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Fexinidazole (Fexinidazole Winthrop°) and sleeping sickness caused by Trypanosoma brucei gambiense

FEATURED REVIEW Human African trypanosomiasis (or sleeping sickness) is endemic in many countries in sub-Saharan Africa. Is fexinidazole more effective than the standard treatments for sleeping sickness due to T. brucei gambiense? Does it have fewer adverse effects? Is it easier to use?
Full review (5 pages) available for download by subscribers.

Fexinidazole (Fexinidazole Winthrop°, Sanofi Aventis) has been evaluated by the European Medicines Agency (EMA) as a treatment for both stages of sleeping sickness due to T. brucei gambiense, in adults and children aged 6 years or more and weighing at least 20 kg. The evaluation was conducted through a European procedure for drugs intended exclusively for use outside the European Union.

  •  A REAL ADVANCE  Fexinidazole is the first drug for patients with trypanosomiasis caused by Trypanosoma brucei gambiense that can be taken orally and has high efficacy in both stages of the disease and acceptable adverse effects. Compared with pentamidine and NECT (nifurtimox + eflornithine combination therapy), which require daily injections or infusions for 7 days, oral administration is a major advantage for patients living in countries with limited health infrastructure, often in rural areas, and sometimes far from a healthcare facility. However, NECT remains the first choice for patients with the most advanced forms of the disease and who have access to this treatment, as it is probably more effective in this situation. 

  •  EDITORS' OPINION  The development of fexinidazole for human African trypanosomiasis caused by Trypanosoma brucei gambiense is a fine example of a productive collaboration between several partners, led by the non-profit Drugs for Neglected Diseases Initiative (DNDi). When each partner fulfils their respective role, no more and no less, it is possible to develop extremely useful drugs, even in fields that are considered unprofitable. More > HERE

©Prescrire 1 December 2020

Source: "Fexinidazole (Fexinidazole Winthrop°) and sleeping sickness caused by Trypanosoma brucei gambiense. Effective and more convenient than injectable treatments" Prescrire International 2020; 29 (221): 285-289. Subscribers only.

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