For the first time in Singapore, an antiviral medicine is being tested as a potential treatment for dengue fever. Singapore General Hospital (SGH) together with researchers at the Program for Emerging Infectious Diseases at Duke-NUS Graduate Medical School (Duke-NUS) will be starting a clinical trial using Celgosivir, a new medicine derived from the seeds of the Moreton Bay Chestnut tree, to determine its efficacy as a treatment for dengue fever. The trial is carried out under the STOP Dengue Translational Clinical Research Programme. Celgosivir is a safe medicine as it was previously tested in the United States, Canada, and Europe for other viral infections. It is an oral drug, similar to medicines used to treat other acute viral disease like flu or chicken pox. “This trial will determine 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. This approach is different from dengue vaccines, which cannot be used to treat a dengue patient when the illness has set in”, said Dr Jenny Low, Principal Investigator of the study and Consultant, Department of Infectious Diseases, Singapore General Hospital. Up to 100 million people are infected with dengue each year and 5,330 cases were reported last year in Singapore alone. At present there are no approved medicines for treating dengue fever anywhere in the world. Only supportive fluid replacement therapy is used to treat vascular leakage in patients with severe illness. “This is a proof-of-concept clinical trial that will investigate whether an antiviral medicine can be used as a potential treatment for dengue fever and also if it is able to prevent dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Laboratory experiments at Duke-NUS have shown that Celgosivir inhibits four serotypes of dengue virus, so we are taking this important next step to find out how well it works in patients,” said Associate Professor Subhash Vasudevan, who directs the Emerging Infectious Diseases Therapeutics Laboratory at Duke-NUS. Individuals, between the age of 21 and 60, who suspect that they are suffering from dengue fever and have had fever for only a day or so, may visit their doctors at polyclinics and GP clinic around Singapore for a simple blood test to confirm the diagnosis. If patients are identified with early stages of dengue fever, they can be referred to the CELgosivir as a treatment Against DENgue (CELADEN) trial at the Investigational Medicine Unit (IMU) located at SGH.
“STOP Dengue is fully behind this research endeavour in search of a specific treatment for dengue”, said A/Prof Leo Yee-Sin, Lead Principal Investigator, STOP Dengue Translational Clinical Research Programme and Clinical Director, Communicable Diseases Centre. Trial participants will be randomly assigned to receive either Celgosivir or placebo. They are required to stay for five days in the treatment suites at the IMU and return for three short visits after discharge. The medicine and treatment will be provided free of charge. The CELADEN clinical trial is approved by the ethics board of Singapore Health Services and the Health Sciences Authority or Singapore with funding support from the STOP Dengue Translational Clinical Research Programme grant obtained from the Singapore Ministry of Health’s National Medical Research Council and the National Research Foundation.