Lancet publication: novel malaria drug suitable for prophylaxis

Malaria remains one of the most serious infectious diseases worldwide and is responsible for more than 600,000 deaths a year, mostly children. Prophylaxis and treatment of the disease is complicated due to emerging resistance to most classes of malaria drugs. Cabamiquine is a malaria drug candidate with a novel mechanism of action: it inhibits protein synthesis in the parasite. Previous research had shown that the drug is well tolerated and is able to to cure malaria when the parasite is present in red blood cells.

The controlled human infection study (CHIM) described in the publication in The Lancet was conducted by the group of infection expert Professor Meta Roestenberg of Leiden University Medical Centre in collaboration with CHDR's Infectious Diseases group. Volunteers were divided by a randomised procedure into different dose groups and a placebo group. All groups received about 3,200 purified malaria parasites (Plasmodium falciparum) intravenously.  They were then administered the drug or placebo two hours or 96 hours after infection. Malaria parasites first develop in the liver for several days before they enter red blood cells. Symptoms emerge once the parasites migrate from the liver to the blood.

The study showed that cabamiquine is useful in malaria prophylaxis. 'We saw a dose-dependent decrease in the probability that a participant had parasites in their blood after infection,' says Dr Ingrid De Visser-Kamerling, Associate Research Director Infectious Diseases. 'Cabamiquin was found to be effective when administered a few hours after infection and when given four days later. We already know that it is effective against malaria parasites in the blood and that it has quite a long half-life. We therefore expect that it can be developed into a prophylactic drug that only needs to be administered once a month.' Further development of cabamiquin will require further clinical trials, including in areas where malaria is endemic.