Ferroquine

In 2022, malaria caused approximately 249 million cases and 608,000 deaths, primarily in Africa. Current treatments target asexual blood-stage parasites, gametocytes, and liver hypnozoites. Standard guidelines recommend a 3-day course of artemisinin-based combination therapies as a first-line treatment of uncomplicated malaria and parenteral artesunate for severe malaria. However, the emergence of partial resistance to artemisinin derivatives threatens the treatment efficacy, highlighting the urgent need for novel antimalarial drugs.

This review summarizes recent progress in the clinical development of antimalarials particularly non-artemisinin compounds under target product profile-1.

Data were gathered from Medicines for Malaria Venture (MMV)'s portfolio and clinical trial databases between 2020 and 2024.

Sixteen clinical trials were reviewed, including safety and efficacy studies involving healthy volunteers, experimentally infected volunteers, asymptomatic Plasmodium falciparum carriers and malaria patients. Six trials evaluated the safety and tolerability of MMV533, ZY19489, INE963, GSK701/MMV367 and intravenous KAE609 in healthy volunteers. Efficacy trials involving experimentally infected volunteers assessed ZY19489 and GSK701/MMV367, whereas studies on asymptomatic carriers tested ZY19489/ferroquine and cabamiquine/pyronaridine. Trials on malaria patients investigated combinations of ganaplacide/lumefantrine-SDF, cabamiquine/pyronaridine, both oral and intravenous cipargamin and INE963.

Although attrition remains a possibility, several promising candidate drugs with novel modes of action are advancing through clinical development. Many are expected to become available for treating uncomplicated and severe malaria within the next decade. These new antimalarials could significantly enhance malaria treatment, reduce resistance, and support global health efforts towards malaria control, elimination and, potentially, eradication.

Hepatitis C viral infections are a leading cause of long‐term liver disease and hepatocellular cancer in drug addicts and other at‐risk people, including those who require frequent blood transfusions. Current drug treatments are expensive and have numerous side effects; hence, more affordable treatment plans are required. Furthermore, there are not any preventives in the market. HCV comes in 8 genotypes, and the prevalence of genotypes varies worldwide. Hence, affordable, pangenotypic preventives are needed. In this study, we selected 83 natural compounds that have been shown to have anti‐HCV properties. In silico screening was done via docking assays to check whether any of these compounds could potentially bind to the receptor interaction site of surface protein‐E2 of genotypes 1a, 1b, 2a, 3a, and 3b. From the binding energies, five compounds were selected that exhibited pangenotypic effects. MD simulation was conducted on these compounds to assess their interaction properties. ADME properties and further drug likeliness revealed one of the compounds, Terfenadine, to be similar to an anti‐allergy drug, Fexofenadine. To assess in vitro validation, a binding assay was set up using E2‐GFP expressed in HEK293T cells with the primary receptor CD81. It was observed that Terfenadine (used as the derivative Fexofenadine) could inhibit an interaction between CD81 and E2. We conclude that there is potential for Terfenadine/fexofenadine to be effective as a preventive against the HCV genotypes 1a, 1b, 2a, 3a, and 3b. Further clinical validation is required to confirm these findings.