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  3. Fosmidomycin as an antimalarial drug: a meta-analysis of clinical trials

Fosmidomycin as an antimalarial drug: a meta-analysis of clinical trials

  • Future Microbiol. 2015;10(8):1375-90. doi: 10.2217/FMB.15.60.
Jose Francisco Fernandes 1 2 3,  Bertrand Lell 1 2,  Selidji Todagbe Agnandji 1 2,  Regis Maurin Obiang 2,  Quique Bassat 4 5,  Peter Gottfried Kremsner 1 2,  Benjamin Mordmüller 1 2,  Martin Peter Grobusch 1 2 3
Affiliations

Affiliations

  • 1 Institut für Tropenmedizin, University of Tübingen, Wilhelmstraße 27, D-72074 Tübingen, Germany.
  • 2 Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon.
  • 3 Center of Tropical Medicine & Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, The Netherlands.
  • 4 Barcelona Center for International Health Research (CRESIB, Hospital Clíníc-Universitat de Barcelona), Barcelona, Spain.
  • 5 Centro de investigação em saúde de Manhiça (CISM), Maputo, Mozambique.
PMID: 26228767 DOI: 10.2217/FMB.15.60
Abstract

With first indications of resistance against artemisinin compounds, the development of novel alternative antimalarials remains an urgent need. One candidate is fosmidomycin (Fos), a phosphonic acid derivative. This PRISMA guideline-adhering and PROSPERO-registered systematic review and meta-analysis provides an overview of the state-of-the-art of the clinical development of Fos as an antimalarial. Pooling six clinical trials of Fos against uncomplicated malaria in African children yielded an overall day 28 cure rate of 85% (95% CI: 71-98%); a Parasite clearance time of 39 h; and a fever clearance time of 30 h. In four adult cohorts, the corresponding values were 70% (95% CI: 40-100%), 49 and 42 h, respectively. Data suggest that besides the partner drug, formulation determines efficacy. We advocate further clinical development of Fos-combinations. PROSPERO registration number: CRD42014013688.

Keywords

DOXP reducto-isomerase; antimalarial drug; clinical studies; drug development; fosmidomycin; fosmidomycin-clindamycin; malaria.

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