[Current therapy of trypanosomiasis].
The authors review the available products used for human african trypanosomiasis (HAT) chemotherapy: pentamidine, suramin, melarsoprol and the new compound DFMO. The administration of pentamidine at the beginning of the nervous stage, when the number of cells in the cerebrospinal fluid do not exceed 20/mn3 is a new approach for HAT treatment. At this time of the disease, patients generally are healthy and the pentamidine therapy avoids the use of the toxic melarsoprol (Arsobal). An alternative protocol for Arsobal therapy (2, 16 mg/kg/d for 10 consecutive days) has been described from pharmacokinetics data to decrease the rate of relapses and the duration of hospital care. Efficacy and tolerance of this new protocol must be evaluated by randomised clinical trials. Preliminary data of clinical trials using short-term DFMO therapy are encouraging. DFMO therapy be less expensive. From its efficacy and tolerance, DFMO is a choice chemotherapy for HAT treatment, especially in the case of resistance to usual trypanocides. Both MLD 73811 and IMOL 881 are new trypanocidal compounds, effective on Trypanosoma brucei rhodesiense and T. b. gambiense. In addition, IMOL 881 is effective on the animal trypanosomes, T. evansi and T. equiperdum. Waiting for the availability of these new products, classical trypanocides remain the basis of HAT treatment.
D012437:Adenosylmethionine Decarboxylase / Q000037:antagonists & inhibitors; D000818:Animals; D001152:Arsenicals / Q000008:administration & dosage / Q000627:therapeutic use; D003839:Deoxyadenosines / Q000008:administration & dosage / Q000627:therapeutic use; D004351:Drug Resistance; D000518:Eflornithine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008549:Melarsoprol / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D010419:Pentamidine / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013498:Suramin / Q000008:administration & dosage / Q000627:therapeutic use; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use; D014344:Trypanocidal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014353:Trypanosomiasis, African / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000517:prevention & control
D001152:Arsenicals; D003839:Deoxyadenosines; D004791:Enzyme Inhibitors; D014227:Triazines; D014344:Trypanocidal Agents; C084448:IMOL 881; D013498:Suramin; D010419:Pentamidine; C065859:MDL 73811; D012437:Adenosylmethionine Decarboxylase; D008549:Melarsoprol; D000518:Eflornithine
Actualités thérapeutiques de la trypanosomiase.