This from the "Mail & Guardian". Anybody heard of this drug combination?


New therapy cures malaria in one day

Elvira van Noort | Johannesburg, South Africa



11 November 2005 04:16

A new combination therapy comprising only three pills cures patients of malaria once and for all in one day, its Belgian manufacturer said on Friday.

The new therapy has been developed by Belgian company Dafra Pharma and will be launched on the African market next year. The recommended price for government procurement will be €1 (about R8) per adult patient and €0,50 (R4) per child, the company said in a statement.

Dafra Pharma, a medium-sized, family-owned pharmaceutical company in Belgium, claims the therapy effectively combats "even the most complicated forms of the disease".

The new therapy of artesunate and sulfamethoxypyrazine/pyrimethamine will be unveiled on November 14 at the special Artemisinin Combination Therapy Symposium at the Multilateral Initiative for Malaria Congress in Yaoundé, Cameroon, which will be attended by 2 000 scientists from around the world.

The low recommended price for government procurement makes this one-day therapy the cheapest of all artemisinin-based combination therapies to combat malaria.

Accordingly, Dafra Pharma has developed three different therapies for patients of different weights, including one especially for children and babies.

The therapy can also be administered to pregnant women without any risks.

The World Health Organisation (WHO) has recommended combining an existing anti-malarial molecule with an artemisinin derivative, a new molecule originating from an old herb used in Chinese medicine, Artemisia annua, in a bid to reduce treatment time and avoid the possible build-up of resistance.

In the past, patients had to take 24 pills over three days. They had to be very closely monitored, and if they failed to take all their medication there was no guarantee they would be cured; they could even become more vulnerable.

Furthermore, the cure was not always definitive, with some patients suffering a relapse within 28 days or already starting to suffer from a fresh bout of malaria following reinfection. This situation was intolerable and had to be improved.

The efficacy of the new therapy has been tested in studies by Professor Louis Penali, from the Pasteur Institute in Abidjan, Côte d'Ivoire, in accordance with the WHO's current 28-day protocol.

After the initial cure, which takes place after just one day, there were no subsequent clinical relapses -- not even 28 days after the start of treatment -- nor were any parasites left in the patients' blood. This finding was reconfirmed in studies conducted in the Democratic Republic of Congo.

According to figures published by the WHO, every year between 1,5-million and 2,7-million people die of malaria and between 350-million and 500-million contract the disease. Official reports from the WHO suggest that one African child under five years of age dies of malaria every 30 seconds.

this is the first I heard of this - I just hope to god that it is right

FOR MORE DETAILS GO TO:


http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=16162284

I just read the study (preferable to catching up on my own clinic charts). It looks like these reasearchers spread the artesunate dosing out over three days, presumably to decrease incidence of the more dangerous adverse effects. That may also just be a different protocol from the Darfa product recommendations. I don't know.

About 11% of the study patients had nausea, and some of them had vomiting. That can lead to discontinuation problems. I wonder if the patients could be pre-treated with chlorpromazine or some other inexpensive anti-emetic 15 -20 minutes before they receive the artenusate. A small money bribe might work just as well to keep the patients around for all three days of the treatment.

As ALF knows, and I am also painfully aware, I am just a simple country (hillbilly) doctor. With that caveat in mind it looks to me that the study was well constructed, and the results were statistically significant.

lawndart