Emodepside found effective against T. trichiura, roundworm and hookworm infestation
Emodepside is new drug that shows activity against T. trichiura and roundworm and hookworm, according to a new study.
In this study, Emodepside showed high cure rates for all three soil-transmitted helminths,” said Emmanuel Mrimi, PhD candidate and first author of the study. The lowest dose tested, 5 mg of emodepside, cured 83% of people infected with whipworm. “An increase of emodepside to 15 mg resulted in complete cure of all people. Curing people infected with whipworm has never been achieved with the current anthelminthic treatments”. In addition, high efficacy was also observed against roundworm and hookworm.
“The drug has also other important characteristics. It is well tolerated and most adverse events in the trial were mild,” said Mrimi. The results have been published today in the renowned New England Journal of Medicine.
Current treatments for soil-transmitted helminth infections in humans have low efficacy against Trichuris trichiura. Emodepside — a drug in veterinary use and under development for the treatment of onchocerciasis in humans-is a leading therapeutic candidate for soil-transmitted helminth infection.
They conducted two phase 2a, dose-ranging, randomized, controlled trials to evaluate the efficacy and safety of emodepside against T. trichiura and hookworm infections. We randomly assigned, in equal numbers, adults 18 to 45 years of age in whom T. trichiura or hookworm eggs had been detected in stool samples to receive emodepside, at a single oral dose of 5, 10, 15, 20, 25, or 30 mg; albendazole, at a single oral dose of 400 mg; or placebo. The primary outcome was the percentage of participants who were cured of T. trichiura or hookworm infection (the cure rate) with emodepside 14 to 21 days after treatment, determined with the use of the Kato–Katz thick-smear technique. Safety was assessed 3, 24, and 48 hours after the receipt of treatment or placebo.
RESULTS
A total of 266 persons were enrolled in the T. trichiura trial and 176 in the hookworm trial. The predicted cure rate against T. trichiura in the 5-mg emodepside group was higher than the predicted cure rate in the placebo group and the observed cure rate in the albendazole group
A dose-dependent relationship was shown in participants with hookworm: the observed cure rate was 32% in the 5-mg emodepside group and 95% in the 30-mg emodepside group; the observed cure rates were 14% in the placebo group and 70% in the albendazole group.
In the emodepside groups, headache, blurred vision, and dizziness were the most commonly reported adverse events 3 and 24 hours after treatment; the incidence of events generally increased in a dose-dependent fashion.
Most adverse events were mild in severity and were self-limited; there were few moderate and no serious adverse events.
Emodepside showed activity against T. trichiura and hookworm infections.
Reference:
Emmanuel C. Mrimi, M.Sc., Sophie Welsche, Ph.D., Said M. Ali, M.Sc., Jan Hattendorf, Ph.D., and Jennifer Keiser, Ph.D.Emodepside for Trichuris trichiura and Hookworm Infection. N Engl J Med 2023; 388:1863-1875. DOI: 10.1056/NEJMoa2212825
