Inpharma 1382 - 12 Apr 2003

Fosmidomycin shows promisingantimalarial activity

A study conducted in Gabon and Thailand indicatesthat fosmidomycin, an inhibitor of the nonmevalonatepathway, may be an effective antimalarial agent,especially when used in combination with other drugs.

In this study, 26 patients with acute uncomplicatedPlasmodium falciparum malaria received oralfosmidomycin 1200mg every 8 hours for 7 days.*

Fever resolved in a mean time of 41 hours, andparasite clearance was also rapid (mean 44 hours). All20 patients evaluated for efficacy had negative bloodsmears on day 7, but 50% of evaluable patients (n = 18)had reappearance of P. falciparum parasitaemia on day28. There was a significant difference in efficacybetween study sites: taking recrudescence into account,the radical cure rate was 78% in Gabon and 22% inThailand. Factors such as host immunity or intrinsicsensitivity of the parasite in these two regions mayaccount for the difference. Fosmidomycin did notappear to have any gametocidal activity, but was welltolerated, with five patients experiencing mild-to-moderate gastrointestinal adverse events.

Fosmidomycin has a number of advantages as anantimalarial agent: it can be synthesised easily andcheaply, has a rapid onset of action and is effective andwell tolerated. However, its use as monotherapy islimited by a short half-life and high rate ofrecrudescence. The authors suggest that "researchshould be directed towards identification of a partnerdrug that would enhance its activity".* Financial support for this study was provided by Jomaa PharmakaGmbH.

Lell B, et al. Fosmidomycin, a novel chemotherapeutic agent for malaria.Antimicrobial Agents and Chemotherapy 47: 735-738, No. 2, Feb2003 800925701

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Inpharma 12 Apr 2003 No. 13821173-8324/10/1382-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved