Pyronaridine–Artesunate versus Mefloquine plus Artesunate for Malaria

• Published in: The New England journal of medicine Vol. 366; no. 14; pp. 1298 - 1309
• Main Authors: Rueangweerayut, Ronnatrai, Phyo, Aung Pyae, Uthaisin, Chirapong, Poravuth, Yi, Binh, Tran Quang, Tinto, Halidou, Pénali, Louis K, Valecha, Neena, Tien, Nong Thi, Abdulla, Salim, Borghini-Fuhrer, Isabelle, Duparc, Stephan, Shin, Chang-Sik, Fleckenstein, Lawrence
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 05.04.2012
• Subjects: Adolescent; Adult; Africa; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimalarials - administration & dosage; Antimalarials - adverse effects; Antimalarials - therapeutic use; Antiparasitic agents; Artemisinin; Artemisinins - administration & dosage; Artemisinins - adverse effects; Artemisinins - therapeutic use; Artesunate; Asia; Biological and medical sciences; Body weight; Child; Child, Preschool; Drug Combinations; Drug dosages; Drug Resistance; Female; General aspects; Genotyping; Human protozoal diseases; Humans; Infectious diseases; Intention to Treat Analysis; Kaplan-Meier Estimate; Liver; Malaria; Malaria, Falciparum - drug therapy; Male; Medical sciences; Mefloquine; Mefloquine - administration & dosage; Mefloquine - adverse effects; Mefloquine - therapeutic use; Middle Aged; Motivation; Naphthyridines - administration & dosage; Naphthyridines - adverse effects; Naphthyridines - therapeutic use; Parasites; Parasitic diseases; Participation; Patients; Pharmaceutical industry; Pharmacology. Drug treatments; Plasmodium falciparum; Proportional Hazards Models; Protozoal diseases; Pyronaridine; Seizures; Substance abuse treatment; Young Adult; Cambodia; Infection; Medicine; Antimalarial; Protozoal disease; Drug combination; Mefloquine; Malaria; Pyronaridine; Artesunate; Parasiticide; Parasitosis; Comparative study
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1007125

New therapies to treat malaria are needed. In this report, in which the authors studied 1271 patients from Asia and Africa, pyronaridine–artesunate was found to be noninferior to mefloquine plus artesunate in the treatment of uncomplicated Plasmodium falciparum malaria. Artemisinin-based combination therapy is critical for the effective treatment and control of Plasmodium falciparum malaria. 1 – 4 However, reports from the Cambodian–Thai border indicate the emergence of artemisinin tolerance or resistance in P. falciparum . 2 – 8 Pyronaridine–artesunate is a fixed-dose, artemisinin-based combination therapy that is being developed for the treatment of uncomplicated P. falciparum and P. vivax malaria. 9 – 11 In phase 2 and 3 clinical trials, a fixed-dose, 3:1 ratio of pyronaridine to artesunate has shown high efficacy in the treatment of falciparum malaria, with cure rates on day 28 of more than 98% (corrected for reinfection with the use of . . .