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Research and Development

Current Choice of Treatment:Praziquntel

Praziquantel is a broad spectrum antiparasitic drug that developed through a joint effort by Germany pharmaceutical companies Merck KGaA and Bayer in early 1980s. In the past 30 years, praziquantel has been the drug of choice used globally to successfully treat millions of patients with schistosomiasis, liver fluke, paragonimiasis, taeniasis or cysticercosis every year.

Disease Prevalence Epidemic Area Treatment
Schistosomiasis 249 million South America, the Caribbean, Africa and the Middle East (Schistosoma mansoni); China, Korea, Japan (Schistosoma japonicum);  Sub-Saharan Africa (Schistosoma haematobium); Southeast Asia and central West Africa (Schistosoma mekongi and Schistosoma intercalatum) Praziquantel 25 mg/kg t.i.d. × 1d, 40 or 60 mg/kg single administration for mass treatment
Clonorchiasis and Opisthorchiasis 35 million China, Korea, Japan, Thailand, Vietnam, Middle-South Asia Praziquantel 25 mg/kg t.i.d. × 3d
Paragonimiasis 20 million China, Korea, Japan, Thailand, India, Malaysia, Philippines,Russia, Africa, South America Praziquantel 25 mg/kg t.i.d. × 3d
Taeniasis 40-60 million (Taeniasis+
Taiwan, Korea, Indonesia, Nepal, Thailand, Philippines, China, Eastern Europe, Africa, Latin America Praziquantel 5-10 mg/kg single administration
Cysticercosis 40-60 million (Taeniasis+
Mexico, Latin America, West Africa, Russia, India, Pakistan, North-East China,  Southeast Asia Long courses with  praziquantel (40-60 mg/kg/d × 3d, repeated treatment 2-3 months later if necessary) as well as supporting therapy with corticosteroids and/or anti-epileptic drugs, and possibly surgery.

Praziquantel is a racemic mixture of biologically active levo-enantiomer (L-isomer) and inactive dextro-enantiomer (D-isomer). Over the year, the World Health Assembly’s intent to provide drug access for controlling schistosomiasis faces several challenges including: (1) limited world-wide praziquantel supply (<30% of annual demand), (2) lack of medical compliance associated with bitter taste and large size of drug tablet caused by dextro-praziquantel, which pose an obstacle for at risk children in endemic (~50% prevalence) regions, and (3) Environmental protection and cost pressure associated with the drug production and delivery, especially considering 50% of the drug product is useless bulk impurity.