title: A "reverse pharmacology" approach for developing an anti-malarial phytomedicine.
abstract: A "reverse pharmacology" approach to developing an anti-malarial phytomedicine was designed and implemented in Mali, resulting in a new standardized herbal anti-malarial after six years of research. The first step was to select a remedy for development, through a retrospective treatment-outcome study. The second step was a dose-escalating clinical trial that showed a dose-response phenomenon and helped select the safest and most efficacious dose. The third step was a randomized controlled trial to compare the phytomedicine to the standard first-line treatment. The last step was to identify active compounds which can be used as markers for standardization and quality control. This example of "reverse pharmacology" shows that a standardized phytomedicine can be developed faster and more cheaply than conventional drugs. Even if both approaches are not fully comparable, their efficiency in terms of public health and their complementarity should be thoroughly considered.
authors.affiliation: Department of Primary Health Care, University of Oxford, UK. merlin.willcox@dphpc.ox.ac.uk
authors.forename: Merlin L
authors.initials: ML
authors.lastname: Willcox
authors.forename: Bertrand
authors.initials: B
authors.lastname: Graz
authors.forename: Jacques
authors.initials: J
authors.lastname: Falquet
authors.forename: Chiaka
authors.initials: C
authors.lastname: Diakite
authors.forename: Sergio
authors.initials: S
authors.lastname: Giani
authors.forename: Drissa
authors.initials: D
authors.lastname: Diallo
mesh_terms: D000962:Antimalarials / Q000302:isolation & purification* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D055808:Drug Discovery; D029001:Herbal Medicine / Q000379:methods; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000469:parasitology; D008302:Mali; D010601:Pharmacology, Clinical / Q000379:methods*; D010944:Plants / Q000737:chemistry*; D010946:Plants, Medicinal; D010961:Plasmodium / Q000187:drug effects*
chemical_list: D000962:Antimalarials