title: Pyronaridine-artesunate combination therapy for the treatment of malaria.
abstract: OBJECTIVE
  Pyronaridine-artesunate is among the most promising novel artemisinin combination therapies for the treatment of malaria. A series of clinical phase II and III trials have been conducted for the indications of uncomplicated falciparum and vivax malaria in Africa and Asia. On the basis of these novel data, this review aims to provide an appraisal of current evidence and a perspective for its future role in the antimalarial portfolio.
  
  
  RESULTS
  Pyronaridine-artesunate demonstrated repeatedly high efficacy in the treatment of vivax and falciparum malaria and noninferiority was established compared to standard comparator regimens. An innovative paediatric drug formulation was developed in parallel to the tablet formulation for the treatment of young children. Pharmacokinetic analysis showed dose linearity, low interindividual variation and absence of a clinically important effect of food on the bioavailability of this drug combination. Overall tolerability and safety data are reassuring; however, further surveillance of safety in special patient populations including young children is warranted.
  
  
  CONCLUSIONS
  Pyronaridine-artesunate - currently under evaluation by the European Medicines Agency - may become a preferred choice as first-line therapy in malaria endemic regions based on its low cost, long shelf-life, simplified once-daily dosing regimen, proven efficacy against falciparum and vivax malaria, and the parallel clinical development of a paediatric drug formulation.
authors: Department of Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Florian
authors: F
authors: Kurth
authors: Sabine
authors: S
authors: Bélard
authors: Arti
authors: A
authors: Basra
authors: Michael
authors: M
authors: Ramharter
mesh_terms: D000962:Antimalarials / Q000493:pharmacokinetics / Q000627:therapeutic use*; D037621:Artemisinins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000378:metabolism; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000378:metabolism; D009287:Naphthyridines / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D009287:Naphthyridines; C031327:artemisinin; C027871:pyronaridine