Medical examination of a patient at the Mycetoma Research Center in Khartoum, Sudan.Credit: Lameck Ododo-DNDi
A successful trial of a treatment for the fungal disease, mycetoma has taken place in Sudan.
Results from phase 2 clinical trial by Drugs for Neglected Diseases Initiative (DNDi), demonstrated that a new oral treatment, fosravuconazole, is safe, tolerated, and effective in treating the fungal form of the chronic disabling disease.
Mycetoma infection is caused by bacteria actinomycetoma or fungi eumycetoma, from thorns pricking people walking barefoot. Children make up about 20-25% of all mycetoma patients. The disease is endemic in Mauritania, Mexico, Nigeria, Senegal, Sudan and India. Amputation is often the only option because existing treatments for both the fungal and bacterial forms are ineffective.
The results, announced at the 13th European Congress on Tropical Medicine and International Health in Utrecht, Netherlands show that the antifungal drug fosravoconazole is safe and efficient (85% efficacy rate) and has fewer side effects than the existing first line drug, itraconazole.
The trials that began in 2017 were done by DNDi in partnership with Sudan’s Mycetoma Research Center, Erasmus MC in the Netherlands and the drug-maker, Eisai, to assess the superiority of fosravuconazole over itraconazole. The researchers found that both drugs had similar efficacy rates, but that fosravuconazole has significant advantages as patients need to take two pills weekly compared to four tablets daily for itraconazole.
Borna Nyaoke, DNDi’s Head of the Mycetoma Disease Programme, told Nature Africa that the reduction in pill burden will increase compliance in patients, especially in Sub-Saharan Africa, who may have comorbidities such as tuberculosis and HIV.
