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Selected studies evaluating efficacy of artemisinin combination therapies

Selected studies evaluating efficacy of artemisinin combination therapies
Reference Drug regimen Result Number patients Age Location Year
Ngasala BE et al[1] Artemether-lumefantrine High efficacy 359 Children Tanzania 2011
Achan J et al[2] Artemether-lumefantrine versus quinine Artemether-lumefantrine superior 175 Children Uganda 2009
Dorsey G et al[3] Artemether-lumefantrine verus artesunate-amodiaquine versus amodiaquine-sulfadoxine-pyrimethamine Artemether-lumefantrine superior 601 Children Uganda 2007
Zwang J et al[4] Artemether-lumefantrine versus artesunate-amodiaquine Artesunate-amodiaquine was followed by fewer recurrences 602 Children Uganda 2016
Toure O et al[5] Artemether-lumefantrine versus arterolane maleate-piperaquine phosphate Comparable efficacy and safety 859 Children Africa and India 2017
Thriemer K et al[6] Artemether-lumefantrine versus artesunate-azithromycin Equivalent cure rates 228 Adults and children Bangladesh 2010
Zwang J et al[7] Artesunate-amodiaquine versus non-ACT therapy Artesunate-amodiaquine superior to non-ACT therapy 11,700 Adults and children Multi-country 2009
Tahar R et al[8] Artesunate-amodiaquine versus atovaquone-proguanil versus artesunate-atovaquone-proguanil Equivalent efficacies by PCR; slower clearance with atovaquone-proguanil arm versus artesunate-atovaquone-proguanil 338 Children Cameroon 2014
Sirima S et al[9] Artesunate-mefloquine versus artemether-lumefantrine Comparable efficacy with similar rates of adverse events 945 Children Burkina Faso, Kenya, and Tanzania 2016
Smithuis F et al[10] Artesunate-mefloquine versus artesunate-amodiaquine versus dihydroartemisinin-piperaquine versus artemether-lumefantrine Artesunate-mefloquine greatest posttreatment suppression 808 Adults and children Myanmar 2010
Rueangweerayut R et al[11] Artesunate-mefloquine versus pyronaridine-artesunate Similar efficacies; longer parasite clearance times with pyronaridine-artesunate 1271 Adults and children Multi-country 2012
Sagara I et al[12] Either pyronaridine-artesunate or dihydroartemisinin-piperaquine versus either artesunate-amodiaquine or artemether-lumefantrine Pyronaridine-artesunate and dihydroartemisinin-piperaquine noninferior to artesunate-amodiaquine and artemether-lumefantrine 4710 Adults and children Burkina Faso, Guinea, and Mali 2018
Zani B et al[13] Dihydroartemisinin-piperaquine versus other ACTs

In Africa: Dihydroartemisinin-piperaquine reduces treatment failure compared with artemether-lumefantrine, (though both with PCR-adjusted failure rates <5%)

In Asia: Dihydroartemisinin-piperaquine as effective as artesunate-mefloquine
16,382 Adults and children Multi-country 2014
Wanzira H et al[14] Dihydroartemisinin-piperaquine versus artemether-lumefantrine Dihydroartemisinin-piperaquine superior 312 Children Uganda 2014
Yeka et al[15] Dihydroartemisinin-piperaquine artemether-lumefantrine Regimens equivalent for treatment of uncomplicated Plasmodium falciparum malaria 599 Children Uganda 2019
Pryce et al[16] Pyronaridine-artesunate compared with alternative ACTs Pyronaridine-artesunate efficacious against uncomplicated P. falciparum malaria; treatment failure rate of <5% at days 28 and 42; may be at least as good as or better than other ACTs 5711 Adults and children Multicountry, Africa, and Asia 5 studies published up until October 2021
ACT: artemisinin combination therapy; PCR: polymerase chain reaction.
References:
  1. Ngasala BE, Malmberg M, Carlsson AM, et al. Efficacy and effectiveness of artemether-lumefantrine after initial and repeated treatment in children <5 years of age with acute uncomplicated Plasmodium falciparum malaria in rural Tanzania: a randomized trial. Clin Infect Dis 2011; 52:873.
  2. Achan J, Tibenderana JK, Kyabayinze D, et al. Effectiveness of quinine versus artemether-lumefantrine for treating uncomplicated falciparum malaria in Ugandan children: randomised trial. BMJ 2009; 339:b2763.
  3. Dorsey G, Staedke S, Clark TD, et al. Combination therapy for uncomplicated falciparum malaria in Ugandan children: a randomized trial. JAMA 2007; 297:2210.
  4. Yeka A, Kigozi R, Conrad MD, et al. Artesunate/amodiaquine versus artemether/lumefantrine for the treatment of uncomplicated malaria in Uganda: A randomized trial. J Infect Dis 2016; 213:1134.
  5. Toure OA, Mwapasa V, Sagara I, et al. Assessment of efficacy and safety of arterolane maleate-piperaquine phosphate dispersible tablets in comparison with artemether-lumefantrine dispersible tablets in pediatric patients with acute uncomplicated Plasmodium falciparum malaria: A phase 3, randomized, multicenter trial in India and Africa. Clin Infect Dis 2017; 65:1711.
  6. Thriemer K, Starzengruber P, Khan WA, et al. Azithromycin combination therapy for the treatment of uncomplicated falciparum malaria in Bangladesh: an open-label randomized, controlled clinical trial. J Infect Dis 2010; 202:392.
  7. Zwang J, Olliaro P, Barennes H, et al. Efficacy of artesunate-amodiaquine for treating uncomplicated falciparum malaria in sub-Saharan Africa: a multi-centre analysis. Malar J 2009; 8:203.
  8. Tahar R, Almelli T, Debue C, et al. Randomized trial of artesunate-amodiaquine, atovaquone-proguanil, and artesunate-atovaquone-proguanil for the treatment of uncomplicated falciparum malaria in children. J Infect Dis 2014; 210:1962.
  9. Sirima SB, Ogutu B, Lusingu JPA, et al. Comparison of artesunate–mefloquine and artemether–lumefantrine fixed-dose combinations for treatment of uncomplicated Plasmodium falciparum malaria in children younger than 5 years in sub-Saharan Africa: a randomised, multicentre, phase 4 trial. Lancet 2016; 16:1123.
  10. Smithuis F, Kyaw MK, Phe O, et al. Effectiveness of five artemisinin combination regimens with or without primaquine in uncomplicated falciparum malaria: an open-label randomised trial. Lancet Infect Dis 2010; 10:673.
  11. Rueangweerayut R, Phyo AP, Uthaisin C, et al. Pyronaridine-artesunate versus mefloquine plus artesunate for malaria. N Eng J Med 2012; 366:1298.
  12. West African Network for Clinical Trials of Antimalarial Drugs (WANECAM). Pyronaridine-artesunate or dihydroartemisinin-piperaquine versus current first-line therapies for repeated treatment of uncomplicated malaria: a randomised, multicentre, open-label, longitudinal, controlled, phase 3b/4 trial. Lancet 2018; 391:1378.
  13. Zani B, Gathu M, Donegan S, et al. Dihydroartemisinin-piperaquine for treating uncomplicated Plasmodium falciparum malaria. Cochrane Database Syst Rev 2014; 1:CD010927.
  14. Wanzira H, Kakuru A, Arinaitwe E, et al. Longitudinal outcomes in a cohort of Ugandan children randomized to artemether-lumefantrine versus dihydroartemisinin-piperaquine for the treatment of malaria. Clin Infect Dis 2014; 59:509.
  15. Yeka A, Wallender E, Mulebeke R, et al. Comparative efficacy of artemether-lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated malaria in Ugandan children. J Infect Dis 2019; 219:1112.
  16. Pryce J, Taylor M, Fox T, Hine P. Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria. Cochrane Database Syst Rev 2022; 6:CD006404.
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