According to the WHO, malaria affected 228 million people worldwide in 2018, resulting in 405,000 deaths. Timely access to the appropriate treatment is key to ensuring a bout of acute uncomplicated malaria does not turn into a severe case.
Eurartesim is a fixed-dose combination of dihydroartemisinin-piperaquine (DHA-PQP), developed by Alfasigma S.p.A. in partnership with MMV, for the treatment of acute uncomplicated P. falciparum malaria. A study evaluating 10,925 patients in four African countries (Burkina Faso, Ghana, Mozambique and Tanzania) showed that Eurartesim was generally well-tolerated by patients.1
DHA-PQP, a first-line treatment for malaria
Cambodia was the first malaria-endemic country to place an order for Eurartesim. The country adopted DHA-PQP as first-line treatment for malaria in 2012. DHA-PQP has also recently been included as a recommended treatment for acute uncomplicated malaria in Burkina Faso’s national treatment guidelines.
MMV has worked with Alfasigma to design patient-friendly packaging to facilitate the correct use of Eurartesim and to ensure alignment with distinct packaging requirements customized to special programmatic uses.
A possible tool for mass drug administration
There has been a growing interest recently in DHA-PQP as a tool for potential use in mass-drug-administration (MDA) campaigns supporting national elimination efforts.
MMV has contributed to the development of training materials for a MDA pilot in Zambia. Similar work has been undertaken in Mozambique through the Mozambican Alliance Towards Elimination of Malaria (MALTEM) project, an initiative designed to provide scientific, technical, operational and economic support to eliminate malaria in Mozambique. Following a cardiac safety issue in one patient from Mozambique, these MDA pilots have reinforced the need for enhanced pharmacovigilance during the use of ACTs for MDA across whole communities.
Studying DHA-PQP as an intermittent preventive treatment for pregnant women
Through a collaboration with the London School of Hygiene and Tropical Medicine, MMV is supporting a study to evaluate the cardiac safety of DHA-PQP in pregnant women compared to sulfadoxine-pyrimethamine (SP), the current standard of care for Intermittent Preventive Treatment in pregnancy (IPTp). This study will also assess the pharmacokinetics of DHA-PQP in pregnancy.
MMV is also collaborating with the Liverpool School of Tropical Medicine to generate additional safety data for the use of DHA-PQP and other ACTs during the first trimester of pregnancy, for which there is currently no recommended malaria treatment.
Another study with our partners from IS Global will assess the protective potential of DHA-PQP in HIV-infected pregnant women in Mozambique and Gabon. The study will analyse potential drug interactions of DHA-PQP and antiretroviral drugs. MMV will be supporting the analysis of the pharmacokinetic data.