Clinical trials

During 2018 the Africa Asia Programme ran around 70 clinical studies – observational, case-control, pharmacokinetics/pharmacodynamic (PK/PD) and randomised controlled trial (RCTs) – at any one time. Highlights include:

• A large multinational trial testing triple artemisinin combination therapies (TACTs) for the treatment of drug resistant falciparum malaria (TRAC II) was completed in 2018, demonstrating that TACTs are well tolerated and effective at treating multi-drug resistant malaria prevalent in much of the GMS;
• These studies have been complemented by detailed drug-drug interaction studies of the components of the triple therapies in healthy volunteers. The most important finding to date – which allowed the multinational clinical trials to proceed – was to show that mefloquine did not potentiate the effects of piperaquine on ventricular repolarisation;
• A large study of the safety of single low dose primaquine, using a novel age-based dosing regimen, in G6PD deficient African children with uncomplicated falciparum malaria is underway in Kinshasa (KIMORU) and Uganda (Imperial-KEMRI-Wellcome);
• The largest ever multicentre study on primaquine radical treatment of vivax malaria (IMPROV) was completed in 2018 and offers an efficacious and tolerated double dose primaquine regimen over 7 days; and
• An RCT in Bangladesh showed a reno-protective effect of paracetamol in adult severe malaria through an anti-oxidative mechanism.