Dihydroartemisinin-Piperaquine versus Artesunate-Amodiaquine: Superior Efficacy and Posttreatment Prophylaxis against Multidrug-Resistant Plasmodium falciparum and Plasmodium vivax Malaria

Abstract

DHP was more effective and better tolerated than AAQ against multidrug-resistant P. falciparum and P. vivax infections. The prolonged therapeutic effect of piperaquine delayed the time to P. falciparum reinfection, decreased the rate of recurrence of P. vivax infection, and reduced the risk of P. vivax gametocyte carriage and anemia.

The Impact of Pharmacokinetic Mismatched Antimalarial Drug Combinations on the Emergence and Spread of Drug Resistant Parasites

“…DP demonstrated better efficacy and tolerability compared to AS-AQ for treatment of drugresistant falciparum and vivax malaria infections. The extended post-treatment prophylactic effect provided by piperaquine delayed falciparum re-infection, diminished the incidence of vivax infection, decreased clinical anemia, and decreased the potential for vivax gametocyte carriage [16,17].…”

“…Piperaquine offers many advantages as a combination partner for treatment of uncomplicated malaria including superior efficacy, lower toxicity, and long-duration prophylaxis. Accordingly, the DP combination offers significant benefits over other available ACTs making it a prime option for the management of uncomplicated malaria [16].…”

“…Long-term studies of combination treatment with chloroquine or treatment with chloroquine analogues like piperaquine may assist in determining the best method of extending the life of existing drugs. [16,19].…”

Antimalarial Drugs – What is in Use and What is in the Pipeline

“…In different clinical trials the combination of piperaquine 22 and dihydroartemisinine 9 (Euartekinm) has been effective and well tolerated [129 -136]. Against P. vivax piperaquine/dihydroartemisinine was more effective than artesunate/amodiaquine [137].…”

An Efficient, Green Chemical Synthesis of the Malaria Drug, Piperaquine

“…Artemisinin Combination Therapies (ACTs) are recommended by the World Health Organization for the treatment of uncomplicated malaria. The combination of dihydroartemisinin + piperaquine (DHAP) has demonstrated superior efficacy and post-treatment prophylaxis against Plasmodial forms of malaria ( Figure 1) [2]. Two major donor agencies, GFATM (the Global Fund for AIDS, Tuberculosis and Malaria) and PEPFAR (US President's Emergency Plan for AIDS Relief), provide several billion USD each year for the management of HIV/AIDS, malaria, and other neglected diseases [3].…”