CV8, a new combination of dihydroartemisinin, piperaquine, trimethoprim and primaquine, compared with atovaquone-proguanil against falciparum malaria in Vietnam.
OBJECTIVE
To study a new combination, based on dihydroartemisinin and piperaquine (CV8) and atovaquone/proguanil (Malarone) for treatment of uncomplicated falciparum malaria in Vietnam.


METHODS
Vietnamese adults with falciparum malaria were allocated randomly to treatment with dihydroartemisinin/piperaquine/trimethoprim/primaquine 256/2560/720/40 mg (CV8, n = 84) or Malarone 3000/1200 mg (n = 81), both over 3 days. Patients were followed-up for 28 days.


RESULTS
All patients recovered rapidly. The mean (95% CI) parasite elimination half-life of CV8 was 6.8 h (6.2-7.4) and of Malarone 6.5 h (6.1-6.9) (P = 0.4). Complete parasite clearance time was 35 (31-39) and 34 h (31-38) (P = 0.9). The 28-day cure rate was 94% and 95%, respectively (odds ratio 0.84, 95% CI 0.18-3.81). No significant side-effects were found.


CONCLUSIONS
CV8 and Malarone are effective combinations against multi-drug resistant falciparum malaria. CV8 has the advantage of a low price.
Giao
Phan T
PT
Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, Amsterdam, The Netherlands.
de Vries
Peter J
PJ
Hung
Le Q
le Q
Binh
Tran Q
TQ
Nam
Nguyen V
NV
Kager
Piet A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D037621:Artemisinins / Q000008:administration & dosage / Q000009:adverse effects; D053626:Atovaquone; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009285:Naphthoquinones / Q000009:adverse effects / Q000627:therapeutic use*; D018512:Parasitemia / Q000188:drug therapy; D010963:Plasmodium falciparum / Q000187:drug effects; D011319:Primaquine / Q000008:administration & dosage / Q000009:adverse effects; D002727:Proguanil / Q000009:adverse effects / Q000627:therapeutic use*; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects; D012717:Sesquiterpenes / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014295:Trimethoprim / Q000008:administration & dosage / Q000009:adverse effects; D014744:Vietnam; D010879:Piperazines
D000962:Antimalarials; D037621:Artemisinins; D053626:Atovaquone; D004338:Drug Combinations; D009285:Naphthoquinones; D011319:Primaquine; D002727:Proguanil; D011804:Quinolines; D012717:Sesquiterpenes; D014295:Trimethoprim; C109496:atovaquone, proguanil drug combination; C039060:artenimol; C034759:piperaquine; D010879:Piperazines