ivermectin formulations for malaria vector control Current status and prospects Carlos Chaccour MD MSc Does IVM kill gambiae Direct feedings 24 hours after 200mcgkg ID: 288745
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Slide1
Slow-release ivermectin formulations for malaria vector control
Current
status and prospects
Carlos Chaccour MD MScSlide2
Does IVM kill gambiae?Direct feedings
24 hours after 200mcg/kgJID 2010Slide3
How much IVM kills gambiae?The minimum insecticidal concentration22.4 ng/ml (18-27 ng/ml) Kobylinski 2010In vitro mixing + membrane16 ng
/ml (14-17 ng/ml) Kobylinski 2012In vitro mixing + membrane6 ng
/ml (4-7 ng/ml) Bousema 2013Volunteers + membraneSlide4
MIC + PK = The mosquitocidal windowSlide5
22
ng/ml
18 hoursSlide6
6
ng
/ml40 hoursSlide7
Why is this important?A key factor for interrupting transmission would be the time IVM remains in blood above mosquito-killing levels (i.e the width of the window)(Slater et al 2014)Slide8
Widening the windowIncrease a single dose (mcg/kg)i.e. Higher CmaxIntermitent treatment i.e. Consecutive peaksSlow release
----> Alter the curve (!)Oral (bowel transit time)Parenteral Slide9
First attempt…Maeda 2003Cunnigham 2006Slide10
3 formulations: F – M - XI – II – III per subjectCuantificationsWeekly (12 weeks)Monthly (12-24 weeks)Extensive toxicology studySlide11Slide12Slide13
Stable concentrations can be safely achieved modifying the formulationSlow release technology available todayThe modelled impact
on transmission is very promisingSlide14
Prospects, gaps and messageNew slow release formulationsSlow release pillTransdermal patchesPill + patch approachPegilated subcutaneous
Knowledge gapsJoint work on TPPSlide15
Juliane Chaccour.Ángel Irigoyen, Ana G. Gil, Felix Hammann, Jose L Del Pozo.The MISSION Team: Santi, Chema, Rocio, Isa, Alberto.Campaign supporters and donnors