Dose-dependent effect and pharmacokinetics of fexinidazole and its metabolites in a mouse model of human African trypanosomiasis

Int J Antimicrob Agents. 2017 Aug;50(2):203-209. doi: 10.1016/j.ijantimicag.2017.01.038. Epub 2017 May 25.

Abstract

Human African trypanosomiasis (HAT) is a neglected tropical disease, with a population of 70 million at risk. Current treatment options are limited. In the search for new therapeutics, the repurposing of the broad-spectrum antiprotozoal drug fexinidazole has completed Phase III trials with the anticipation that it will be the first oral treatment for HAT. This study used the recently validated bioluminescence imaging model to assess the dose and rate of kill effect of fexinidazole in infected mice, and the dose-dependent effect of fexinidazole on trypanosome infection. Pharmacokinetics of fexinidazole in plasma and central nervous system (CNS) compartments were similar in both infected and uninfected mice. Drug distribution within the CNS was further examined by microdialysis, showing similar levels in the cortex and hippocampus. However, high variability in drug distribution and exposure was found between mice.

Keywords: Bioluminescence; Fexinidazole; Microdialysis; Pharmacokinetics; Time–kill; Trypanosoma brucei.

MeSH terms

  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / pharmacokinetics*
  • Antiprotozoal Agents / pharmacology*
  • Cerebral Cortex / chemistry
  • Cerebrospinal Fluid / chemistry
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Female
  • Hippocampus / chemistry
  • Luminescent Measurements
  • Mice
  • Nitroimidazoles / administration & dosage
  • Nitroimidazoles / pharmacokinetics*
  • Nitroimidazoles / pharmacology*
  • Plasma / chemistry
  • Treatment Outcome
  • Trypanosoma / drug effects*
  • Trypanosomiasis, African / drug therapy*
  • Whole Body Imaging

Substances

  • Antiprotozoal Agents
  • Nitroimidazoles
  • fexinidazole