In a study testing the safety and efficacy of treatment with tribendimidine for intestinal worm infections, researchers have published some positive results. The group - comprising of researchers from the Swiss Tropical Institute in Basel, the National Institute of Parasitic Diseases (IPD) in Shanghai, the Yunnan Institute of Parasitic Diseases in Simao, China, and the Jiangsu Institute of Parasitic Diseases in Wuxi, China - shows that this new Chinese drug is more successful than the standard albendazole for the treatment of hookworm, large roundworm, whipworm, threadworm, and tapeworm. Full results of the study are published in the open-access journal PLoS Neglected Tropical Diseases.

Over one billion people around the world have some type of intestinal worm infection (or intestinal helminth infection). Often they lead to problems in child and maternal health, nutritional status, physical performance, and cognitive development. If people had access to safe water and sanitation, many of these intestinal worm infections would become less prevalent. In reality, infections are usually handled using drugs that reduce morbidity. Currently there are four drugs that the World Health Organization recommends for treating helminth infections transmitted by soil. This small pool of medications means that there is a great concern that the worms will develop resistance to the drugs.

The drug tribendimidine is a member of a chemical class that is different than current treatments for worm infections. Developed at IPD and Shandong Xinhua Pharmaceutical in Zibo, China, the drug was approved by the China State Food and Drug Administration in 2004.

The safety and efficacy study consisted of 123 patients who were tested for intestinal helminth infections. Researchers randomly assigned some patients to take tribendimidine and others to take the common albendazole treatment. Doses were set at 200 mg for children aged 5 to 14 years and 400 mg for individuals 15 years old and higher.

In humans situated in a highly endemic setting in China, administration of a single oral dose of tribendimidine cured up to 92% of the common soil-transmitted helminth infections. The researchers also noted that the drug more effectively fought threadworm and tapeworm infections - 55% of threadworm infections and 67% of tapeworm infections were cured after treatment with tribendimidine. Further, the medication reduced the infection intensity of large roundworms and hookworms. Among the final study cohort, the researchers did not find any adverse treatment-related events.

Repeated dosing should be tested, and results should be validated with larger samples in various epidemiological settings in order to further improve treatment outcomes, note the authors.

Tribendimidine and Albendazole for Treating Soil-Transmitted Helminths, Strongyloides stercoralis and Taenia spp.: Open-Label Randomized Trial
Steinmann P, Zhou X-N, Du Z-W, Jiang J-Y, Xiao S-H, et al.
PLoS Neglected Tropical Disease (2008). 2(10): e322.
doi:10.1371/journal.pntd.
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: Peter M Crosta

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