Artemisinin-naphthoquinone for treating uncomplicated Plasmodium falciparum malaria
This review examines trials evaluating the effects of artemisinin-naphthoquine compared to other artemisinin-based combination therapies
Abstract
This Cochrane Review summarises trials evaluating the effects of artemisinin-naphthoquine compared to other artemisinin-based combination therapies (ACTs) recommended by the World Health Organization (WHO) for treating adults and children with uncomplicated P. falciparum malaria. After searching for relevant trials up to January 2015, we included 4 randomized controlled trials, enrolling 740 adults and children.
Uncomplicated malaria is the mild form of malaria which usually causes a fever, with or without headache, tiredness, muscle pains, abdominal pains, nausea, and vomiting. If left untreated, uncomplicated malaria can develop into severe malaria with kidney failure, breathing difficulties, fitting, unconsciousness, and eventually death.
The WHO recommends ACT for treating people with P. falciparum malaria. 5 combinations are currently recommended, all administered over 3 days. Artemisinin-naphthoquine is a new combination developed in China, which is being marketed and evaluated as one-day or three-day regimens.
Artemisinin-naphthoquine versus artemether-lumefantrine
In 3 small trials from Benin, Côte d’Ivoire, and Papua New Guinea, both artemisinin-naphthoquine and AL had a very low incidence of treatment failure at Day 28 (low quality evidence), and in the trial from Papua New Guinea it remained low in both groups at Day 42 (very low quality evidence).
Artemisinin-naphthoquine versus dihydroartemisinin-piperaquine
In a single small study from Indonesia, treatment failure at Day 28 and Day 42 was very low with both artemisinin-naphthoquine and DHA-P (very low quality evidence).
Conclusions
The results of these few trials of artemisinin-naphthoquine are promising, but larger trials from multiple settings are required to be confident that artemisinin-naphthoquine is as effective and well tolerated as other antimalarials.
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Citation
Isba, R.; Zani, B.; Gathu, M.; Sinclair, D. Artemisinin-naphthoquine for treating uncomplicatedPlasmodium falciparummalaria. Cochrane Database of Systematic Reviews (2015) : CD011547. [DOI: 10.1002/14651858.CD011547]
Links
Artemisinin-naphthoquinone for treating uncomplicated <i>Plasmodium falciparum</i> malaria