Moxidectin: an oral treatment for human onchocerciasis
Open accessAbstract
INTRODUCTION: Moxidectin is a milbemycin endectocide recently approved for the treatment of human onchocerciasis. Onchocerciasis, earmarked for elimination of transmission, is a filarial infection endemic in Africa, Yemen, and the Amazonian focus straddling Venezuela and Brazil. Concerns over whether the predominant treatment strategy (yearly mass drug administration (MDA) of ivermectin) is sufficient to achieve elimination in all endemic foci have refocussed attention upon alternative treatments. Moxidectin's stronger and longer microfilarial suppression compared to ivermectin in both phase II and III clinical trials indicates its potential as a novel powerful drug for onchocerciasis elimination. AREAS COVERED: This work summarizes the chemistry and pharmacology of moxidectin, reviews the phase II and III clinical trials evidence on tolerability, safety, and efficacy of moxidectin versus ivermectin, and discusses the implications of moxidectin's current regulatory status. EXPERT OPINION: Moxidectin's superior clinical performance has the potential to substantially reduce times to elimination compared to ivermectin. If donated, moxidectin could mitigate the additional programmatic costs of biannual ivermectin distribution because, unlike other alternatives, it can use the existing community-directed treatment infrastructure. A pediatric indication (for children <12 years) and determination of its usefulness in onchocerciasis-loiasis co-endemic areas will greatly help fulfill the potential of moxidectin for the treatment and elimination of onchocerciasis.
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Some veterinary antibiotics were first approved in animals.
“However, some were first approved in animals (14).”
From DrugCentral 2023 extends human clinical data and integrates veterinary drugs (2023) · cites this paper as [14]
Nearly all veterinary antibiotics were first approved in humans.
“Nearly all veterinary antibiotics were first approved in humans.”
From DrugCentral 2023 extends human clinical data and integrates veterinary drugs (2023) · cites this paper as [14]
The antibiotic moxidectin, initially approved for animal use, was later approved for humans.
“This is not always true: the antibiotic moxidectin, initially approved for animal use, was later approved for humans (14).”
From DrugCentral 2023 extends human clinical data and integrates veterinary drugs (2023) · cites this paper as [14]
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- Authors
- Milton, P., Hamley, J. I. D., Walker, M., & Basáñez, M.-G.
- Affiliations
- London Centre for Neglected Tropical Disease Research (GB)
- Royal Veterinary College (GB)
- London Centre for Neglected Tropical Disease Research and MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Venue
- Expert Review of Anti-infective Therapy
- Publisher
- Informa UK Limited
- Published
- 2020-07-26
- Volume
- 18
- Issue
- 11
- Pages
- 1067-1081
- ISSN
- 1478-7210 (ISSN-L)
- 1744-8336
- OpenAlex
- W3044273225
- Cited by
- 211
- References
- 111
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 21 · 2023: 14 · 2022: 17 · 2021: 17 · 2020: 1 · 2019: 5 · 2018: 8 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 5 · 2012: 9
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Expert Review of Anti-infective Therapy (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RVC Research Online (Royal Veterinary College) (submittedVersion, cc-by)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Medical Research Council Doctoral Training Program
- Topics
- Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Research on Leishmaniasis Studies
- Keywords
- moxidectin, onchocerciasis, ivermectin, mass drug administration, onchocerciasis elimination, safety and tolerability, regulatory status, pediatric formulations, community-directed treatment
- MeSH terms
- Mass Drug Administration, Administration, Oral, Animals, Anthelmintics, Humans, Ivermectin, Onchocerciasis, Macrolides, Disease Eradication
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