Emerging treatments

Arpraziquantel

Arpraziquantel (L-praziquantel) is a praziquantel derivative formulated as a palatable orodispersible tablet, which is suitable for use in preschool-aged children. An open-label, partly randomised, phase 3 study found similar cure rates between arpraziquantel and praziquantel (87.8% versus 81.3%). Common adverse events included abdominal pain, diarrhoea, vomiting, and somnolence.[77] The European Medicines Agency has approved arpraziquantel for the treatment of schistosomiasis in children aged 3 months to 6 years who weigh at least 5 kg.

Artemisinin and derivatives

The antimalarial drug and its derivatives (artemether and artesunate) are effective against immature schistosome larvae, but do not affect adult worms.[78] Studies are ongoing to determine whether artemisinin during acute illness can be effective in eliminating migrating immature larval burden and prevent establishment of chronic infection.[79]​​[80][81]​ Artemisinin derivatives alone are inferior to praziquantel in chronic infection.[82] In high-transmission settings, it is expected that combination therapy with praziquantel and artemisinin may reduce egg burden more effectively than praziquantel alone.[83] The role of combination therapy with artemisinin derivatives in the management of schistosomiasis infection has not been clearly defined.[82][84]​​[85]​ Evidence on the use of artemisinin derivatives for urinary schistosomiasis is currently inconclusive, and further research is warranted.[86]

Use of this content is subject to our disclaimer