New Combination Malaria Treatment Equally Effective

Pyronaridine-artesunate as effective as mefloquine plus artesunate for uncomplicated malaria

THURSDAY, April 5 (HealthDay News) -- Fixed-dose, combination pyronaridine-artesunate treatment is as effective as mefloquine plus artesunate in treating malaria infection, according to a study published in the April 5 issue of the New England Journal of Medicine.

Ronnatrai Rueangweerayut, M.D., from Mae Sot General Hospital in Tak, Thailand, and colleagues randomly assigned 1,271 patients from Asia or Africa (3 to 60 years old) with confirmed uncomplicated Plasmodium falciparum (P. falciparum) malaria to a fixed-dose combination of 180 mg pyronaridine plus 60 mg artesunate (848 patients) or 250 mg mefloquine plus 100 mg artesunate (423 patients) once daily for three days.

Based on the end point of adequate clinical and parasitological response on day 28, corrected for reinfection, in the per-protocol population, the researchers found that efficacy was similar for the two groups, at 99.2 percent in the pyronaridine-artesunate group and 97.8 percent for the mefloquine plus artesunate group. In the intention-to-treat population, efficacy on day 42 was 83.1 percent in the pyronaridine-artesunate group and 83.9 percent in the mefloquine plus artesunate group. Among the 211 Cambodian patients, median parasite clearance times were significantly longer in both groups.

"Fixed-dose pyronaridine-artesunate was efficacious in the treatment of uncomplicated P. falciparum malaria," Rueangweerayut and colleagues conclude. "In Cambodia, extended parasite clearance times were suggestive of in vivo resistance to artemisinin."

The study was supported by a public-private partnership between Shin Poong Pharmaceutical Company and Medicines for Malaria Venture; several authors disclosed financial ties to the latter.

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