期刊
EXPERT OPINION ON PHARMACOTHERAPY
卷 22, 期 18, 页码 2483-2493出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/14656566.2021.1959913
关键词
Plasmodium falciparum; malaria; artemisinin-based combination therapies; resistance
资金
- University Hospital Tubingen, Germany
Malaria, the most devastating parasitic disease, is currently treated with artemisinin-based combination therapies (ACTs). Some ACTs are failing to cure malaria patients due to resistance in Southeast Asia, raising concerns about resistant Plasmodium falciparum emerging in other regions. Alternative treatments to ACTs are needed, and the development of new antimalarial drug classes should be accelerated to safeguard against parasite resistance.
Introduction Malaria, the most devastating parasitic disease, is currently treated with artemisinin-based combination therapies (ACTs). Unfortunately, some ACTs are unable to rapidly clear Plasmodium falciparum parasites from the blood stream and are failing to cure malaria patients; a problem, so far, largely confined to Southeast Asia. There is a fear of resistant Plasmodium falciparum emerging in other parts of the world including Sub-Saharan Africa. Strategies for alternative treatments, ideally non-artemisinin based, are needed. Areas covered This narrative review gives an overview of approved antimalarials and of some compounds in advanced drug development that could be used when an ACT is failing. The selection was based on a literature search in PubMed and WHO notes for malaria treatment. Expert opinion The ACT drug class can still cure malaria in malaria endemic regions. However, the appropriate ACT drug should be chosen considering the background resistance of the partner drug of the local parasite population. Artesunate-pyronaridine, the 'newest' recommended ACT, and atovaquone-proguanil are, so far, effective, and safe treatments for uncomplicated falciparum malaria. Therefore, all available ACTs should be safeguarded from parasite resistance and the development of new antimalarial drug classes needs to be accelerated.
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