New treatments for onchocerciasis – the current clinical pipeline

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Onchocerciasis, also termed river blindness, is a disease caused by the parasite Onchocerca volvulus and is the second most common cause of blindness due to infection. This neglected tropical disease is currently treated by the mass drug administration of ivermectin, with annual, community-directed treatment being carried out in high burden regions.

However, this approach has its challenges; control programs can be disrupted or delayed due to resource limitation or instability, in addition, cross-border foci make logistics challenging [1]. The drug itself also has downfalls; ivermectin suppresses the production of microfilariae by female worms but it doesn’t target adult worms, moreover, parasites have a low susceptibility to ivermectin when onchocerciasis is co-endemic with loiasis, and finally there is potential for the emergence of resistant parasite strains [1].

Some of these difficulties could be addressed with new drugs or drug combinations with higher effect for the parasite – leading us to ask, what new treatments are currently in the clinical pipeline?

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