Cochrane: This
Cochrane Review summarises trials evaluating the effects of
artemisinin-naphthoquine compared to other artemisinin-based combination
therapies (ACTs) recommended by the World Health Organization (WHO) for
treating adults and children with uncomplicated P. falciparum malaria.
After searching for relevant trials up to January 2015, we included four randomized controlled trials, enrolling 740 adults and children.
What is uncomplicated malaria and how might artemisinin-naphthoquine work
Uncomplicated malaria is the mild form of malaria which usually causes a fever, with or without headache, tiredness, muscle pains, abdominal pains, nausea, and vomiting. If left untreated, uncomplicated malaria can develop into severe malaria with kidney failure, breathing difficulties, fitting, unconsciousness, and eventually death.
The WHO recommends ACT for treating people with P. falciparum malaria. Five combinations are currently recommended, all administered over three days. Artemisinin-naphthoquine is a new combination developed in China, which is being marketed and evaluated as one-day or three-day regimens.
What the research says
Artemisinin-naphthoquine versus artemether-lumefantrine
In three small trials from Benin, Côte d'Ivoire, and Papua New Guinea, both artemisinin-naphthoquine and AL had a very low incidence of treatment failure at Day 28 (low quality evidence), and in the trial from Papua New Guinea it remained low in both groups at Day 42 (very low quality evidence).
Artemisinin-naphthoquine versus dihydroartemisinin-piperaquine
In a single small study from Indonesia, treatment failure at Day 28 and Day 42 was very low with both artemisinin-naphthoquine and DHA-P (very low quality evidence).
Conclusions
The results of these few trials of artemisinin-naphthoquine are promising, but larger trials from multiple settings are required to be confident that artemisinin-naphthoquine is as effective and well tolerated as other antimalarials.
After searching for relevant trials up to January 2015, we included four randomized controlled trials, enrolling 740 adults and children.
What is uncomplicated malaria and how might artemisinin-naphthoquine work
Uncomplicated malaria is the mild form of malaria which usually causes a fever, with or without headache, tiredness, muscle pains, abdominal pains, nausea, and vomiting. If left untreated, uncomplicated malaria can develop into severe malaria with kidney failure, breathing difficulties, fitting, unconsciousness, and eventually death.
The WHO recommends ACT for treating people with P. falciparum malaria. Five combinations are currently recommended, all administered over three days. Artemisinin-naphthoquine is a new combination developed in China, which is being marketed and evaluated as one-day or three-day regimens.
What the research says
Artemisinin-naphthoquine versus artemether-lumefantrine
In three small trials from Benin, Côte d'Ivoire, and Papua New Guinea, both artemisinin-naphthoquine and AL had a very low incidence of treatment failure at Day 28 (low quality evidence), and in the trial from Papua New Guinea it remained low in both groups at Day 42 (very low quality evidence).
Artemisinin-naphthoquine versus dihydroartemisinin-piperaquine
In a single small study from Indonesia, treatment failure at Day 28 and Day 42 was very low with both artemisinin-naphthoquine and DHA-P (very low quality evidence).
Conclusions
The results of these few trials of artemisinin-naphthoquine are promising, but larger trials from multiple settings are required to be confident that artemisinin-naphthoquine is as effective and well tolerated as other antimalarials.
Authors' conclusions:
The results of these few
trials of artemisinin-naphthoquine are promising, but further trials
from multiple settings are required to reliably demonstrate the relative
efficacy
and safety compared to established ACTs. Future trials should be
adequately powered to demonstrate non-inferiority, and regimens
incorporating three days of the artemisinin component are probably
preferable to the one-day regimens.