Artemisinin resistance and artemisinin-based combination therapy efficacy. Status report, August 2018
(2018; 10 pages)

Abstract

Artemisinin-based combination therapies (ACTs) are recommended by WHO as the first-and second-line treatment for uncomplicated P. falciparum malaria as well as for chloroquine-resistant P. vivax malaria. ACTs combine an artemisinin derivative with a partner drug. The role of the artemisinin compound is to reduce the number of parasites during the first three days of treatment (reduction of parasite biomass), while the role of the partner drug is to eliminate the remaining parasites (cure).

WHO currently recommends five different ACTs. However, WHO is considering the use of artesunate-pyronaridine, a new ACT that has received a positive scientific opinion from the European Medicines Agency (EMA), in areas where other ACTs are failing. In the absence of resistance, all six partner drugs would be highly efficacious as monotherapies at the dose used in the ACT. Two injectable treatments, artesunate and artemether, are recommended for the treatment of severe malaria and should be followed by an ACT once the patient can tolerate oral therapy.

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