Artemisinin-based combination regimens are recommended by WHO for the treatment of uncomplicated
Plasmodium falciparum malaria. One such combination comprises the
artemisinin derivative
dihydroartemisinin and the bisquinolone
piperaquine. Eurartesim® is the only
dihydroartemisinin/
piperaquine formulation that meets international good manufacturing practice standards. This article reviews the pharmacological properties of
dihydroartemisinin and
piperaquine, and the therapeutic efficacy and tolerability of
dihydroartemisinin/
piperaquine in the treatment of uncomplicated P.
falciparum malaria. A number of trials have shown
dihydroartemisinin/
piperaquine to be highly effective in the treatment of uncomplicated P.
falciparum malaria. Two pivotal, randomized, open-label, multicentre trials demonstrated the Eurartesim® formulation of
dihydroartemisinin/
piperaquine to be noninferior to
artesunate plus
mefloquine in children and adults in Asia and noninferior to
artemether/lumefantrine in children in Africa, in terms of polymerase chain reaction-corrected cure rates. In both trials,
dihydroartemisinin/
piperaquine recipients were significantly less likely than
artesunate plus
mefloquine recipients or
artemether/lumefantrine recipients to experience
reinfection. Gametocyte carriage was greater in patients receiving
dihydroartemisinin/
piperaquine than in those receiving comparator
antimalarial regimens. The Eurartesim® formulation of
dihydroartemisinin/
piperaquine was generally well tolerated in the treatment of uncomplicated P.
falciparum malaria, and was associated with significantly less
nausea,
vomiting and
dizziness than
artesunate plus
mefloquine. Although prolongation of the corrected QT interval has been reported in patients receiving
dihydroartemisinin/
piperaquine, there are currently no clinical data signalling that it is associated with clinically significant arrhythmias. In conclusion,
dihydroartemisinin/
piperaquine is a valuable option for use in the first-line treatment of uncomplicated P.
falciparum malaria.