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The global pipeline of new medicines for the control and elimination of malaria.

Anthony MP, Burrows JN, Duparc S, Moehrle JJ, Wells TN - Malar. J. (2012)

Bottom Line: Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment.In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines.The nascent pipeline of new medicines is significantly stronger than five years ago.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medicines for Malaria Venture (MMV), 20 rte de Pré-Bois 1215, Geneva, Switzerland.

ABSTRACT
Over the past decade, there has been a transformation in the portfolio of medicines to combat malaria. New fixed-dose artemisinin combination therapy is available, with four different types having received approval from Stringent Regulatory Authorities or the World Health Organization (WHO). However, there is still scope for improvement. The Malaria Eradication Research agenda identified several gaps in the current portfolio. Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment. In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines. There is also a big opportunity for new medicines to prevent reinfection and to provide chemoprotection. This study reviews the global portfolio of new medicines in development against malaria, as of the summer of 2012. Cell-based phenotypic screening, and 'fast followers' of clinically validated classes, mean that there are now many new classes of molecules starting in clinical development, especially for the blood stages of malaria. There remain significant gaps for medicines blocking transmission, preventing relapse, and long-duration molecules for chemoprotection. The nascent pipeline of new medicines is significantly stronger than five years ago. However, there are still risks ahead in clinical development and sustainable funding of clinical studies is vital if this early promise is going to be delivered.

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The global portfolio of anti malarial medicines under development organized by development stage (as of March 2012). This includes all projects in formal regulatory preclinical safety and pharmacokinetic studies. Projects carried out in collaboration with MMV are shown in open boxes, whereas those with no active MMV involvement are shown with a dashed border. Data are from MMV internal reports[59], and Thomson Pharma. Compounds have been defined as ‘on hold’ when no significant progress along the development process has been made publicly available in the last 12 months. Natural products are defined as Herbal Medicinal Products undergoing testing in malaria patients in GCP quality studies, using standardized extracts. Updates of this figure are available on a quarterly basis[60]).
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Figure 3: The global portfolio of anti malarial medicines under development organized by development stage (as of March 2012). This includes all projects in formal regulatory preclinical safety and pharmacokinetic studies. Projects carried out in collaboration with MMV are shown in open boxes, whereas those with no active MMV involvement are shown with a dashed border. Data are from MMV internal reports[59], and Thomson Pharma. Compounds have been defined as ‘on hold’ when no significant progress along the development process has been made publicly available in the last 12 months. Natural products are defined as Herbal Medicinal Products undergoing testing in malaria patients in GCP quality studies, using standardized extracts. Updates of this figure are available on a quarterly basis[60]).

Mentions: What challenges remain for the next generation of medicines? There is a continual threat of the emergence of resistance, both to artemisinin and the partner medicine. This will require new classes of medicines. In addition to this there are four areas of focus for drug discovery. Firstly, in the context of malaria eradication, there is a need for medicines that can be administered as a single dose, which will allow direct monitoring of administration and improve compliance. These should have activity against all existing resistant strains of parasite. Secondly, new medicines are needed that kill gametocytes, and thus prevent transmission. Thirdly, there is a need for medicines which prevent relapses of P. vivax. Finally there is a need for molecules with longer half-lives to give chemoprophylaxis or long-term protection against re-infection[58]. Figure3 highlights the global portfolio of anti-malarial medicines in development organized by development stage (as of March 2012). Figure4 shows the global portfolio of anti-malarial medicines organized by therapeutic type, as discussed below.


The global pipeline of new medicines for the control and elimination of malaria.

Anthony MP, Burrows JN, Duparc S, Moehrle JJ, Wells TN - Malar. J. (2012)

The global portfolio of anti malarial medicines under development organized by development stage (as of March 2012). This includes all projects in formal regulatory preclinical safety and pharmacokinetic studies. Projects carried out in collaboration with MMV are shown in open boxes, whereas those with no active MMV involvement are shown with a dashed border. Data are from MMV internal reports[59], and Thomson Pharma. Compounds have been defined as ‘on hold’ when no significant progress along the development process has been made publicly available in the last 12 months. Natural products are defined as Herbal Medicinal Products undergoing testing in malaria patients in GCP quality studies, using standardized extracts. Updates of this figure are available on a quarterly basis[60]).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472257&req=5

Figure 3: The global portfolio of anti malarial medicines under development organized by development stage (as of March 2012). This includes all projects in formal regulatory preclinical safety and pharmacokinetic studies. Projects carried out in collaboration with MMV are shown in open boxes, whereas those with no active MMV involvement are shown with a dashed border. Data are from MMV internal reports[59], and Thomson Pharma. Compounds have been defined as ‘on hold’ when no significant progress along the development process has been made publicly available in the last 12 months. Natural products are defined as Herbal Medicinal Products undergoing testing in malaria patients in GCP quality studies, using standardized extracts. Updates of this figure are available on a quarterly basis[60]).
Mentions: What challenges remain for the next generation of medicines? There is a continual threat of the emergence of resistance, both to artemisinin and the partner medicine. This will require new classes of medicines. In addition to this there are four areas of focus for drug discovery. Firstly, in the context of malaria eradication, there is a need for medicines that can be administered as a single dose, which will allow direct monitoring of administration and improve compliance. These should have activity against all existing resistant strains of parasite. Secondly, new medicines are needed that kill gametocytes, and thus prevent transmission. Thirdly, there is a need for medicines which prevent relapses of P. vivax. Finally there is a need for molecules with longer half-lives to give chemoprophylaxis or long-term protection against re-infection[58]. Figure3 highlights the global portfolio of anti-malarial medicines in development organized by development stage (as of March 2012). Figure4 shows the global portfolio of anti-malarial medicines organized by therapeutic type, as discussed below.

Bottom Line: Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment.In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines.The nascent pipeline of new medicines is significantly stronger than five years ago.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medicines for Malaria Venture (MMV), 20 rte de Pré-Bois 1215, Geneva, Switzerland.

ABSTRACT
Over the past decade, there has been a transformation in the portfolio of medicines to combat malaria. New fixed-dose artemisinin combination therapy is available, with four different types having received approval from Stringent Regulatory Authorities or the World Health Organization (WHO). However, there is still scope for improvement. The Malaria Eradication Research agenda identified several gaps in the current portfolio. Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment. In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines. There is also a big opportunity for new medicines to prevent reinfection and to provide chemoprotection. This study reviews the global portfolio of new medicines in development against malaria, as of the summer of 2012. Cell-based phenotypic screening, and 'fast followers' of clinically validated classes, mean that there are now many new classes of molecules starting in clinical development, especially for the blood stages of malaria. There remain significant gaps for medicines blocking transmission, preventing relapse, and long-duration molecules for chemoprotection. The nascent pipeline of new medicines is significantly stronger than five years ago. However, there are still risks ahead in clinical development and sustainable funding of clinical studies is vital if this early promise is going to be delivered.

Show MeSH
Related in: MedlinePlus