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Qinghaosu in combinations.

N J White1

  • 1Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. fnrijw@diamond.mahidol.ac.th

Medecine Tropicale : Revue Du Corps De Sante Colonial
|April 23, 1999
PubMed
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Combining antimalarial drugs, particularly artemisinin derivatives with slow-acting options, is crucial. This strategy helps protect existing malaria treatments against parasite resistance, safeguarding their efficacy for longer periods.

Area of Science:

  • * Pharmacology and Tropical Medicine
  • * Drug Resistance Mechanisms
  • * Antimalarial Drug Development

Background:

  • * Limited pipeline of new antimalarial drugs.
  • * High capacity of the malaria parasite to develop drug resistance.
  • * Urgent need to preserve the effectiveness of current antimalarial therapies.

Purpose of the Study:

  • * To evaluate the rationale for using antimalarial drug combinations.
  • * To assess the evidence supporting combination therapy in delaying drug resistance.
  • * To recommend optimal strategies for deploying antimalarial drugs, especially artemisinin derivatives.

Main Methods:

  • * Review of existing literature on antimalarial drug resistance.
  • * Analysis of experimental data from animal models.

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  • * Assessment of circumstantial evidence from human malaria treatment.

    • Main Results:

    • * Experimental animal studies unequivocally demonstrate that drug combinations delay resistance onset.
    • * Formal proof in human malaria is challenging but circumstantial evidence strongly suggests a similar effect.
    • * Certain antimalarial drugs are highly vulnerable to resistance conferred by single or double point mutations.

    Conclusions:

    • * Antimalarial combination therapy is a rational approach to combat drug resistance.
    • * Artemisinin derivatives should be combined with all slow-acting antimalarial drugs.
    • * Drugs with vulnerable resistance profiles must always be deployed in combination with an artemisinin derivative to prevent high-level resistance.