July 30, 2018
A recent collaborative study by the WorldWide Antimalarial Resistance Network (WWARN), published in Lancet Infectious Diseases, has important implications for drug dosing of vivax malaria patients. Vivax malaria affects over 13 million people each year and accounts for the majority of malaria cases in Asia. Led by Dr Rob Commons and Prof Ric Price at the Menzies School of Health Research, the study involved individual patient pooled analysis of over 5000 patients and 37 clinical trials. The study had three key findings:
- Over one-third of patients in current trials and efficacy studies are currently given less than the recommended dose of chloroquine.
- In children younger than 5 years who do not receive primaquine a minor increase in the dose of chloroquine could reduce the risk of vivax recurrence by over 40% in the first 6 weeks
- The addition of primaquine to chloroquine provides the greatest reduction in the risk of recurrence over this period – a reduction of 90%.
Dr Rob Commons said the study “highlights the public health benefits that could be gained by improving implementation of primaquine radical cure. However, we still need to ensure that treatment is safe through appropriate patient follow up and G6PD testing.”
The important study represents the largest individual patient data meta-analysis of P. vivax clinical trials to date, and according to Dr Commons, “demonstrates the benefits of investigators working together and sharing data to answer secondary questions beyond those planned in their initial studies.”