An open, randomized comparison of artesunate plus mefloquine vs. dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria in the Lao People's Democratic Republic (Laos).
OBJECTIVE
To determine the efficacy and safety of oral dihydroartemisinin-piperaquine (DP, Artekin) in the treatment of uncomplicated Plasmodium falciparum malaria in southern Laos.


METHODS
An open, randomized clinical trial of oral artesunate-mefloquine (AM) vs. DP in 220 patients with acute uncomplicated falciparum malaria in Savannakhet Province, Laos.


RESULTS
The 42-day cure rates (95% CI), as determined by survival analysis and adjusted for reinfection, were excellent and similar for the two groups [99 (94-100)% and 100 (100-100)% for AM and DP, respectively]. The median (range) fever and parasite clearance times for the AM and DP groups were also similar [20 (4-63) h and 2 (1-4) days vs. 20 (7-57) and 2 (1-4) days, logrank P = 0.4 and 0.17, respectively]. There were more patients with at least one potential side effect following treatment in the AM group when compared with the DP group [64/110 (58%) vs. 48/110 (44%), respectively, P = 0.031].


CONCLUSIONS
Dihydroartemisinin-piperaquine did not have superior efficacy to AM for the treatment of uncomplicated falciparum malaria in Laos but was associated with fewer adverse effects.
Mayxay
M
M
Wellcome Trust, Mahosot Hospital, Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR.
Thongpraseuth
V
V
Khanthavong
M
M
Lindegårdh
N
N
Barends
M
M
Keola
S
S
Pongvongsa
T
T
Phompida
S
S
Phetsouvanh
R
R
Stepniewska
K
K
White
N J
NJ
Newton
P N
PN
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D037621:Artemisinins / Q000008:administration & dosage* / Q000009:adverse effects; D000077332:Artesunate; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007812:Laos / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D015767:Mefloquine / Q000008:administration & dosage* / Q000009:adverse effects; D018512:Parasitemia / Q000188:drug therapy / Q000453:epidemiology; D011804:Quinolines / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D012008:Recurrence; D012717:Sesquiterpenes / Q000008:administration & dosage* / Q000009:adverse effects; D017211:Treatment Failure; D016896:Treatment Outcome; D010879:Piperazines
D000962:Antimalarials; D037621:Artemisinins; D000077332:Artesunate; D015767:Mefloquine; D011804:Quinolines; D012717:Sesquiterpenes; C039060:artenimol; C034759:piperaquine; D010879:Piperazines