ABSTRACT

Introduction

Moxidectin is a milbemycin endectocide recently approved for the treatment of human onchocerciasis. Onchocerciasis, earmarked for elimination of transmission, is a filarial infection endemic in Africa, Yemen, and the Amazonian focus straddling Venezuela and Brazil. Concerns over whether the predominant treatment strategy (yearly mass drug administration (MDA) of ivermectin) is sufficient to achieve elimination in all endemic foci have refocussed attention upon alternative treatments. Moxidectin’s stronger and longer microfilarial suppression compared to ivermectin in both phase II and III clinical trials indicates its potential as a novel powerful drug for onchocerciasis elimination.

Areas covered

This work summarizes the chemistry and pharmacology of moxidectin, reviews the phase II and III clinical trials evidence on tolerability, safety, and efficacy of moxidectin versus ivermectin, and discusses the implications of moxidectin’s current regulatory status.

Expert opinion

Moxidectin’s superior clinical performance has the potential to substantially reduce times to elimination compared to ivermectin. If donated, moxidectin could mitigate the additional programmatic costs of biannual ivermectin distribution because, unlike other alternatives, it can use the existing community-directed treatment infrastructure. A pediatric indication (for children <12 years) and determination of its usefulness in onchocerciasis–loiasis co-endemic areas will greatly help fulfill the potential of moxidectin for the treatment and elimination of onchocerciasis.

中文翻译：

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Moxidectin：一种人类盘尾丝虫病的口服治疗药物。

摘要

介绍

莫昔克丁是最近被批准用于治疗人盘尾丝虫病的一种米尔倍霉素内酯。盘尾丝虫病专门用于消除传播，是非洲，也门和亚马逊地区的委内瑞拉和巴西的丝虫病流行地区。有关主要治疗策略（伊维菌素的年度大规模药物管理（MDA））是否足以在所有地方性病灶中消除的担忧，已将注意力重新集中在替代治疗上。在II期和III期临床试验中，莫昔克丁与伊维菌素相比，对微丝线的抑制作用更强，更长，这表明它具有作为消灭盘尾丝虫病的新型强大药物的潜力。

覆盖区域

这项工作总结了莫昔克丁的化学和药理作用，回顾了莫昔克丁与伊维菌素的耐受性，安全性和有效性的II和III期临床试验证据，并讨论了莫昔克丁当前调节状态的含义。

专家意见

与伊维菌素相比，莫昔克丁的卓越临床性能具有显着减少消除时间的潜力。如果捐赠，莫昔克丁可以减轻伊维菌素每半年分发的额外程序成本，因为与其他替代品不同，它可以使用现有的社区指导治疗基础设施。儿科适应症（适用于<12岁的儿童）以及其在盘尾丝虫病-疯子病流行地区的有用性的确定将极大地帮助发挥莫昔克丁治疗和消除盘尾丝虫病的潜力。