Helminth
infections are responsible for a considerable public health burden, yet the current
drug armamentarium is small. Given the high cost of
drug discovery and development, the high failure rates and the long duration to develop novel treatments,
drug repurposing circumvents these obstacles by finding new uses for compounds other than those they were initially intended to treat. In the present review, we summarize in vivo and clinical trial findings testing clinical candidates and marketed drugs against schistosomes, food-borne trematodes, soil-transmitted helminths, Strongyloides stercoralis, the major human
filariases lymphatic filariasis and
onchocerciasis,
taeniasis,
neurocysticercosis and
echinococcosis. While expanding the applications of broad-spectrum or veterinary
anthelmintics continues to fuel alternative treatment options,
antimalarials,
antibiotics, antiprotozoals and
anticancer agents appear to be producing fruitful results as well. The trematodes and nematodes continue to be most investigated, while cestodal
drug discovery will need to be accelerated. The most clinically advanced
drug candidates include the
artemisinins and
mefloquine against
schistosomiasis,
tribendimidine against liver flukes,
oxantel pamoate against
trichuriasis, and
doxycycline against
filariasis. Preclinical studies indicate a handful of promising future candidates, and are beginning to elucidate the broad-spectrum activity of some currently used
anthelmintics. Challenges and opportunities are further discussed.