Understanding high-level resistance to antimalarial PfATP4 inhibitors

Recent years have seen new, urgently-needed malaria medicines enter the clinical development pipeline. One new medicine that has performed very well in clinical studies is cipargamin. Unfortunately, we have shown that malaria parasites grown in the laboratory are capable of acquiring a high level of resistance to this medicine. We seek to understand the cause and features of this high level resistance in order to assess the magnitude of the threat it poses and devise risk mitigation strategies.