BREAKTHROUGHS BLOG

November 19, 2018

Research Roundup: New treatment for sleeping sickness, innovations to combat AMR, and Merck Ebola vaccine update

Ansley Kahn
Program Assistant
GHTC
PATH/Mike Wang
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The first all-oral drug for sleeping sickness received a positive scientific opinion Friday from the European Medicines Agency, paving the way for the treatment to be rolled out in endemic countries in 2019. Developed by the Drugs for Neglected Diseases initiative (DNDi) and Sanofi, fexinidazole is a tablet taken once daily for ten days that treats the most common form of sleeping sickness, a neglected tropical disease spread by tsetse flies that causes neuropsychiatric symptoms and can be deadly if left untreated. Current treatments for sleeping sickness require a complicated series of infusions and pills, are costly, and involve long hospital stays, which pose a huge burden on health systems to treat the disease. Fexinidazole is a simple once-a-day pill that could reduce this logistical burden. About 65 million people in sub-Saharan Africa are at risk of sleeping sickness.

A novel device colloquially known as a “wiggle- ometer” may one day help physicians and health workers fight the growth of antimicrobial resistance (AMR). The device, which is a sub-cellular fluctuation imaging machine, detects minute movements in bacteria to determine whether they’ve been affected by an antibiotic, signaling to doctors whether a specific antibiotic works against a specific infection. Today, many physicians prescribe a broad-spectrum antibiotic to patients because of the lack of access to rapid diagnostic tests to determine the nature of an infection and what antibiotics will be effective against it. This overuse and misuse of antibiotics drives the growth of AMR. The “wiggle-ometer” is one of more than 70 projects from around the world competing for the £8 million Longitude Prize, launched by the United Kingdom government to fight AMR. The prize will be awarded to a team that develops an affordable, accurate, easy-to-use test for bacterial infections.

Merck has begun the process of submitting the evidence required for regulatory approval of its experimental Ebola vaccine with the US Food and Drug Administration (FDA). The FDA gave the vaccine a “breakthrough therapy designation” in 2016—a form of regulatory fast track which allows a manufacturer to meet more frequently with the FDA to discuss filing and to submit material on a rolling basis, all with the aim of speeding the item through licensure. Merck’s experimental Ebola vaccine is currently being used in the Ebola outbreak in the Democratic Republic of Congo under compassionate use protocol, after having shown to be protective in a clinical trial in Guinea at the end of the West African Ebola outbreak of 2014-2016. Though there are a few experimental Ebola vaccines in development, Merck’s is furthest along in development. Merck initially planned to file with the FDA in 2017 but missed that goal due to “unexpected engineering and construction delays” at the manufacturing plant built to produce the vaccine. Merck now says it hopes to complete the filing process sometime next year.

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