Last Updated: June 25, 2026

CLINICAL TRIALS PROFILE FOR PYRIMETHAMINE; SULFADOXINE


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505(b)(2) Clinical Trials for PYRIMETHAMINE; SULFADOXINE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT00203801 ↗ Combination Antimalarials in Uncomplicated Malaria Completed Global Fund N/A 2002-01-01 The purpose of this study is to study the efficacy of sulfadoxine-pyrimethamine on its own and compare this with efficacy of a new combination antimalarial therapy, either sulphadoxine-pyrimethamine plus artesunate or artemether-lumefantrine.
New Combination NCT00203801 ↗ Combination Antimalarials in Uncomplicated Malaria Completed Medical Research Council, South Africa N/A 2002-01-01 The purpose of this study is to study the efficacy of sulfadoxine-pyrimethamine on its own and compare this with efficacy of a new combination antimalarial therapy, either sulphadoxine-pyrimethamine plus artesunate or artemether-lumefantrine.
New Combination NCT00203801 ↗ Combination Antimalarials in Uncomplicated Malaria Completed World Health Organization N/A 2002-01-01 The purpose of this study is to study the efficacy of sulfadoxine-pyrimethamine on its own and compare this with efficacy of a new combination antimalarial therapy, either sulphadoxine-pyrimethamine plus artesunate or artemether-lumefantrine.
New Combination NCT00203801 ↗ Combination Antimalarials in Uncomplicated Malaria Completed University of Cape Town N/A 2002-01-01 The purpose of this study is to study the efficacy of sulfadoxine-pyrimethamine on its own and compare this with efficacy of a new combination antimalarial therapy, either sulphadoxine-pyrimethamine plus artesunate or artemether-lumefantrine.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for PYRIMETHAMINE; SULFADOXINE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000727 ↗ A Controlled Comparative Trial of Sulfamethoxazole-Trimethoprim Versus Aerosolized Pentamidine for Secondary Prophylaxis of Pneumocystis Carinii Pneumonia in AIDS Patients Receiving Azidothymidine (AZT) Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To determine if the drug combination sulfamethoxazole-trimethoprim (SMX-TMP), given by mouth, and the drug pentamidine (PEN), given by inhaled aerosol, are effective in preventing a relapse of Pneumocystis carinii pneumonia (PCP) when they are given to patients who have recovered from a first episode of PCP and are being given zidovudine (AZT) to treat primary HIV infection. AZT prolongs survival in patients with AIDS and decreases the occurrence of opportunistic infections such as PCP. However, PCP recurs in about 43 percent of patients receiving AZT, indicating a need for other treatments to reduce the relapse rate. The two medications to be tested in this study, SMX/TMP and aerosolized PEN, have also been partially effective in preventing recurrence of PCP. It is hoped that the combination of AZT with these medications will be more effective than AZT or one of the medications alone.
NCT00013689 ↗ Pyrimethamine and Sulfadoxine for Treatment of Autoimmune Lymphoproliferative Syndrome Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 2001-03-01 This study will evaluate the safety and effectiveness of an antibiotic called Fansidar on autoimmune lymphoproliferative syndrome (ALPS). Patients with ALPS have enlarged lymph glands, spleen and/or liver, abnormal blood cell counts and overactive immune function. Current treatments are aimed at suppressing the immune system and improving symptoms, such as anemia (low red blood cell count) and low white blood cell and platelet counts. These treatments, however, are only partially effective and may have complications. Fansidar is a combination of two drugs, sulfadoxine and pyrimethamine, that is used to treat or prevent parasitic infections such as malaria. Recently a child with ALPS who was treated with Fansidar for a different illness had a marked shrinkage of the lymph organs. This study will examine whether Fansidar can shrink the lymph glands or spleen in patients with ALPS. Patients with ALPS between the ages of 4 and 70 years who have had lymph gland enlargement for at least 1 year and are not allergic to sulfa drugs may be eligible for this study. Candidates will be screened with a medical history and physical examination and blood tests. Females of reproductive age will have a urine pregnancy test. Participants will be evaluated at the NIH Clinical Center in Bethesda, MD, with blood tests and a computed tomography (CT) scan of the lymph nodes. For the CT scan, the patient lies on a table during an X-ray scan of the neck, part of the chest, and, if the spleen has not been removed, the stomach area. When these baseline tests are completed, patients will be given Fansidar pills to take once a week for 12 weeks. The dosage will be increased after 2 weeks and again after 4 weeks. At 2, 4, 6, 8 and 10 weeks after starting the treatment and 2 weeks after the last dose, patients will have blood drawn to check for possible side effects of therapy. Women will have a repeat urine pregnancy test at week 6 of treatment. Within a week before completing treatment or after completing treatment, patients will return to NIH for a history, physical examination, blood tests and CT scan. Patients who responded well to treatment will be offered to return to NIH again 3, 6 and 12 months later to repeat the evaluations. If ALPS symptoms recur during this time, patients will be offered another 12-week course of Fansidar and the procedure, including the 3, 6 and 12-month evaluations will be repeated again. If symptoms recur again, patients will be asked to resume Fansidar for 6 months or longer, with doses adjusted as needed. During this time, patients will be seen at NIH every 12 weeks for evaluation and blood will be drawn by the patient's private physician every 6 weeks or 2 and 4 weeks after the dose is increased to check for side effects.
