A drug that may be effective for treating dengue fever is being tested for the first time on patients.

An antiviral drug may prove effective for treating patients with early stages of dengue fever – an illness for which there is currently no vaccine or cure.

The clinical trial of Celgos​ivir, a medicine derived from the seeds of the Moreton Bay Chestnut tree, was started in mid-July 2012, and conducted by researchers at Singapore General Hospital​ (SGH) and Duke-NUS Graduate Medical School​ (Duke-NUS).

This is the first time that Celgosivir is bei​ng tested on patients with dengue fever.

Dengue fever affects up to 100 million people ​​​worldwide each year. In 2011, about 5,330 cases were reported in Singapore.

Associate Professor Subhash Vasudevan​, who directs the Emerging Infectious Diseases Therapeutics Laboratory at Duke-NUS, said, “Laboratory experiments at Duke-NUS have shown that Celgosivir inhibits four serot​ypes of the dengue virus, so we took this important next step to find out how well it works in patients.”

Dr Jenny Low​, the principal investigator of the study and Senior Consultant, ​ Department of Infectious Diseases​, Singapore General Hospital​ (SGH), a member of the SingHealth​ group, said, “The trial aims to find out if Celgosivir can reduce the amount of virus, fever duration and pain in patients who receive the treatment early in the course of dengue fever.

“The approach is different f​rom that of dengue vaccines, which cannot be used to treat a dengue patient once he becomes ill.”

Assoc Prof Subhash said the trial will also investigate whether Celgosivir can be used to treat dengue fever, and whether it is able to prevent more severe forms of dengue, such as dengue haemorrhagic fever and dengue shock syndrome.

The $1.6 million clinical trial was approved by the ethics board of Singapore Health Services and the Health Sciences Authority of Singapore.

It is funded by the STOP Dengue Translational Clinical Research Programme under the Ministry of Health’s National Medical Research Council and the National Research Foundation.

Conducting the trial

The investigators are aiming to recruit 50 dengue patients, aged 21 to 60. [Editor's Note, April 2013: Recruitment period is now closed.]

To be eligible, the patients must be suffering from the early stages of dengue fever, diagnosed within one to two days of infection.

The participants are to be referred by doctors from polyclinics, general practitioner clinics and the Communicable Diseases Centre (CDC).

They will be given Celgosivir tablets or a placebo, and monitored by SGH’s Investigational Medicine Unit (IMU), where they will stay for five days.

After completing the course of the medicine, they will be assessed to see if they are well enough to be discharged.

After discharge, the participants will return to the IMU on three separate occasions – seven, 10 and 15 days later – for further assessment. Their medicine and treatment are provided for free.

Read on to find out more about Celgosivir and dengue fever​.

Ref: T12