Ganaplacide plus lumefantrine solid dispersion formulation: considerations for development and rollout

Abstract

Due to reliance on antimalarials for clinical case management, drug resistance is a recurrent challenge for malaria control and elimination that requires relentless discovery and development of novel medicines with new modes of action. 1 Feachem RGA Chen I Akbari O et al. Malaria eradication within a generation: ambitious, achievable, and necessary. Lancet. 2019; 394: 1056-1112 Summary Full Text Full Text PDF PubMed Scopus (167) Google Scholar Since the widespread use of chloroquine in the 1950s, resistance has compromised the efficacy of all major classes of antimalarial drugs that are widely used to treat Plasmodium falciparum. These drugs include sulfadoxine–pyrimethamine and since 2007, 2 Fairhurst RM Dondorp AM Artemisinin-resistant Plasmodium falciparum malaria. Microbiol Spectr. 2016; 4 (10.1128/microbiolspec.EI10-0013-2016.) Crossref PubMed Scopus (174) Google Scholar artemisinin-class medicines and partner drugs, which have been crucial for preventing deaths from malaria in the past two decades. 1 Feachem RGA Chen I Akbari O et al. Malaria eradication within a generation: ambitious, achievable, and necessary. Lancet. 2019; 394: 1056-1112 Summary Full Text Full Text PDF PubMed Scopus (167) Google Scholar , 3 Ishengoma DS Saidi Q Sibley CH Roper C Alifrangis M Deployment and utilization of next-generation sequencing of Plasmodium falciparum to guide anti-malarial drug policy decisions in sub-Saharan Africa: opportunities and challenges. Malar J. 2019; 18: 267 Crossref PubMed Scopus (15) Google Scholar Partial resistance to artemisinin-based combinations threatens their efficacy throughout southeast Asia, and is now emerging rapidly in sub-Saharan Africa. 4 Rosenthal PJ Has artemisinin resistance emerged in Africa?. Lancet Infect Dis. 2021; 21: 1056-1057 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar Although complete resistance has not yet been documented, this risk would be disastrous, necessitating urgent development of new antimalarial drugs that are effective against artemisinin-resistant parasites. Ganaplacide (KAF156) plus lumefantrine solid dispersion formulation combination for uncomplicated Plasmodium falciparum malaria: an open-label, multicentre, parallel-group, randomised, controlled, phase 2 trialGanaplacide plus lumefantrine-SDF was effective and well tolerated in patients, especially adults and adolescents, with uncomplicated P falciparum malaria. Ganaplacide 400 mg plus lumefantrine-SDF 960 mg once daily for 3 days was identified as the optimal treatment regimen for adults, adolescents, and children. This combination is being evaluated further in a phase 2 trial ( NCT04546633 ). Full-Text PDF