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

September 24, 2019 - 14:59 -- Open Access
André Daher, Ghait Aljayyoussi, David G. Lalloo, et al.
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
Michael T. Bretscher, Jamie T. Griffin, Azra C. Ghani and Lucy C. Okell
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
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
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
Louise Roggelin, Dennis Tappe, Bernd Noack, Marylyn M. Addo, Egbert Tannich and Camilla Rothe
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
Nancy C. Sambol, Jordan W. Tappero, Emmanuel Arinaitwe, Sunil Parikh
PLoS ONE 11(5): e0154623

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

Tolerability and safety of weekly primaquine against relapse of Plasmodium vivax in Cambodians with glucose-6-phosphate dehydrogenase deficiency

August 26, 2015 - 16:21 -- Open Access
Sim Kheng, Sinoun Muth, Eva Christophe, et al.
BMC Medicine 2015, 13:203

This study was conducted to assess the tolerability of a primaquine regimen in Cambodian severely deficient G6PD variants to ascertain whether a weekly primaquine could be given without testing for G6PDd.

Not Open Access | A Simple Real-Time PCR and Amplicon Sequencing Method for Identification of Plasmodium Species in Human Whole Blood

May 20, 2015 - 15:12 -- NOT Open Access
Lefterova MI, Budvytiene I, Sandlund J, Färnert A, Banaei N
J Clin Microbiol. 2015 May 13. pii: JCM.00542-15.

Here we describe a SYBR Green-based real-time PCR assay for Plasmodium species identification from whole blood, which uses a panel of reactions to detect species-specific non-18S rRNA gene targets.

Simultaneous quantitation of chloroquine and primaquine by UPLC-DAD and comparison with a HPLC-DAD method

February 24, 2015 - 16:13 -- Open Access
Tiago A Miranda, Pedro HR Silva, Gerson A Pianetti, Isabela C César
Malaria Journal 2015, 14:29 (28 January 2015)

Thus, the aim of this study was to develop and validate a novel UPLC-DAD method for simultaneously quantifying chloroquine and primaquine in tablet formulations.

Primaquine: the risks and the benefits

November 10, 2014 - 17:56 -- Open Access
Elizabeth A Ashley, Judith Recht, Nicholas J White
Malaria Journal 2014, 13:418 (3 November 2014)

All but one death followed multiple dosing to prevent vivax malaria relapse. Review of dose-response relationships and clinical trials of primaquine in G6PD deficiency suggests that the currently recommended WHO single low dose (0.25 mg base/kg) to block falciparum malaria transmission confers a very low risk of haemolytic toxicity.

Not Open Access | Reduced Dose of Primaquine Effective in Blocking Malaria Transmission

January 17, 2014 - 19:00 -- NOT Open Access
M. J. Friedrich
JAMA. 2014;311(3):235

A single lower dose of primaquine is as effective as the higher standard dose that is recommended for preventing transmission of the malarial parasite Plasmodium falciparum from humans to mosquitoes, report researchers from the London School of Hygiene and Tropical Medicine, in the United Kingdom


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