and it is believed that in the near future half a billion courses of ACT will be required worldwide, requiring over 400 tons of artemisinin.
Although the chemical synthesis of artemisinin is not currently economically viable, a new synthetic drug, RBx-11160, based on the artemisinin trioxane ring structure, is under development by Ranbaxy in partnership with the non-profit organisation Medicines for Malaria Venture. It has so far been successful in Phase I and II trials as a monotherapy.
In June 2007, the US FDA approved an IND protocol for the use of artesunate, marketed by Sigma-Tau for the treatment of severe malaria. Artesunate is only the second non-oral drug available for the treatment of malaria. Other non-artemisinin-based drugs currently on the market for the treatment and prophylaxis of malaria include halofantrine (treatment only), atovaquone + proguanil, malarex and mefloquinine (prophylaxis only). With the aim of relieving the burden of malaria in the developing world, Novartis, under an agreement with the WHO, is offering its orally-active product, artemether + lumefantrine, at cost price for use in developing countries due to the high demand for effective therapies at affordable prices. It seems that non-profit drug therapies are playing an increasingly important role in the accessibility of effective, affordable drug therapies in Sub-Saharan Africa, and with the growing trend in the non-profit development arena, hope for the future looks promising.
It is also hoped that the publication of the genome sequence of P. falciparum in 2002 will lead to the identification of novel and effective antimalarial drug targets, introducing more pharmacological approaches to help treat one of the worlds most problematic diseases. Graph 2 shows the antimalarial drugs currently in active development based on their primary pharmacology.