NCT00065390 ↗ Pyrimethamine to Treat Autoimmune Lymphoproliferative Syndrome Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 2003-07-01 This study will examine whether the drug pyrimethamine can shrink lymph nodes and spleen in patients with autoimmune lymphoproliferative syndrome (ALPS). In this disease, lymphocytes (white blood cells) do not die as they normally would. As a result, patients have enlarged lymph glands, spleen, or liver, and other problems that may involve blood cell counts and autoimmune disease (overactivity of the immune system). Pyrimethamine is an orally administered antibiotic that has been used to treat or prevent malaria and toxoplasma, and may be effective in shrinking lymph nodes and spleen. Patients with ALPS who are between 2 and 70 years of age and have had lymph gland enlargement for at least 1 year may be eligible for this study. Candidates will be screened with a medical history and physical examination, blood tests, and possibly a bone marrow test. Females of reproductive age will be screened with a urine pregnancy test. Women who are capable of becoming pregnant must use an effective method of birth control during the entire study period, because, taken during early months of pregnancy, pyrimethamine can cause birth defects in the fetus. Women who are pregnant or nursing are excluded from the study. Participants will undergo the following tests and procedures: - CT scan: For this test, the patient lies still in the CT scanner while images are taken of the neck, chest, and stomach area. A contrast dye is injected into a vein to brighten the CT images. Very young children will be evaluated on a case by case basis to determine whether a CT scan will be performed. - Bone marrow biopsy: Participants undergo this test to rule out underlying bone marrow disease if they have not had a bone marrow test done in the last six months prior to enrolling in pyrimethamine study, as pyrimethamine can affect bone marrow function. Under local anesthesia, a needle is inserted into the back part of the hipbone and a small amount of marrow is removed. (Children are sedated for this test.) - Leukapheresis: This is a procedure for collecting a small proportion of circulating white blood cells while conserving the majority of blood cells. Specifically, blood is drawn from a needle placed in an arm vein and is directed into a cell separator machine, which separates the blood cells by spinning. A small proportion of circulating white cells are removed, and the red cells, platelets, plasma and majority of white cells are returned to the patient's blood circulation. Only patients who are 7 years of age or older and weigh at least 55 pounds undergo this procedure. Other participants who choose not to have apheresis will have about 3 tablespoons of blood drawn instead. - Pyrimethamine administration: When the above tests are completed, participants begin taking pyrimethamine. The dose is determined according to the individual's weight and is gradually increased during the study period. Patients take the drug twice a week for a total of 12 weeks. - Blood tests: Blood samples are collected during weeks 2, 4, 6, 8, and 10 after beginning treatment, and 2 weeks after the last dose of pyrimethamine. The purpose of these blood tests is to check for possible drug-related side effects. Patients who develop a skin rash, mouth sores or other side effects may have one or more doses of the treatment drug withheld. When indicated, the patient will be directed to stop taking the study drug. If needed, drug side effects will be treated with a vitamin supplement, folinic acid, taken by mouth, 3 times weekly. - Evaluations at the NIH Clinical Center will comprise of a pretreatment visit, one end of treatment visit at the end of 12 weeks and an optional post-treatment visit 3months after stopping pyrimethamine therapy. Patients who respond well to treatment may be asked to return to NIH for additional visits at 3, 6, and 12 months after the treatment has ended for repeat evaluations. If their lymph glands or spleen become much larger after stopping pyrimethamine, they will be offered treatment for another 12 weeks. If they respond to the second course of treatment, they will return to NIH again after 3, 6, and 12 months. If the symptoms return again, patients will be asked to resume treatment for an additional 6 months or more. They will have blood drawn periodically by their private physician and will return to NIH for evaluation every 12 weeks.
NCT00074841 ↗ Trial of Azithromycin Plus Chloroquine Versus Sulfadoxine-Pyrimethamine Plus Chloroquine for the Treatment of Uncomplicated Malaria in India Completed Pfizer Phase 2/Phase 3 2003-09-01 This primary objective of this study is to assess whether the combination of Azithromycin with chloroquine is non-inferior to the combination of sulfadoxine-pyrimethamine plus chloroquine, when used to treat uncomplicated cases of malaria due to Plasmodium falciparum in adults in India.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for PYRIMETHAMINE; SULFADOXINE

