Nifurtimox/eflornithine

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Nifurtimox/eflornithine
Combination of
Nifurtimox antiparasitic agent
Eflornithine antiparasitic agent

Nifurtimox/eflornithine is a combination of two antiparasitic drugs, nifurtimox and eflornithine, used in the treatment of African trypanosomiasis (sleeping sickness). [1] [2] It was developed by Drugs for Neglected Diseases initiative and partners [3] and is included in the World Health Organization's Model List of Essential Medicines. [4] It is distributed in a kit with material to treat four patients, which weighs 39 kg and has a volume of 170 dm3 , making the transport to remote rural hospitals a logistical challenge. [5]

A treatment regimen known as nifurtimox-eflornithine combination treatment (NECT) is used in second stage gambiense African trypanosomiasis throughout Africa where the disease is endemic. [6] The regimen involves slow infusion of 400 mg of eflornithine every 12 hours for 7 days combined with 15 mg/kg of nifurtimox orally three times a day for 10 days. [6] The World Health Organization 2019 guidelines still recommend NECT in cases of advanced disease, but otherwise advise the use of fexinidazole. [7]

References

  1. ↑ Priotto G, Kasparian S, Mutombo W, Ngouama D, Ghorashian S, Arnold U, et al. (July 2009). "Nifurtimox-eflornithine combination therapy for second-stage African Trypanosoma brucei gambiense trypanosomiasis: a multicentre, randomised, phase III, non-inferiority trial". Lancet. 374 (9683). London, England: 56–64. doi:10.1016/S0140-6736(09)61117-X. hdl: 10144/72797 . PMID   19559476. S2CID   32757305.
  2. ↑ Alirol E, Schrumpf D, Amici Heradi J, Riedel A, de Patoul C, Quere M, et al. (January 2013). "Nifurtimox-eflornithine combination therapy for second-stage gambiense human African trypanosomiasis: Médecins Sans Frontières experience in the Democratic Republic of the Congo". Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 56 (2): 195–203. doi: 10.1093/cid/cis886 . PMID   23074318.
  3. ↑ "Nifurtimox-eflornithine combination therapy (NECT) | DNDi". 31 December 2003.
  4. ↑ "Nifurtimox-eflornithine combination treatment for sleeping sickness (human African trypanosomiasis): WHO wraps up training of key health care personnel". World Health Organization. March 23, 2010. Archived from the original on October 21, 2014.
  5. ↑ Eperon G, Balasegaram M, Potet J, Mowbray C, Valverde O, Chappuis F (November 2014). "Treatment options for second-stage gambiense human African trypanosomiasis". Expert Review of Anti-Infective Therapy. 12 (11): 1407–1417. doi:10.1586/14787210.2014.959496. PMC   4743611 . PMID   25204360.
  6. 1 2 Franco JR, Simarro PP, Diarra A, Ruiz-Postigo JA, Samo M, Jannin JG (2012). "Monitoring the use of nifurtimox-eflornithine combination therapy (NECT) in the treatment of second stage gambiense human African trypanosomiasis". Research and Reports in Tropical Medicine. 3: 93–101. doi: 10.2147/RRTM.S34399 . PMC   6067772 . PMID   30100776.
  7. ↑ "WHO publishes new guidelines for the treatment of sleeping sickness". www.who.int. Retrieved 2025-06-13.
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