Title:Medicinal Chemistry and Target Identification of Synthetic Clinical and
Advanced Preclinical Antimalarial Candidates (2000 - 2022)
Volume: 23
Issue: 3
Author(s): Peter Mubanga Cheuka*, Dickson Mambwe and Godfrey Mayoka
Affiliation:
- Department of Chemistry, School of Natural Sciences, University of Zambia, P.O. Box 32379, Lusaka, Zambia
Keywords:
Malaria, Clinical candidates, Preclinical candidates, Medicinal chemistry, Drug discovery, Target identification.
Abstract:
Background: The downward trend in malaria cases and deaths is steadily reversed -
627,000 deaths in 2020 compared to 405,000 deaths in 2018. Drug resistance has compromised the
effectiveness of currently available treatment options, with some reports documenting molecular
markers of resistance to artemisinins in African countries in addition to the Greater Mekong subregion,
which was initially associated with this kind of resistance. Therefore, the development of novel
drugs is crucial to replenishing the antimalarial drug arsenal toward malaria eradication. In this
review, we summarize the progress made in antimalarial drug discovery in the period 2000 - 2022,
focusing on drug candidates which have made it to advanced preclinical trials (drugs tested in rodent
species and at least one higher species such as dog or monkey) and beyond.
Methods: We searched Google Scholar and selected studies meeting these defined criteria. We
highlight the medicinal chemistry optimization of these compounds; the preclinical/clinical evaluation
and the mechanisms of action.
Results and Conclusion: Although the pipeline seems promising, the prospect of having an antimalarial
medicine that meets the current target product profiles (TPPs) towards the malaria eradication
agenda is far from reality. Some of the key TPP attributes required include multistage activity, resistance-
proof; ability to achieve a single dose cure and safety across a wide range of patient populations.
Clinical trials are ongoing for some promising molecules, inspiring optimism toward identifying
better drugs that meet these defined TPPs. Until then, concerted research efforts should continue
to be mounted to populate the antimalarial drug discovery and development pipeline.