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Common antimalarial drug could be used to treat major injury

A common anti-malarial drug Artesunate could be used to reduce organ failure following injury, according to an early study in rats led by Queen Mary University of London

Queen Mary University of London

A common anti-malarial drug Artesunate could be used to reduce organ failure following injury, according to an early study in rats led by Queen Mary University of London (QMUL).

The repurposing of the affordable and safe drug could help save the lives of major trauma patients, and the promising results have already led to human clinical trials being planned for this year, supported by the Health Innovation Challenge Fund.

Trauma is a leading cause of death with five million victims a year. About 40 per cent of trauma deaths are due to hemorrhagic shock, which is when severe blood loss makes it difficult for the heart to pump sufficient blood around the body, leading to multiple organ failure.

Lead researcher Chris Thiemermann from QMUL's Centre for Trauma Sciences said: "Multiple organ failure affects one in three severely injured patients, and one in four of those will die. Those that survive still experience prolonged periods in intensive care, infections and other complications. But despite its catastrophic impact, there are still no specific treatments for organ failure.

"We've now discovered that the drug Artesunate, which has already been used by thousands of people with malaria, is also effective for treating severe haemorrhage and blood loss in rats.

"Not only is the drug extremely safe, having already been tested in over 180 clinical trials, but it is also cheap. It could therefore be a highly effective option for the NHS and the rest of the world, and we're now getting ready to test its effect on organ injury in a human population."

The study, published in the Annals of Surgery, showed that when injured rats were administered Artesunate, the drug had a marked protective impact on organ integrity and reduced organ failure.

The drug appeared to work by enhancing the protection of organs by reducing the body's excessive inflammatory response to injury and blood loss, and by activating well-known cell-survival pathways.

The lower dose of Artesunate shown in the study to be effective in hemorrhagic shock is identical to the dose used in patients with malaria, many of which also have multiple organ dysfunction.

Artesunate is based on an ancient Chinese herbal remedy, produced in large quantities in China, and is recommended by the World Health Organization as the treatment of choice for severe malaria. It has also been shown to have anti-cancer, anti-viral and anti-inflammatory effects. Professor Tu of the Chinese Academy of Sciences was awarded the 2015 Nobel Prize for Medicine & Physiology for her discovery of the artemisinins (artesunate-like drugs).

The researchers say that Artesunate would be administered as an intravenous injection to code red patients with major haemorrhage, in the helicopter, ambulance, or on arrival in A&E.

On the basis of these laboratory tests, a new clinical trial is being set up at the Royal London Hospital, UK. Running for two years, Artesunate will be administered to a sample of patients admitted to the Major Trauma Centre, and outcomes measured during their hospital stay and following discharge. This Health Innovation Challenge Fund trial is supported by the Wellcome Trust and the Department of Health.

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Notes to the editor

Research paper

Artesunate Protects Against the Organ Injury and Dysfunction Induced by Severe Hemorrhage and Resuscitation. Regina Sordi, Kiran K. Nandra, Fausto Chiazza, Florence L. Johnson, Claudia P. Cabrera, Hew D. Torrance, Noriaki Yamada, Nimesh S.A. Patel, Michael R. Barnes, Karim Brohi, Massimo Collino and Christoph Thiemermann. Annals of Surgery 2016

About Queen Mary University of London

Queen Mary University of London (QMUL) is one of the UK's leading universities, and one of the largest institutions in the University of London, with 20,260 students from more than 150 countries.

A member of the Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research - in the most recent national assessment of the quality of research, we were placed ninth in the UK (REF 2014).

We also offer something no other university can: a stunning self-contained residential campus in London's East End. As well as our home at Mile End, we have campuses at Whitechapel, Charterhouse Square and West Smithfield dedicated to the study of medicine, and a base for legal studies at Lincoln's Inn Fields.

We have a rich history in London with roots in Europe's first public hospital, St Barts; England's first medical school, The London; one of the first colleges to provide higher education to women, Westfield College; and the Victorian philanthropic project, the People's Palace based at Mile End.

QMUL has an annual turnover of £350m, a research income worth £100m, and generates employment and output worth £700m to the UK economy each year.

About the Health Innovation Challenge Fund

The Health Innovation Challenge Fund is a parallel funding partnership between the Wellcome Trust and the Department of Health to stimulate the creation of innovative healthcare products, technologies and interventions and to facilitate their development for the benefit of patients in the NHS and beyond. http://www.hicfund.org.uk

About the Department of Health

The Department of Health (DH) helps people to live better for longer. The Department leads, shapes and funds health and care in England, making sure people have the support, care and treatment they need, with the compassion, respect and dignity they deserve.

The Department encourages health research and use of new technologies because it's important to the development of new, more effective treatments for NHS patients. Innovation is needed so that decisions about health and care are based on the best and latest evidence. http://www.dh.gov.uk

About the Wellcome Trust

The Wellcome Trust is a global charitable foundation dedicated to improving health. We support bright minds in science, the humanities and the social sciences, as well as education, public engagement and the application of research to medicine. http://www.wellcome.ac.uk

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