Randomized, controlled dose-optimization studies of dihydroartemisinin-piperaquine for the treatment of uncomplicated multidrug-resistant falciparum malaria in Thailand.
Abstract | BACKGROUND: 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.
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Authors | Elizabeth 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 |
Journal | The Journal of infectious diseases
(J Infect Dis)
Vol. 190
Issue 10
Pg. 1773-82
(Nov 15 2004)
ISSN: 0022-1899 [Print] United States |
PMID | 15499533
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antimalarials
- Artemisinins
- Drug Combinations
- Quinolines
- Sesquiterpenes
- Artesunate
- artenimol
- piperaquine
- Mefloquine
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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
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