An Open Randomized Clinical Trial of Artekin® vs Artesunate-mefloquine in the Treatment of Acute Uncomplicated Falciparum Malaria
C Pengruksa, K Chalermrut, N Tangpukdee, P Wilairatana, S Kano, S Krudsood, S Phongtananant, S Srivilairit, U Silachamroon, W Thanachartwet, Sornchai Looareesuwan
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand. Tel: +66 (0) 2354-9159; Fax: +66 (0) 2354-9158 E-mail: tmslr@mahidol.ac.th
บทคัดย่อ
Malaria remains a major cause of morbidity and mortality in tropical countries and subtropical regions in the world. Southeast Asia has the most resistant malaria parasites in the world, which has limited treatment options in this region. In response to this situation, short-course artemisinin-based combination therapies (ACTs) have been developed. The combination of dihydroartemisinin (DHA) and piperaquine (PQP) in the form of Artekin® has been developed as an alternative to established combinations, such as artesunate-mefloquine, primarily to reduce treatment costs and toxicity. We conducted a study comparing a standard treatment for acute uncomplicated falciparum malaria (artesunate 4 mg/kg/day together with mefloquine 8 mg/kg/day oral route  once a day for 3 days) (Group A) and a combination of dihydroartemisinin 40 mg and piperaquine 320 mg in the form of Artekin® given once a day for 3 days (Group B) to determine safety, efficacy, and tolerability. One hundred and eighty patients were randomly enrolled at the ratio of 1:2 into groups A:B. All patients had rapid initial clinical and parasitological responses. There were no significant differences in fever clearance time or parasite clearance time between both groups. The 28-day cure rates were high, at 100% and 99%, in groups A and B, respectively. We conclude that Artekin® was as effective and well-tolerated as artesunate-mefloquine, and can be used alternatively as the current treatment for multidrug-resistant P. falciparum malaria.
ที่มา
Southeast Asian Journal of Tropical Medicine & Public Health ปี 2548, September ปีที่: 36 ฉบับที่ 5 หน้า 1085-1091