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China in liver fluke drug breakthrough

30th November 2010

An experimental drug invented in China may help treat Southeast Asian liver fluke, Opisthorchis viverrini, according to a recent Swiss study, and has a 70% cure rate.

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The researchers also found that antimalarial drugs such as artemether, artesunate, and mefloquine should not be used to treat the flukes.

The Southeast Asian liver fluke is mainly found in Thailand, Laos, Vietnam, and Cambodia.

The parasite burrows into the flesh of fish.

When humans eat the fish, they pass the parasite's eggs into the water, renewing the organisms life cycle, as well as infecting themselves with it.

For the recent study, the Swiss researchers compared the Chinese drug (tribendimidine) to the standard liver fluke treatment (praziquantel), as well as to a class of antimalarial drugs reported to work against Opisthorchis viverrini.

Jennifer Keiser of the Swiss Tropical and Public Health Institute, who led the study, said that her team's results were very encouraging for tribendimidine, and that cure rates were also much better than praziquantel.

She said that, while researchers would need to confirm the results in larger trials, the drug would also need to move outside the Chinese market in order to be developed further.

For the purposes of the study, the researchers tested the drugs on school children in Laos, where infection rates are above 50%.

After treating 125 children with one of five randomly selected options, the researchers measured the cure rate of the various drugs, as well as the number of eggs expelled from the children's bodies following a round of treatment.

Children treated with tribendimidine had a 70% cure rate, the highest.

Children treated with praziquantel, the standard treatment today, had a 56% cure rate.

Less than 10% of the children who were treated using the anti-malarial drugs were treated, and some drugs did not seem to have any effect on the parasites at all.

The researchers also said that praziquantel and tribendimidine were very good at clearing eggs.

According to World Health Organisation (WHO) estimates, about 67 million people are at risk of becoming infected with Southeast Asian liver flukes, which can hasten the development of certain types of cancers, including bile duct cancer.

Over time, all types of parasite evolve drug-resistance, and many doctors and researchers fear that Opisthorchis viverrini has already developed resistance to praziquantel.

The researchers said that praziquantel was currently the only drug treatment currently available outside China.

 

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