Conclusive win of artesunate over quinine

MMV applauds the results from the multi-country clinical trial, AQUAMAT, conducted by Prof Nick White and his team, which concludes beyond a doubt that artesunate should be the preferred treatment for severe malaria.

08 Nov 2010

Professor White of the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme in Mae Sot, Thailand, and his colleagues, conducted the  African Quinine v. Artesunate Malaria Trial (AQUAMAT) which demonstrated that compared with quinine, artesunate reduced the mortality rate from 10.9% to 8.5%, a relative reduction of 22.5%.

The trial was conducted in nine African countries, in which 5,425 children with severe malaria under 15 years of age were given either artesunate or quinine. The risk of coma or convulsion and, post-treatment hypoglycaemia were all found to be lower in the artesunate group than the quinine group. In addition, artesunate was easier to administer and was well-tolerated.

“This news could not have come at a better time,” said MMV’s CSO Dr Timothy Wells. “Just last week we had news that Guilin’s injectable artesunate for the treatment of severe malaria had been prequalified by the WHO. MMV partnered in this project with Guilin, to improve its manufacturing processes for this product to GMP standards. Prequalification implies that the medicine will now be accessible to all countries using donor funds to procure antimalarials, for example from the Global Fund. And now AQUAMAT conclusively demonstrates that artesunate is better than quinine in the treatment of severe malaria. This is another step in making sure that caregivers and health workers will move to artesunate, as the best treatment for their patients.”

Registered users of The Lancet's website have free access to the following article:

Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial