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Celgosivir could be the first drug in the world for treating dengue fever
 SCIENTISTS in Singapore are starting a clinical trial on what could turn out to be the world’s first drug to treat people with dengue fever. The Health Sciences Authority (HSA) has given the green light for Celgosivir to be tested on patients in the country. The compound, derived from the seeds of the Moreton Bay Chestnut tree, has been shown to work against all four types of dengue during experiments on mice by researchers atSingapore General Hospital (SGH) and Duke- NUS Graduate Medical School. “The trial is a very important first step... to prove that the drug works on humans,” said principal investigator Jenny Low.
The infectious diseases consultant at SGH added that laboratory studies have been promising. “We are excited and positive about it.” The tablet was initially developed for other diseases like HIV, but had yet to make it to market. It, however, was not linked to fighting dengue fever until now. “We are taking an old drug and asking if there is a new use for it,” said Associate Professor Subhash Vasudevan of Duke- NUS, who started examining Celgosivir in 2007 to fight dengue.
There are two other ongoing clinical trials in Singapore on dengue, said HSA. These, however, are investigations on vaccines, approved in 2008 and 2011. “There are no antiviral drugs ready to go into clinical trials against dengue at this point, except for this one,” said Prof Subhash, who heads the Emerging Infectious Diseases Therapeutics Laboratory at Duke-NUS. The trial is expected to begin as early as next week. If all goes well, there could be a drug on the market for the common mosquito-borne infection in two to three years. This is much faster than the typical 15-year process to create and market a new drug from scratch, he said. Currently, dengue sufferers are put only on supportive treatment. For example, some severe cases may require fluids to be given intravenously to counter fluid leakage from blood vessels.
In Singapore, about 5,330 dengue cases were reported last year. Worldwide, up to 100 million people are infected yearly. Last week, there were 138 new cases in Singapore, 17 fewer than the warning level of 155 a week. The $1.6 million clinical trial aims to recruit 50 people who had dengue and this will be done through polyclinics, private general practitioners’ clinics and the Communicable Disease Centre at Tan Tock Seng Hospital. The money comes from the STOP Dengue Translational Clinical Research Programme grant under the Health Ministry’s National Medical Research Council and the National Research Foundation.
During the 15-day trial, dengue patients – who have to be 21 to 60 years old – are given either the drug or a placebo. Each has to take nine doses of the drug – four tablets at first, then two tablets at 12-hour intervals. They have to stay at SGH’s Investigational Medicine Unit for five days for monitoring. Blood tests will be done regularly to track the level of virus in the body. They will have to return to the unit three times for check-ups after that.
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