title: A randomized, double-blind, placebo-controlled, dose-ranging trial of tafenoquine for weekly prophylaxis against Plasmodium falciparum.
abstract: Tafenoquine is a promising new 8-aminoquinoline drug that may be useful for malaria prophylaxis in nonpregnant persons with normal glucose-6-phosphate dehydrogenase (G6PD) function. A randomized, double-blind, placebo-controlled chemoprophylaxis trial was conducted with adult residents of northern Ghana to determine the minimum effective weekly dose of tafenoquine for the prevention of infection by Plasmodium falciparum. The primary end point was a positive malaria blood smear result during the 13 weeks of study drug coverage. Relative to the placebo, all 4 tafenoquine dosages demonstrated significant protection against P. falciparum infection: for 25 mg/week, protective efficacy was 32% (95% confidence interval [CI], 20%-43%); for 50 mg/week, 84% (95% CI, 75%-91%); for 100 mg/week, 87% (95% CI, 78%-93%); and for 200 mg/week, 86% (95% CI, 76%-92%). The mefloquine dosage of 250 mg/week also demonstrated significant protection against P. falciparum infection (protective efficacy, 86%; 95% CI, 72%-93%). There was little difference between study groups in the adverse events reported, and there was no evidence of a relationship between tafenoquine dosage and reports of physical complaints or the occurrence of abnormal laboratory parameters. Tafenoquine dosages of 50, 100, and 200 mg/week were safe, well tolerated, and effective against P. falciparum infection in this study population.
authors.affiliation: US Navy Medical Research Unit No. 3, Cairo, Egypt.
authors.forename: Braden R
authors.initials: BR
authors.lastname: Hale
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
authors.forename: David J
authors.initials: DJ
authors.lastname: Fryauff
authors.forename: Kwadwo A
authors.initials: KA
authors.lastname: Koram
authors.forename: Martin
authors.initials: M
authors.lastname: Adjuik
authors.forename: Abraham R
authors.initials: AR
authors.lastname: Oduro
authors.forename: W Roy
authors.initials: WR
authors.lastname: Prescott
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Baird
authors.forename: Francis
authors.initials: F
authors.lastname: Nkrumah
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Ritchie
authors.forename: Eileen D
authors.initials: ED
authors.lastname: Franke
authors.forename: Fred N
authors.initials: FN
authors.lastname: Binka
authors.forename: John
authors.initials: J
authors.lastname: Horton
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018890:Chemoprevention; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000962:Antimalarials; C055852:tafenoquine