Drug associations as alternative and complementary therapy for neglected tropical diseases

• Published in: Acta tropica Vol. 225; p. 106210
• Main Authors: Ferraz, Leslie Raphael Moura, Silva, Laysa Creusa Paes Barreto Barros, Souza, Myla Lôbo de, Alves, Larissa Pereira, Sales, Victor de Albuquerque Wanderley, Barbosa, Ilka do Nascimento Gomes, Andrade, Mateus Chaves de, Santos, Widson Michael dos, Rolim, Larissa Araújo, Rolim-Neto, Pedro José
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-01-2022
• Subjects: Alternative therapy; Combination therapy; Drug conjugation; Drug repositioning; Drug repositioning; Alternative therapy; Combination therapy; Drug conjugation
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2021.106210

•Efficient NTD control can be achieved when different public health approaches are put in place, including the supply and distribution of more effective drugs.•There is a serious lack of R&D funding for new agents to combat NTDs.•FDCs can be presented as viable alternatives for combating NTDs.•FDCs can promote simplification of the therapeutic regimen, circumvent parasitic resistance and problems related to toxicity.•Despite efforts to increase the therapeutic arsenal, pharmacokinetic studies to confirm the efficacy and maintenance of the quality of therapy are still insufficient.
The present paper aims to establish different treatments for neglected tropical disease by a survey on drug conjugations and possible fixed-dose combinations (FDC) used to obtain alternative, safer and more effective treatments. The source databases used were Science Direct and PubMed/Medline, in the intervals between 2015 and 2021 with the drugs key-words or diseases, like "schistosomiasis", "praziquantel", "malaria", "artesunate", "Chagas' disease", "benznidazole", "filariasis", diethylcarbamazine", "ivermectin", " albendazole”. 118 works were the object of intense analysis, other articles and documents were used to increase the quality of the studies, such as consensuses for harmonizing therapeutics and historical articles. As a result, an effective NTD control can be achieved when different public health approaches are combined with interventions guided by the epidemiology of each location and the availability of appropriate measures to detect, prevent and control disease. It was also possible to verify that the FDCs promote a simplification of the therapeutic regimen, which promotes better patient compliance and enables a reduction in the development of parasitic resistance, requiring further studies aimed at resistant strains, since the combined APIs usually act by different mechanisms or at different target sites. In addition to eliminating the process of developing a new drug based on the identification and validation of active compounds, which is a complex, long process and requires a strong long-term investment, other advantages that FDCs have are related to productive gain and gain from the industrial plant, which can favor and encourage the R&D of new FDCs not only for NTDs but also for other diseases that require the use of more than one drug.