Condition Name

Condition Name for PYRIMETHAMINE; SULFADOXINE
Intervention Trials
Malaria 82
Pregnancy 11
Malaria, Falciparum 11
Malaria in Pregnancy 10
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Condition MeSH

Condition MeSH for PYRIMETHAMINE; SULFADOXINE
Intervention Trials
Malaria 131
Malaria, Falciparum 35
HIV Infections 7
Infections 6
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Clinical Trial Locations for PYRIMETHAMINE; SULFADOXINE

Trials by Country

Trials by Country for PYRIMETHAMINE; SULFADOXINE
Location Trials
Malawi 17
Tanzania 13
Uganda 12
Mozambique 12
Burkina Faso 10
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Trials by US State

Trials by US State for PYRIMETHAMINE; SULFADOXINE
Location Trials
Maryland 2
Alabama 1
Washington 1
Ohio 1
New York 1
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Clinical Trial Progress for PYRIMETHAMINE; SULFADOXINE

Clinical Trial Phase

Clinical Trial Phase for PYRIMETHAMINE; SULFADOXINE
Clinical Trial Phase Trials
PHASE1 1
Phase 4 37
Phase 3 43
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Clinical Trial Status

Clinical Trial Status for PYRIMETHAMINE; SULFADOXINE
Clinical Trial Phase Trials
Completed 100
Not yet recruiting 14
Unknown status 9
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Clinical Trial Sponsors for PYRIMETHAMINE; SULFADOXINE

Sponsor Name

Sponsor Name for PYRIMETHAMINE; SULFADOXINE
Sponsor Trials
London School of Hygiene and Tropical Medicine 46
Centers for Disease Control and Prevention 23
Gates Malaria Partnership 18
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Sponsor Type

Sponsor Type for PYRIMETHAMINE; SULFADOXINE
Sponsor Trials
Other 340
U.S. Fed 26
NIH 17
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Pyrimethamine Sulfadoxine (SP) Clinical Trials Update, Market Analysis and Projections

Last updated: April 24, 2026

What is pyrimethamine–sulfadoxine in the clinic today?

Pyrimethamine–sulfadoxine (fixed-dose combination, SP) is an antimalarial used for treatment and, in many programs, for prevention in pregnancy where it remains policy-supported. Commercially, the combination persists as a lower-cost, older-generation regimen with market access driven by national malaria control programs, WHO guidance, and resistance patterns (particularly sulfadoxine-pyrimethamine resistance).

What is the current clinical-trials signal?

No complete, consistently verifiable, up-to-date global clinical-trials dataset is available in the provided prompt context. Under the operating constraint to avoid producing incomplete or potentially incorrect trial listings, this section is omitted.

Where is the market concentrated?

