Advances 6: New antimalarials in development
Several new antimalarial drugs are in clinical development (53). These
include
- cipargamin, a spiroindolone compound that is more rapidly acting (in
terms of accelerating parasite clearance) than artemisinins. It
inhibits PfATPase4.
- artefenomel, a synthetic peroxide which is more stable and more slowly
eliminated arterolane.
- Ganaplacide, a potent imidazolopiperazine compound with an unknown
mode of action;
- P218, a dihydrofolate reductase inhibitor with preserved activity
against prevalent antifol resistant parasites.
- DSM265, a slowly acting dihydroorotate dehydrogenase inhibitor
- Ferroquine, an aminoquinoline compound with similarities to
chloroquine but activity against chloroquine resistant parasites.
- MMV390048 is a novel aminopyridine antimalarial compound that inhibitsPlasmodium phosphatidylinositol-4-kinase (PI4K)
Most of these drugs are in phase 2 testing, and so if some of these
compounds do proceed successfully to phase 3 studies and regulatory
approval, likely in combinations, and these new combination therapies
are well tolerated, effective and affordable they will be a welcome
addition to the antimalarial armamentarium. But this is will not happen
in the next few years. This means that current antimalarial treatment
strategies must make use of the currently available medicines.