Triclabendazole and sutezolid are not effective in vivo against Plasmodium berghei

Drug repositioning has emerged as an attractive strategy to accelerate the development of new antimalarial therapies, particularly by evaluating compounds already used against pathologies co-endemic with malaria. This approach offers the advantage of leveraging existing pharmacokinetic, toxicological, and safety data, thereby potentially shortening the drug development pipeline. However, transposing a compound from its original therapeutic indication to an antimalarial use is far from straightforward: differences in target biology, parasite stage specificity, pharmacodynamic requirements, and host-parasite interactions can result in a loss of efficacy despite promising in vitro or structural rationale. Rigorous in vivo validation therefore remains indispensable before any repositioning hypothesis can be considered translationally relevant.

In this context, we evaluated the blood-stage antimalarial activity of triclabendazole, an antihelminthic drug used against co-endemic fascioliasis, together with its metabolite triclabendazole sulfoxide, and sutezolide, an oxazolidinone antibiotic, in a murine model of Plasmodium berghei ANKA infection following oral administration. None of the three compounds demonstrated significant antimalarial activity under these experimental conditions, contradicting a previously published repositioning hypothesis.

Beyond these specific findings, our study is deliberately framed within the 3Rs principles (Replacement, Reduction, Refinement) governing animal experimentation. We argue that publishing negative in vivo results is not only scientifically legitimate but ethically necessary: sharing such data allows research teams working on similar preclinical models to build on existing knowledge, avoid unnecessary experimental duplication, and ultimately reduce the number of animal procedures performed across the field. We advocate for wider dissemination of negative outcomes in antimalarial drug repositioning research as a concrete contribution to more responsible and efficient use of animal models in preclinical pharmacology.

Graphical Abstract