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Primaquine

Optimal timing of primaquine to reduce Plasmodium falciparum gametocyte carriage when co-administered with artemether–lumefantrine

January 24, 2020 - 14:49 -- Open Access
Author(s): 
Seif Shekalaghe, Dominic Mosha, Ali Hamad, Thabit A. Mbaga, Michael Mihayo, Teun Bousema, Chris Drakeley and Salim Abdulla
Reference: 
Malaria Journal 2020 19:34, 21 January 2020

Primaquine is an important gametocytocidal drug that is combined with conventional malaria treatment for prevention of Plasmodium falciparum malaria transmission. Primaquine has been administered together on the first or the last day of conventional treatment but the impact of primaquine timing has never been examined. This study aimed to assess safety, efficacy and optimal timing of single full-dose (0.75 mg/kg) primaquine when added to a standard 6-dose regimen of artemether–lumefantrine (AL).

The use of ultrasensitive quantitative-PCR to assess the impact of primaquine on asymptomatic relapse of Plasmodium vivax infections: a randomized, controlled trial in Lao PDR

January 7, 2020 - 14:55 -- Open Access
Author(s): 
Koukeo Phommasone, Frank van Leth, Mayfong Mayxay, et al.
Reference: 
Malaria Journal 2020 19:4, 3 January 2020

Trials to assess the efficacy of the radical cure of Plasmodium vivax malaria with 8-aminoquinolines require that most post-treatment relapses are identified, but there is no consensus on the optimal duration of follow-up in either symptomatic or asymptomatic vivax malaria. The efficacy of a 14-day course of primaquine on the cumulative incidence of recurrent asymptomatic P. vivax infections detected by ultrasensitive quantitative PCR (uPCR) as a primary endpoint was assessed.

Coupling the Antimalarial Cell Penetrating Peptide TP10 to Classical Antimalarial Drugs Primaquine and Chloroquine Produces Strongly Hemolytic Conjugates

December 23, 2019 - 14:59 -- Open Access
Author(s): 
Aguiar L, Biosca A, Lantero E, Gut J, Vale N, Rosenthal PJ, Nogueira F, Andreu D, Fernàndez-Busquets X, Gomes P
Reference: 
Molecules 2019, 24(24), 4559

Recently, we disclosed primaquine cell penetrating peptide conjugates that were more potent than parent primaquine against liver stage Plasmodium parasites and non-toxic to hepatocytes. The same strategy was now applied to the blood-stage antimalarial chloroquine, using a wide set of peptides, including TP10, a cell penetrating peptide with intrinsic antiplasmodial activity. Chloroquine-TP10 conjugates displaying higher antiplasmodial activity than the parent TP10 peptide were identified, at the cost of an increased hemolytic activity, which was further confirmed for their primaquine analogues.

Killing of Plasmodium vivax by Primaquine and Tafenoquine

October 30, 2019 - 09:45 -- Open Access
Author(s): 
Miles B. Markus
Reference: 
Trends In Parasitology, Volume 35, ISSUE 11, P857-859, November 01, 2019

Primaquine administration results in H 2O 2 accumulation in bone marrow, where gametocytes and asexual parasites are therefore killed. This finding, by Camarda et al. , supports the theory that the nonperipheral blood origin of recurrent Plasmodium vivax malaria is both hypnozoites (relapse source) and merozoites (recrudescence source), not hypnozoites only.

Medical Condition: 

The efficacy of dihydroartemisinin-piperaquine and artemether-lumefantrine with and without primaquine on Plasmodium vivax recurrence: A systematic review and individual patient data meta-analysis

October 15, 2019 - 15:36 -- Open Access
Author(s): 
Robert J. Commons, Julie A. Simpson, Ric N. Price, et al.
Reference: 
PLoS Med 16(10): e1002928

Artemisinin-based combination therapy (ACT) is recommended for uncomplicated Plasmodium vivax malaria in areas of emerging chloroquine resistance. We undertook a systematic review and individual patient data meta-analysis to compare the efficacies of dihydroartemisinin-piperaquine (DP) and artemether-lumefantrine (AL) with or without primaquine (PQ) on the risk of recurrent P. vivax.

Medical Condition: 

Pharmacokinetics/pharmacodynamics of chloroquine and artemisinin-based combination therapy with primaquine

September 24, 2019 - 14:59 -- Open Access
Author(s): 
André Daher, Ghait Aljayyoussi, David G. Lalloo, et al.
Reference: 
Malaria Journal 2019 18:325, 23 September 2019

Activation of hypnozoites of vivax malaria causes multiple clinical relapses, which contribute to the Plasmodium vivax burden and continuing transmission. Artemisinin-based combination therapy (ACT) is effective against blood-stage P. vivax but requires co-administration with primaquine to achieve radical cure. The therapeutic efficacy of primaquine depends on the generation of a therapeutically active metabolite via cytochrome P450 2D6 (CYP2D6). Impaired CYP2D6 metabolism has been associated with primaquine treatment failure. This study investigated the association between impaired CYP2D6 genotypes, drug-exposure to the long-acting ACT component (schizonticidal drugs) and tolerance and efficacy.

Medical Condition: 

Modelling the benefits of long-acting or transmission-blocking drugs for reducing Plasmodium falciparum transmission by case management or by mass treatment

August 22, 2017 - 17:51 -- Open Access
Author(s): 
Michael T. Bretscher, Jamie T. Griffin, Azra C. Ghani and Lucy C. Okell
Reference: 
Malaria Journal 2017 16:341, 16 August 2017

These results emphasise the importance of increasing access to treatment for routine case management, and the potential value of choosing first-line anti-malarial treatment policies according to local malaria epidemiology to maximise impact on transmission.

Medical Treatment: 

Barriers to routine G6PD testing prior to treatment with primaquine

August 14, 2017 - 15:34 -- Open Access
Author(s): 
Benedikt Ley, Kamala Thriemer, Jessica Jaswal, Eugenie Poirot, Mohammad Shafiul Alam, Ching Swe Phru, Wasif Ali Khan, Lek Dysoley, Gao Qi, Chong Chee Kheong, Ummi Kalthom Shamsudin, Ingrid Chen, Jimee Hwang, Roly Gosling and Ric N. Price
Reference: 
Malaria Journal 2017 16:329, 10 August 2017

Greater efforts are needed to increase awareness of the benefits of the radical cure of Plasmodium vivax and this should be supported by economic analyses exploring the cost effectiveness of routine G6PD testing.

Sharp increase of imported Plasmodium vivax malaria seen in migrants from Eritrea in Hamburg, Germany

June 21, 2016 - 14:29 -- Open Access
Author(s): 
Louise Roggelin, Dennis Tappe, Bernd Noack, Marylyn M. Addo, Egbert Tannich and Camilla Rothe
Reference: 
Malaria Journal 2016 15:325, 17 June 2016

Countries hosting Eritrean refugees need to be aware of vivax malaria occurring in this group and the risk of autochthonous cases due to local transmission by indigenous, vector competent Anopheles species.

Rethinking Dosing Regimen Selection of Piperaquine for Malaria Chemoprevention: A Simulation Study

May 24, 2016 - 15:30 -- Open Access
Author(s): 
Nancy C. Sambol, Jordan W. Tappero, Emmanuel Arinaitwe, Sunil Parikh
Reference: 
PLoS ONE 11(5): e0154623

Once weekly chemoprevention of DP predicts favourable exposures with respect to both trough and peak concentrations.

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