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 randomized, phase 3 study found similar cure rates between arpraziquantel and praziquantel (87.8% versus 81.3%). Common adverse events included abdominal pain, diarrhea, vomiting, and somnolence.[78] The European Medicines Agency has approved arpraziquantel for the treatment of schistosomiasis in children ages 3 months to 6 years who weigh at least 5 kg.

Artemisinin and derivatives

The antimalarial drug artemisinin and its derivatives (artemether and artesunate) are effective against immature schistosome larvae, but do not affect adult worms.[79] 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.[80]​​[81][82]​ Artemisinin derivatives alone are inferior to praziquantel in chronic infection.[83] In high-transmission settings, it is expected that combination therapy with praziquantel and artemisinin may reduce egg burden more effectively than praziquantel alone.[84] The role of combination therapy with artemisinin derivatives in the management of schistosomiasis infection has not been clearly defined.[83][85]​​[86]​ Evidence on the use of artemisinin derivatives for urinary schistosomiasis is currently inconclusive, and further research is warranted.[87]

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