They develop into adults that reside in body cavities, most commonly the peritoneal cavity or pleural cavity, but also occasionally in the pericardium (M. perstans), subcutaneous tissue (M. ozzardi) or dermis (M. steptocerca).In M. perstans, size range for female worms is 70 to 80 mm long and 120 μm in diameter, and the males measure approximately 45 mm by 60 μm. In M. steptocerca, the females measure approximately 27 mm long. Their diameter is 50 μm at the level of the vulva (anteriorly) and ovaries (near the posterior end), and up to 85 μm at the mid-body. Males measure 50 μm in diameter. In M. ozzardi, adult worms are rarely found in humans. The size range for females worms is 65 to 81 mm long and 0.21 to 0.25 mm in diameter but unknown for males. Adult worms recovered from experimentally infected Patas monkeys measured 24 to 28 mm long and 70 to 80 μm in diameter (males) and 32 to 62 mm long and .130 to .160 mm in diameter (females).Adults produce unsheathed and non-periodic (sub-periodic in M. perstans) microfilariae that reach the blood stream. A midge or black fly ingests microfilariae during a blood meal. After ingestion, the microfilariae migrate from the midgut through the hemocoel to the thoracic muscles of the arthropod. There the microfilariae develop into first-stage larvae and later into third-stage infective larvae. The third-stage infective larvae migrate to the arthropod’s proboscis where they can then infect another human when the midge or blackfly takes a blood meal.
The trial was conducted at 29 sites in the United States, Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Poland, Singapore, Spain, and the United Kingdom.The major efficacy outcome measure was progression-free survival (PFS) based on assessment by blinded independent central review (BICR) using modified RECIST 1.1 in which lymph nodes and bone lesions were not target lesions and a progressively growing new tumor nodule within a pre-existing tumor mass must meet specific criteria to be considered unequivocal evidence of progression. Additional efficacy outcome measures included overall response rate (ORR) by BICR and overall survival (OS). The trial demonstrated a statistically significant improvement in PFS for participants in the ripretinib arm compared with those in the placebo arm (HR 0.15; 95% CI: 0.09, 0.25; p<0.0001).The U.S. Food and Drug Administration (FDA) granted the application for ripretinib priority review and fast track designations, as well as breakthrough therapy designation and orphan drug designation. The FDA granted approval of Qinlock to Deciphera Pharmaceuticals, Inc.

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Ripretinib was approved for medical use in the United States in May 2020, and in Australia in July 2020.On 16 September 2021, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Qinlock, intended for the treatment of advanced gastrointestinal stromal tumour (GIST) in people who have received prior treatment with three or more kinase inhibitors.