Nicola Caldwell, Rana Afshar, Beatriz Baragaña, Amaya L. Bustinduy, Conor R. Caffrey, James J. Collins, Daniela Fusco, Amadou Garba, Mark Gardner, Mireille Gomes, Karl F. Hoffmann, Michael Hsieh, Nathan C. Lo, Case W. McNamara, Justin Komguep Nono, Gilda Padalino, Kevin D. Read, Meta Roestenberg, Thomas Spangenberg, Sabine Specht, and Ian H. Gilbert
ACS Infect. Dis. 2023, 9, 5, 1046–1055
In September 2022, the Drug Discovery Unit at the University of Dundee, UK, organised an international meeting at the Wellcome Collection in London to explore the current clinical situation and challenges associated with treating schistosomiasis. The aim of this meeting was to discuss the need for new treatments in view of the clinical situation and to ascertain what the key requirements would be for any potential new anti-schistosomals. This information will be essential to inform ongoing drug discovery efforts for schistosomiasis. We also discussed the potential drug discovery pathway and associated criteria for progressing compounds to the clinic. To date, praziquantel (PZQ) is the only drug available to treat all species causing schistosomiasis, but it is often unable to completely clear parasites from an infected patient, partially due to its inactivity against juvenile worms. PZQ-mediated mass drug administration campaigns conducted in endemic areas (e.g., sub-Saharan Africa, where schistosomiasis is primarily prevalent) have contributed to reducing the burden of disease but will not eliminate the disease as a public health problem. The potential for Schistosoma to develop resistance towards PZQ, as the sole treatment available, could become a concern. Consequently, new anthelmintic medications are urgently needed, and this Perspective aims to capture some of the learnings from our discussions on the key criteria for new treatments.