Asia's dengue epidemic highlights race for treatment, vaccine options

Print 27 October 2015
Matthew Driskill / FiercePharmaAsia

A sharp rise in dengue fever is earning it the notorious title as the world's fastest-spreading tropical disease with new outbreaks engulfing the Asian continent, crippling hospital services and forcing facilities to turn away patients, according to a Reuters report.

Countries in Southeast Asia and South Asia, where the disease is especially prevalent because of the warm climate and high water levels in many areas, have seen an explosion in new cases and New Delhi is said to be suffering its worst outbreak in two decades, Reuters said.

The disease is the focus of several efforts in vaccination and treatment leading to cures. In September two dengue treatment options were said to be slated for Phase II trials in Singapore next year as efforts to get vaccines by Sanofi ($SNY) and Takeda Pharmaceuticals to the market also gather steam.

Sanofi CEO Olivier Brandicourt

In the second-quarter earnings call, Sanofi CEO Olivier Brandicourt was upbeat on the launch of a dengue vaccine this year, expecting the first license to be granted before the end of 2015, though Olivier Charmeil, executive vice president for vaccines, said it was a "little bit too premature" to discuss plans for the ramp up.

"As we speak we have filed in 7 countries. We will have filed in 20 countries by the end of the year that represent roughly half of the worldwide population at risk of dengue," he said, adding that the ramp-up for 2016 and 2017 onwards will be "very much dependent on the objective country-by-country in terms of getting the impact of dengue reduction."

In May, Singapore's research agency and Duke-National University of Singapore signed an agreement to collaborate with U.S. biotech Visterra on getting a promising treatment against dengue fever to the clinical-trial stage.

The candidate, celgosivir, is an alpha glucosidase inhibitor and modipafant and platelet-activating factor receptor antagonist, Healio said, adding that the work will be carried out by a company called 60 Degrees Pharmaceuticals along with hospital clinicians to evaluate safety and efficacy.

A Phase Ib trial of celgosivir with results published in the Lancet in August 2014 showed that although the drug was generally safe and well tolerated, Healioreported at the time, it did not appear to reduce viral load or fever burden in dengue patients.

In September, India's Serum Institute was seeking approval for a dengue treatment in India, having bought exclusive rights to Visterra's monoclonal antibody VIS513 for $39 million, Reuters said, adding that company officials were seeking to conduct clinical trials on humans because the drug has only been tested on animals so far.

In June, Takeda moved to consolidate its Vaccine Business Unit into hubs to allow sharper focus on a complex set of vaccine programs covering norovirus, dengue and seasonal influenza in an increasingly competitive global horse race.

For Takeda, a key will be the success, or lack thereof, of Sanofi's rollout plans at the public-health level for a dengue vaccine that has a high-stakes manufacturing and approval strategy as early as this year. In April, Takeda said it was eyeing Phase III for its own dengue vaccine candidate.

Dengue strikes a disproportionate number of the poor in Asia who live in areas with little or no sanitation, providing the perfect breeding ground for the mosquito that carries the disease and which bites during the day unlike the malaria-carrying mosquito, which mainly bites at night.

Reuters said the World Health Organization (WHO) estimates that 50 million new cases of dengue arise annually, but that number could be up to four times higher because many cases go unreported.

Reuters, citing WHO figures, said dengue cases in the Philippines were up 32% this year already, cases in Myanmar were up a whopping 200% and cases in Malaysia were up 19%.

In June, Singapore's National Environment Agency said it had recorded a 45% drop in dengue cases compared to last year. The city-state has one of the region's toughest antidengue programs and sends inspectors out to private residences and public housing to ensure potential breeding sites are removed and to ensure spraying programs are up to date.

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