SP demand is concentrated in endemic malaria geographies where public-health supply chains purchase through government tenders, donor procurement, or pooled purchasing mechanisms. Product demand is shaped by:

  • National first-line and intermittent-preventive-therapy (IPT) policies (especially IPTp in pregnancy where SP is used if efficacy remains acceptable).
  • Resistance-driven shifts away from SP for case management and toward alternative ACT-based regimens where failures rise.
  • Budget cycles for malaria commodities and donor funding continuity.

How does resistance affect usage and procurement?

Sulfadoxine-pyrimethamine efficacy declines with rising parasite resistance, which directly reduces SP’s role in treating uncomplicated malaria and limits its continued use for prevention where national policy is based on local therapeutic efficacy thresholds. Procurement patterns typically follow these policy shifts:

  • Higher use where therapeutic efficacy remains adequate.
  • Reduced use or replacement where recurrent failures and recrudescence rise.

Market sizing: what can be projected from the available facts?

No quantitative market numbers, pricing, units, or validated forecast basis are provided in the prompt context. Under the operating constraint to avoid incomplete or potentially incorrect projections, the forecast is omitted.

What is the investment-relevant risk map?

Even without new-trial granularity, business risk for SP is structurally driven:

Primary risk drivers

  • Policy risk: replacement in therapeutic and preventive indications when national malaria control policy changes.
  • Resistance risk: reduced efficacy in the field leads to formulary downgrades and procurement shifts.
  • Supply-chain risk: reliance on generic supply and procurement cycles affects tender timing and volume.
  • Regulatory/labeling risk: national registration and procurement specifications can tighten as guidelines evolve.

Key mitigants

  • Formulary fit: maintaining alignment with IPT and any residual treatment uses where efficacy remains acceptable.
  • Cost position: SP’s generic economics typically keep it competitive where procurement targets lowest-cost per delivered dose.
  • Program procurement: multi-year malaria control planning can smooth demand even when utilization is adjusted by resistance.

Competitive landscape

SP’s competitive set is dominated by:

  • ACTs for uncomplicated malaria treatment (market-share pressure for any SP role in treatment).
  • Alternative IPT regimens in pregnancy where SP is replaced by other options due to resistance or guideline changes.
  • Other antimalarial generics supplied into endemic-market tenders.

Because SP is an established generic combination, competitive dynamics primarily reflect procurement policy rather than new-to-market innovation.


Key Takeaways

  • Pyrimethamine–sulfadoxine remains a commodity-driven antimalarial whose demand is determined by national malaria policy and resistance thresholds.
  • The prompt does not provide enough verifiable, up-to-date clinical-trial data to produce a reliable “clinical trials update.”
  • Quantitative market sizing and projections are not supportable from the provided context without risking incorrect figures.
  • The dominant commercial risks are policy shifts and sulfadoxine-pyrimethamine resistance, which can rapidly change procurement and indication use.

FAQs

1) Is pyrimethamine–sulfadoxine still used for malaria in pregnancy?

In many endemic settings it has been used for intermittent preventive treatment in pregnancy when efficacy thresholds support continued SP policy. Actual use depends on country-specific resistance data and current national guidelines.

2) Why does the market for SP change without new patents or new drugs?

Because SP is a low-cost, policy-dependent regimen. When resistance increases, ministries of health often revise treatment and prevention recommendations, shifting procurement from SP to alternatives.

3) What is the biggest driver of clinical demand: treatment or prevention?

Prevention programs in endemic regions can be the larger demand driver when SP is used for pregnancy IPT. Treatment demand is more volatile due to resistance and guideline updates.

4) Does ACT replacement reduce SP demand immediately?

It can, particularly for uncomplicated malaria case management. However, SP may persist in specific prevention indications longer if policy remains acceptable under local efficacy data.

5) Is there a patent-protected pipeline component for SP?

SP is widely generic. Commercial differentiation and pipeline-driven growth are not intrinsic to the product unless new fixed-dose formulations, combinations, or distinct regulatory pathways are introduced and adopted by programs.


References (APA)

[1] World Health Organization. (2023). WHO malaria policy recommendations. https://www.who.int/teams/global-malaria-programme/policies
[2] World Health Organization. (2015). Guidelines for the treatment of malaria (3rd ed.). https://apps.who.int/iris/handle/10665/162441

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