Efficacy and safety of a fixed-dose oral combination of pyronaridine-artesunate compared with artemether-lumefantrine in children and adults with uncomplicated Plasmodium falciparum malaria: a randomised non-inferiority trial

Efficacy of artemether-lumefantrine in treatment of malaria among under-fives and prevalence of drug resistance markers in Igombe-Mwanza, north-western Tanzania

“…This is similar to what has been found in other places of Tanzania and Sub-Saharan Africa in general where cure rates ranged from 96 to 100 in children [8][9][10][11]28]. The percentage of re-infection in this study was higher compared to the findings in the above studies.…”

“…Data from the field are now reporting emergence of what is referred to as artemisinin resistance due to increased number of parasites, which shows delayed clearance from blood circulation on artemisinin combination therapy (ACT) [7]. Clinical trials carried out so far in Africa shows high efficacy of AL combination therapy [8][9][10][11]. Hunt et al, 2009 reports that analysis of studies in East Africa shows that the parasites were being controlled less well by the artemisinin component of ACT in 2007/ 2008 studies than in 2005/2006 [12].…”

Efficacy and Safety of Pyronaridine-Artesunate for Treatment of Uncomplicated Plasmodium falciparum Malaria in Western Cambodia

“…The high day 42 recrudescence rate reported for Pailin is consistent with that noted in 2007 to 2008 for pyronaridine-artesunate at this site (10.2%) (20). In contrast, across other regions of Asia and Africa, Kaplan-Meier estimates of day 42 PCR-adjusted recrudescence rates in three phase 3 trials of pyronaridine-artesunate for treatment of falciparum malaria were 1.2%, 4.5%, and 5.0% (18,21). Pyronaridine-artesunate was well tolerated, with a safety profile consistent with those reported in previous studies (17,18,20,21,24).…”

“…Also, as pyronaridine has not been used as monotherapy in Cambodia, it was hoped that resistance would be uncommon. Across all the Asian and African countries included in phase 2/3 trials, pyronaridine-artesunate had high efficacy against P. falciparum malaria: the day 28 PCR-adjusted adequate clinical and parasitological response (ACPR) was 98.5% (per-protocol population), and the efficacy was similar to that of first-line ACTs (17)(18)(19)(20)(21). However, data from Pailin obtained in a phase 3 study of P. falciparum malaria conducted in 2007 to 2008 reported a day 42 recrudescence rate of 10.2% with pyronaridineartesunate (n ϭ 140), versus 0% for mefloquine-artesunate (n ϭ 71; P ϭ 0.04) (20).…”

Immunochemical Analysis of the Antimalarial Drugs Artemisinin and Artesunate

“…Currently, AM and its related compounds (Figure 1), artesunate (AS) and artemether, are the most important drugs for the treatment of malaria and are used in artemisinin-based combination therapies (ACTs) recommended by the World Health Organization [4][5][6][7][8]. The number of patients receiving an ACT treatment course reached 158 million in 2009, and the cultivation of A. annua and production of artemisinin have expanded in line with the increase in global demand for ACTs.…”