Developments in the treatment of leishmaniasis and trypanosomiasis.

The leishmaniases and trypanosomiases are diseases caused by related parasites belonging to the kinetoplastidae family. They share common biological traits, which are comparatively better known than for other parasites, and which would favour the identification of common targets. Yet, very few new drugs are on the horizon and treatment relies on old, often toxic and ineffective drugs. Miltefosine may soon become the first oral drug registered for Leishmaniasis. Other compounds in clinical trials are paromomycin, sitamquine and lipid formulations of amphotericin B. For African trypanosomiasis old drugs primarily indicated for Chagas disease are being considered (nifurtimox, megazole). Earlier projects are berenil, bisamidines and triazines for African trypanosomiasis, and novel azoles and cruzipain inhibitors for Chagas disease.