We review, for the first time, a 20-year Chinese story of research and development pertaining to
tribendimidine, a promising
anthelmintic agent that is safe and exhibits a broad spectrum of activity.
Tribendimidine was first synthesized at the National Institute of
Parasitic Diseases in Shanghai in the mid 1980s. In laboratory studies,
tribendimidine showed high efficacy against Nippostrongylus braziliensis in rats, Necator americanus in hamsters, Ancylostoma caninum and Toxocara canis in dogs, and Syphacia mesocriceti in mice. Activity was also found against several species of cestodes in chicken. In clinical trials, a single oral dose of 400 mg
tribendimidine, administered to patients infected only with N. americanus, or with N. americanus and Ancylostoma duodenalis, resulted in cure rates of 85.7% (132/154) and 89.8% (53/59), respectively. In comparison, a single oral dose of 400 mg
albendazole resulted in significantly lower cure rates, namely 65.5% (91/139; chi(2) = 16.47, P < 0.001) and 71.7% (43/60; chi(2) = 6.29, P = 0.012), respectively. Single oral doses of
tribendimidine (300 mg) and
albendazole (400mg) were equally effective against Ascaris lumbricoides
infections; cure rates were 96.0% (97/101) and 98.1% (101/103), respectively. In 5-14-year-old children with an
Enterobius vermicularis infection, treated with a single oral dose of 200 mg
tribendimidine, a cure rate of 81.6% (93/114) was observed.
Tribendimidine was well-tolerated as only mild and transient side effects were observed. It would be of great public health significance if these findings are confirmed in other epidemiological settings, as more than one-quarter of the world population is currently affected by intestinal nematodes, with only very few drugs currently available on the market.