Repurposing drugs in dengue fight


Hepatitis C medicine and others being tested in search for quicker treatment

PETALING JAYA: A number of repurposed antiviral drugs, including one that is being used to treat Hepatitis C, is currently being evaluated as potential treatment against dengue, according to Drugs for Neglected Diseases initiative (DNDi).

DNDi South-East Asia director Jean-Michel Piedagnel pointed out that the antiviral Nelfinavir is one of these promising drugs currently under evaluation by DNDi and Dengue Alliance partners.

He mentioned Nelfinavir as one of the potential drugs used in the drug repurposing.

In principle the steps involved in drug repurposing are a quicker method in the fight against dengue. It includes identifying the drug, getting approval for the study protocol, conducting clinical trials and then getting approval from the Food and Drug Administration.

“Researchers from the Dengue Alliance are gathering all the needed safety and efficiency data to make an evidence-based decision on which drug that eventually will be selected for the next phase, and tested on humans during the clinical trial.

“We anticipate being able to decide and announce this drug candidate within a few weeks. But Nelfinavir has not yet been named as a candidate for clinical development,” he told The Star, adding they are currently at the preclinical stage of 1 and 2.

Recently Health Minister Datuk Seri Dr Dzulkefly Ahmad revealed that the drug repurposing method is being used as part of the latest approach in the fight against dengue.

On this, Piedagnel clarified that it was likely the minister was referring to the mandatory pre-clinical studies currently being conducted by Dengue Alliance researchers to evaluate the drug candidates, including Nelfinavir.

As such, he said once all pre-clinical data is collected, they can determine which antiviral drug will undergo clinical trial.

Piedagnel added that the most effective strategy in reaching the goal is by developing a treatment combination of different drugs.

For this reason, Dengue Alliance researchers are in parallel looking for a host-directed therapy that could be administered alongside this antiviral drug.

“Drawing from their previous highly successful collaboration with the MOH in delivering a new and effective Hepatitis C treatment, we are optimistic about replicating the success.

“The goal is to create a treatment for dengue that is affordable, equitable and accessible.

“Using repurposed drugs ... could have a low risk of failure, shorter research and development cycle, high success rate, and less investment needed as these drugs have been approved by the regulatory bodies,” Piedagnel said.

International Medical University deputy vice-chancellor of Research Prof Datuk Dr Lokman Hakim Sulaiman said drug repurposing is indeed a quicker method in the fight against dengue.

However, he agreed that such a method could have been explored earlier as there was no drug yet for dengue.

“Drug repurposing is faster because there is no need for long tedious safety studies.

“Since the drug is already in use for treatment of other diseases/infection, therefore it is also less costly,” he said, adding that the focus should be on dengue as the disease is most endemic in the country.

On the conditional approval given for Takeda’s Qdenga dengue vaccine, Dr Lokman suggested that those living in highly endemic dengue areas, especially in the Klang Valley, should consider taking it.

The former Health deputy director-general (public health) added that it was not just about individual efforts but more of the whole of society and whole of government efforts to curb the spread of dengue.

As of March 9, a total of 457 daily cases with 585 active outbreak localities have been recorded nationwide.

From Jan 1 until March 3, a total of 19 deaths have also been recorded.

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