HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Randomized, controlled dose-optimization studies of dihydroartemisinin-piperaquine for the treatment of uncomplicated multidrug-resistant falciparum malaria in Thailand.

AbstractBACKGROUND:
Dihydroartemisinin-piperaquine (DP) is a new and relatively inexpensive artemisinin-containing fixed-combination antimalarial treatment. An adult treatment course contained 6.4 mg/kg dihydroartemisinin (DHA), which is >40% lower than the level in most artemisinin-containing combinations. This raised the possibility that the efficacy of the current coformulation may not be optimal in the treatment of multidrug-resistant falciparum malaria.
METHODS:
In 2 large randomized, controlled studies in Thailand, the recommended dose of DP was compared with a regimen with additional artemisinin derivative (12 mg/kg; DP+) and with mefloquine plus artesunate (MAS3).
RESULTS:
A total of 731 patients were included: 201 in a hospital-based study and 530 in a community study. Day-28 cure rates in the hospital-based study were 100% (95% confidence interval [CI], 93.9%-100%) in the MAS3 and DP+ groups and 98.3% (95% CI, 91%-99.7%) in the DP group, with a single recrudescence on day 21. In the community study, polymerase chain reaction genotyping-adjusted cure rates on day 63 were 96.1% (95% CI, 92.6%-99.7%) in the DP group, 98.3% (95% CI, 96.1%-100%) in the DP+ group, and 94.9% (95% CI, 91.2%-98.6%) in the MAS3 group (P=.2). Adverse events were few, with an excess of mild abdominal pain in the DP group.
CONCLUSIONS:
The current dosage of DP (6.4 mg/kg DHA and 51.2 mg/kg piperaquine phosphate) given over the course of 48 h is highly effective, safe, and well tolerated for the treatment of multidrug-resistant falciparum malaria, and its efficacy is not improved by the addition of more DHA.
AuthorsElizabeth A Ashley, Srivicha Krudsood, Lucy Phaiphun, Siripan Srivilairit, Rose McGready, Wattana Leowattana, Robert Hutagalung, Polrat Wilairatana, Alan Brockman, Sornchai Looareesuwan, Francois Nosten, Nicholas J White
JournalThe Journal of infectious diseases (J Infect Dis) Vol. 190 Issue 10 Pg. 1773-82 (Nov 15 2004) ISSN: 0022-1899 [Print] United States
PMID15499533 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Artemisinins
  • Drug Combinations
  • Quinolines
  • Sesquiterpenes
  • Artesunate
  • artenimol
  • piperaquine
  • Mefloquine
Topics
  • Adolescent
  • Adult
  • Animals
  • Antimalarials (administration & dosage, adverse effects, therapeutic use)
  • Artemisinins (administration & dosage, adverse effects, therapeutic use)
  • Artesunate
  • Child
  • Child, Preschool
  • Drug Combinations
  • Drug Resistance, Multiple
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infant
  • Malaria, Falciparum (drug therapy, parasitology)
  • Male
  • Mefloquine (administration & dosage, adverse effects, therapeutic use)
  • Middle Aged
  • Plasmodium falciparum (drug effects, growth & development, isolation & purification)
  • Quinolines (administration & dosage, adverse effects, therapeutic use)
  • Sesquiterpenes (administration & dosage, adverse effects, therapeutic use)
  • Thailand

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: