Mycetoma is a neglected tropical disease characterized by deformity and disability with various health and socio-economic impacts on the affected communities. It is endemic in many tropical and subtropical regions, with cases reported globally. Mycetoma is a chronic inflammatory disease caused by true fungi or certain bacteria and hence the classifications eumycetoma and actinomycetoma respectively.
It affects poor people in rural areas who tend to go barefoot – mostly 20-40 year-old males. It attacks the skin, the deep muscle structures and the bone, often entering the body via thorn pricks or lesions on the feet. In over 80% of patients, it leads to major deformity, requires amputations, and can even cause death. Mycetoma is endemic in tropical and subtropical areas known as the ‘Mycetoma belt’ (between latitude 30 North and 15 South). The belt includes Sudan, Mauritania, Senegal, Somalia, Ethiopia, Chad, Yemen, Venezuela, Mexico, India, and others. While there are serious gaps in knowledge about disease burden, the Mycetoma Research Centre in Khartoum, Sudan, recorded around 6,500 patients since 1991.
Actinomycetoma (bacterial form) has a 90% cure rate, while the eumycetoma (fungal form) cure rate is only 25-35%.
To treat eumycetoma, there is only one current treatment option, which is expensive, toxic, and only cures about 30% of patients even after twelve months of treatment. Those who are not cured are at risk of repeated amputations as the infection spreads throughout the body. DNDi and the Japanese pharmaceutical company Eisai Co., Ltd announced at the 9th European Congress on Tropical Medicine and International Health (ECTMIH) their agreement to proceed with the clinical development of Eisai’s anti-fungal drug fosravuconazole for the potential new treatment of eumycetoma
One project in the development phase:
- Fosravuconazole: Newer azole-drugs seem promising and one of the most promising is fosravuconazole. It is a potent investigational triazole compound that exhibits broad spectrum antifungal activity, has a remarkably long half-life in humans with a large volume of distribution, and has a good safety profile. DNDi is currently preparing for a Phase II proof-of-concept clinical trial in Sudan to assess the comparative efficacy, safety, and tolerability of fosravuconazole in patients with eumycetoma caused by Madurella mycetomatis.
For more information on the partners and donors involved in DNDi’s Mycetoma programme, please click on the hyperlink that links to the project.