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Designing antifilarial drug trials using clinical trial simulators

Walker, M; Hamley, J; Milton, P; Monnot, F; Pedrique, B; Basáñez, M


M Walker

J Hamley

P Milton

F Monnot

B Pedrique

M Basáñez


Lymphatic filariasis and onchocerciasis are neglected tropical diseases (NTDs) targeted for elimination by mass (antifilarial) drug administration. These drugs are predominantly active against the microfilarial progeny of adult worms. New drugs or combinations are needed to improve patient therapy and to enhance the effectiveness of interventions in persistent hotspots of transmission. Several therapies and regimens are currently in (pre-)clinical testing. Clinical trial simulators (CTSs) project patient outcomes to inform the design of clinical trials but have not been widely applied to NTDs, where their resource-saving payoffs could be highly beneficial. We demonstrate the utility of CTSs using our individual-based onchocerciasis transmission model (EPIONCHO-IBM) that projects trial outcomes of a hypothetical macrofilaricidal drug. We identify key design decisions that influence the power of clinical trials, including participant eligibility criteria and post-treatment follow-up times for measuring infection indicators. We discuss how CTSs help to inform target product profiles.


Walker, M., Hamley, J., Milton, P., Monnot, F., Pedrique, B., & Basáñez, M. (2020). Designing antifilarial drug trials using clinical trial simulators. Nature Communications, 11(1),

Journal Article Type Article
Acceptance Date May 3, 2020
Publication Date Jun 1, 2020
Deposit Date Jun 16, 2020
Publicly Available Date Jun 16, 2020
Journal Nature Communications
Publisher Nature Research
Peer Reviewed Peer Reviewed
Volume 11
Issue 1
Public URL
Publisher URL


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