NECT Is Next Implementing the New Drug Combination Therapy for Trypanosoma brucei gambiense Sleeping Sickness 英文参考文献.docVIP

Viewpoints NECTIsNext:ImplementingtheNewDrugCombination TherapyforTrypanosomabruceigambienseSleeping Sickness OliverYun1*,GerardoPriotto2,JacquelineTong3,LaurenceFlevaud4,Franc?oisChappuis3,5 1Me′decins Sans Frontie`res/Doctors Without Borders, New York, New York, United States of America, 2Epicentre, Paris, France, 3Me′decins Sans Frontie`res, Geneva, Switzerland,4Me′decins SansFrontie`res,Barcelona,Spain,5GenevaUniversityHospitals,Geneva,Switzerland Introduction InApril2009,anewtreatmentoption, nifurtimox-eflornithine combination ther- apy (NECT), was added to the WHO Essential Medicines List (EML) for the treatment of second-stage T. b. gambiense HAT[6].NECTwasadded totheEML based on the high efficacy and good safety profile observed inall studies done to date, against a background of recog- nized severity of stage 2 disease and toxicity of existing treatments. Surveil- lance of adverse events was strongly recommended [7]. Compared with eflor- nithine monotherapy, NECT is easier to administer and requires fewer human and material resources. In the current Chagas disease (American trypanosomia- sis), and shown to have varying efficacy againstHAT[8–10]. Fatal if untreated, human African trypanosomiasis (HAT; sleeping sickness) afflictsanestimated50,000–70,000people each year [1], all in sub-Saharan Africa, with only a minority of cases (nearly 12,000in2008)beingreported[2].HAT is one of four neglected tropical diseases (NTDs) identified by the World Health Organization (WHO) as requiring Inno- vative and Intensified Disease Manage- ment (IDM), along with Chagas disease, leishmaniasis,andBuruliulcer[3].These particular NTDs have poorly understood burdens,lackoptimalcontroltools,receive From 2001 through 2004, Epicentre, the research and epidemiology arm of Me′decins Sans Frontie`res/Doctors With- out Borders (MSF), conducted two se- quential clinicaldrug-combination studies at HAT treatment sites in northern Uganda, which revealed the potential of theni