A new clinical trial led by Liverpool School of Tropical Medicine will test two easily accessible, cost-effective oral drugs that could revolutionise snakebite treatment.
The Centre for Snakebite Research & Interventions (CSRI) at LSTM has been awarded £4.2m by Open Philanthropy for a large-scale Phase II drug trial to test the potential of two repurposed drugs for use in treating snakebite envenoming.
Snakebite envenoming is a priority neglected tropical disease (NTD), responsible for over 100,000 deaths and 400,000 disabilities annually, predominantly in low- and middle-income countries (LMICs).
The only current treatment, animal-derived antivenom, is costly, difficult to administer, and not readily available in rural areas where the burden of snakebite is highest. The new trial seeks to address these issues by evaluating two innovative oral drugs that could offer a far more accessible and affordable alternative, or a complimentary therapy.
Professor Nicholas Casewell, Director of CSRI at LSTM, said: "Snakebite envenoming has long been a neglected public health issue, particularly for people in rural, resource-poor settings.
"This funding allows us to move forward with clinical trials of two really promising drugs, each with the potential to provide a safer, more accessible treatment that can be easily administered shortly after a bite occurs, and hopefully prevent major pathology or loss of life. If the trials are successful, these drugs could transform the future treatment of snakebite victims."
The trials will focus on the treatment of envenoming from vipers, the snake family responsible for most snakebite-related deaths and disabilities worldwide. Viper venoms contain snake venom metalloproteinase (SVMP) enzymes, which cause severe bleeding, clotting disorder and tissue damage. Both drugs to be used in the trial have been shown in preclinical studies to inhibit these enzymes, preventing the deadly effects of envenoming.
The trials are planned in partnership with leading scientists at the Fundação de Medicina Tropical in Brazil and the Kumasi Centre for Collaborative Research in Ghana, where venomous snakes such as Bothrops atrox (lanceheads) and Echis ocellatus (saw-scaled vipers) are prevalent. The trial consortium also contains scientists from the University of Liverpool, Cambridge University, Vrije Universiteit Amsterdam and KEMRI-Wellcome in Kilifi, Kenya.
Dr Michael Abouyannis, clinical lead on the project for LSTM, said: “Undertaking snakebite trials is complicated, and this project will be no exception, but, particularly with the support of such a skilled and passionate group of partners, we are confident it will be a success.”
“The two orally administered treatments we are assessing show great promise and could truly revolutionise the treatment of snakebite. I think I speak for everyone involved when I say I’m excited to see the trial’s results.”
Developing safe, affordable, and easy-to-administer treatments like oral drugs could be critical in achieving the World Health Organization's (WHO) goal to halve snakebite-related deaths and disabilities by 2030. Evaluating their safety and efficacy in trials such as this represents a pivotal step towards this goal.