ASMQ (artesunate-mefloquine)

The ACT artesunate-mefloquine (ASMQ), developed by DNDi and Farmanguinhos and manufactured by Cipla via a technology transfer, was prequalified by WHO in 2012. As one of five ACTs recommended by WHO in their guidelines for the treatment of uncomplicated P. falciparum malaria, ASMQ has an important role to play in the global effort to improve timely access to treatment. Currently, ASMQ is the recommended first- or second-line treatment in five countries in South America and four countries in Southeast Asia. Recently, ASMQ has been identified as the preferred alternative to dihydroartemisinin-piperaquine (DHA-PQP) in parts of Cambodia where rising levels of drug resistance have diminished the efficacy of DHA-PQP.

Through an agreement with DNDi in 2015, MMV agreed to take over access stewardship of ASMQ, supporting product adoption and use per its recommended label, and helping disseminate evidence-based information regarding product efficacy and safety for consideration by national treatment programmes in line with WHO’s guidance.

In July 2016, a new study by Sirima et al evaluating ASMQ’s safety and efficacy in young African children (6-59 months old) was published in The Lancet. The results showed that the safety and efficacy of ASMQ were comparable to those of dispersible artemether-lumefantrine. In addition, ASMQ was as well tolerated as the comparator drug, and rates of re-infection appeared lower in the ASMQ arm, probably due to the longer half-life of mefloquine compared to lumefantrine.  

  • Access in Action

    • As of Q1 2019, over 2 million ASMQ treatments had been ordered, primarily for use in the greater Mekong sub-region and in Latin America.

    • In Q4 2015, critically-needed supplies of ASMQ were delivered to Cambodia as part of the national strategy to re-introduce ASMQ in regions where DHA-PQP has experienced declining efficacy in recent years. Throughout 2016 and 2017, ASMQ has remained a critical drug of choice for Cambodia’s national malaria control programme.  It was one of the commodities considered for a strategic regional stockpile for the Greater Mekong Subregion in 2018.

    • In January 2016, WHO’s Prequalification team announced that the shelf-life of ASMQ has been extended from 24 months to 36 months. This new extension of ASMQ’s shelf-life should help reduce supply-chain management pressures related to warehousing and distribution of ASMQ.


    Past and current partners:

    Cipla, DNDi  

     

    Updated August 2019