Sleeping sickness is an awful disease that has afflicted hundreds of thousands of people in Africa. The customary treatment for sleeping sickness was also quite awful: a drug that is toxic to the kidneys, followed by an arsenic-based drug that’s toxic to the brain. The treatment kills up to a tenth of all patients. But thanks to a recent discovery, people can take the drug fexinidazole to treat the disease instead.
Sleeping sickness begins with fever and aches. Then things get worse. The parasite that causes the disease will disrupt sleeping patterns and cause aggressiveness and psychosis.
For many years, therapy would begin with a lumbar puncture to see if the parasite has invaded the central nervous system, followed by injections of a drug that damages your kidneys, followed by an arsenic-based drug that harms your brain. But left untreated, the acute form of sleeping sickness is almost always fatal. So people suffered through the treatment.
But scientists have discovered that fexinadazole can be used to treat sleeping sickness, first the chronic variety, and more recently for acute sleeping sickness as well. European regulators approved the drug based on results from a clinical trial showing that a 10-day course of pills cures acute sleeping sickness in 97% of patients. That will lead to approval of the drug by countries outside of the EU, many of which more or less automatically approve drugs approved by the European Medicines Agency.
As NPR notes,
How quickly the disease progresses depends on the variant. There’s the gambiense variant of the parasite, which causes the chronic form. It’s found in West and Central Africa, takes months to develop after infection and is responsible for 92% of all sleeping sickness cases, which are now down to under 1,000 per year.
Then there’s the rhodesiense variant, which causes the acute form…It’s only found in East Africa, with most recent cases in Malawi. This less common form of sleeping sickness only takes weeks to fully develop.
Both parasites are spread by tsetse flies. The chronic form only circulates in humans…
But the acute form has an animal reservoir, which makes surveillance a challenge. Experts know the rhodesiense parasite is always lurking in the animal population and has led to large outbreaks in the human population in the past….Experts think that an outbreak of this acute form of sleeping sickness infected half a million people in 1900 and more recently “there were outbreaks in the late ’80s, where in one year in Uganda, 8,000 people died,” according to Dr. Christian Burri, deputy head of the Department of Medicine at the Swiss Tropical and Public Institute, who was not directly involved in the latest clinical trial. There were outbreaks in the ’90s and 2000s as well…
There’s hope for an even better solution on the horizon. Earlier this year, NPR reported on a single-dose oral drug that could cure the chronic form of sleeping sickness; that drug has not yet been tested against the acute form, though there are plans to do so soon.
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