Drug makers can help stop the spread of antimalarial drug resistance, says expert

By Flora Southey contact

- Last updated on GMT

GettyImages/frank600
GettyImages/frank600
Antimalarial drug resistance in Southeast Asia is threatening the control and elimination of malaria, and drug makers can help, says a tropical medicine expert.

Associate professor of tropical medicine at the London School of Hygiene & Tropical Medicine, Shunmay Yeung, told us an increasing number of microorganisms in Southeast Asia are no longer sensitive to the antimalarial drug artemisinin.

“Artemisinin-resistant parasites have a selective advantage over artemisinin-sensitive parasites,” ​she told us.

“This means they can survive and multiply when exposed to treatment with artemisinin, whilst the sensitive parasites are killed off,” ​she explained. 

The Greater Mekong Delta subregion

Earlier this month, The Lancet​ announced that drug resistant malaria parasites – plasmodium falciparum ​– had been detected in Vietnam.

According to the report, artemisinin resistance is associated with mutations in the pfKelch ​gene.

“Initially multiple independent ​Kelch mutations were observed, but in a recent sinister development, a single dominant artemisinin-resistant ​P falciparum C580Y mutant lineage has arisen in western Cambodia, outcompeted the other resistant malaria parasites, and subsequently acquired resistance to​[antimalarial drug] piperaquine.

Yeung similarly told us artemisinin resistance is spreading quickly across the Southeast Asian region.

“Resistance was first described on the Cambodia-Thai border in 2008 and is now found throughout the region and getting worse,” ​she told us.

“There seems to be a combination of emergence of resistance strains in different locations, and spread of resistance strains from one place to another,” ​she added.

Combination therapies

 Yeung told us drug makers can respond to this crisis by “developing new, effective and safe, fixed-dose combination therapies where the partner drugs have novel modes of action but similar half-lives.”

“This is to avoid either drug being left ‘unprotected’ by the other,” ​she said.

The approach is being trialled by the Worldwide Antimalarial Resistance Network (WWARN), which is testing several Triple Artemisinin-based Combination Therapies (TACT​).

“The project examines the safety, tolerability and efficacy of these TACT combinations, and study the pharmacokinetic and dynamic drug interactions,” ​said WWARN.

Related topics: Globalisation, Drug Delivery

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