Current drug strategies for the treatment and control of schistosomiasis

ABSTRACT

Introduction

Schistosomiasis, one of the current Neglected Tropical Diseases (NTDs) affects over 230 million people globally, with nearly 700 million at risk in more than 74 countries. Praziquantel (PZQ) has served as the primary treatment for the past four decades; however, its effectiveness is limited as it solely eliminates adult worms. In regions where infections are frequent, PZQ exhibits only temporary efficacy and has restricted potential to disrupt the prolonged transmission of the disease.

Areas covered

A comprehensive exploration using the PubMed database was conducted to review current pharmacotherapy approaches for schistosomiasis. This review also encompasses recent research findings related to potential novel therapeutics and the repurposing of existing drugs.

Expert opinion

Current schistosoma treatment strategies, primarily relying on PZQ, face challenges like temporary effectiveness and limited impact on disease transmission. Drug repurposing, due to economic constraints, is decisive for NTDs. Despite PZQ’s efficacy, its failure to prevent reinfection highlights the need for complementary strategies, especially in regions with persistent environmental foci. Integrating therapies against diverse schistosome stages boosts efficacy and impedes resistance. Uncovering novel agents is essential to address resistance concerns in tackling this neglected tropical disease. Integrated strategies present a comprehensive approach to navigate the complex challenges.

KEYWORDS:

• Schistosomiasis
• Neglected tropical diseases (NTDs)
• Praziquantel (PZQ)
• drug repurposing
• drug discovery

Article highlights

• Schistosomiasis, an NTD, affects 230 million people globally, with 700 million at risk in 74 countries.

• Praziquantel’s (PZQ) four-decade use is impeded by limited efficacy against adult worms and a temporary impact on disease transmission.

• Preventive chemotherapy through Mass Drug Administration (MDA) with Praziquantel (PZQ) is the primary approach in addressing schistosomiasis. Integrated with health education, snail control, and sanitation actions, it strives for comprehensive elimination.

• Current strategies also include studying candidates from previous treatments, repurposing existing drugs, advancements in formulations, and exploring combination therapy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the Doctoral Fellowship Program of “Junta de Castilla y León” co-funded by “Fondo Social Europeo” (MAV-M Resolución ORDEN EDU/1868/2022). Instituto de Salud Carlos III grant PI22/01721 (AM, JL-A), MCIN/AEI/doi 10.13039/501100011033 co-founded by the European Union, grant PID2022-136462NB-I00 (AM, BV) and MCIN/AEI/doi 10.13039/501100011033 co-founded by European Union grant PID2021-127471OB-I00 (JL-A, RP) Rafael Peláez (RP) is the Principal Researcher of the project PID2021-127471OB-I00.