Research in treatment
Sleeping sickness is notoriously difficult to treat considering toxicity and protocol complexity of the drugs currently available for treatment. Furthermore, in the last years, parasite resistance to existing drugs has started to appear and the lack of new molecules to treat the disease has become a major issue.
Following the discovery of suramin (1920), pentamidine (1940) and melarsoprol (1949), a last drug, eflornithine, was registered for the treatment of sleeping sickness in 1990.
The development of drugs for treatment of sleeping sickness: a historical review, by Dietmar Steverding.
Eflornithine is ineffective in the Rhodesiense form of the disease and it is cumbersome to administer requiring enough skilled staff and bulky supplementary material and therefore elaborate logistics. As a consequence, despite a lower toxicity than melarsoprol, its extensive use by National Sleeping Sickness Control Programmes (SSNCP) has been hindered.
The use of eflornithine by NSSCPs was increased, based on its free distribution as a kit containing all the materials, expendables and equipment needed for its administration. WHO also trained national staff on how to manage the drug.
The development of a combination therapy involving nifurtimox and eflornithine, which has been approved by the WHO Expert Committee on the Selection and Use of Essential Medicines at its 17th meeting on 30 April 2009, has facilitated the access to less toxic but effective treatments for the gambiense form. WHO continues the supply - in collaboration with MSF-Logistique - of the drugs and the additional materials needed for their use and will ensure the training to get skilled staff at country level to guarantee adequate use of the combination.
Other recent advances made in the treatment of sleeping sickness involve use of simplified protocols namely the short melarsoprol course either for T. b. gambiense as for T. b. rhodesiense. A clinical trial is ongoing on a short course to reduce treatment of pentamidine to three days. Another clinical trial is planned for oral use of melarsoprol.
Different efforts to develop new drugs are on going.
Drugs for Neglected Disease initiative (DNDi)
Is a collaborative, patients’ needs-driven, non-profit drug research and development organization that is developing new treatments for Neglected Diseases. DNDi’s primary focus has been the development of drugs for the most neglected diseases, such as human African trypanosomiasis (HAT, or sleeping sickness), visceral leishmaniasis (kala-azar), and Chagas disease.
Consortium to Develop Drugs for Neglected Tropical Diseases
A Consortium was formed to boost drug development for the treatment of two deadly diseases, African sleeping sickness and Leishmaniasis.
University of North Carolina and DNDi Agree to Synergize Novel R&D Efforts to Develop Drugs for the Most Neglected
The University of North Carolina is leading the Consortium for Parasitic Drug Development (CPDD), set up to work in the discovery and development of new drugs for the treatment of neglected diseases. mainly focused on human African trypanosomiasis and visceral leishmaniasis.
The University of North Carolina at Chapel Hill (UNC-CH) and the Drugs for Neglected Diseases initiative (DNDi) have entered into a synergistic collaboration to ensure that needs-driven. R&D for the most neglected diseases is handled in the most efficient manner possible.
The university of north carolina and DNDi agree to synergize novel R&D efforts to develop drugs for the most neglected
University of Dundee, College of Life Sciences
The College of Life Sciences is committed to maximising its Research Impact. Over 200 potential targets in the African trypanosome have been identified, assessed and prioritized for a drug discovery campaign using a number of important selection criteria.
University of Glasgow
The Institute for Infection, Immunology and Inflammation is developing a safer version of the melarsoprol that could be administered orally in pill form.
The Faculty of Biomedical and Life Sciences is developing new models to test the ability of drugs to treat this fatal disease in the brain.