Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Pyronaridine-artesunate Efficacy and Safety in Uncomplicated Plasmodium falciparum Malaria in Areas of Artemisinin-resistant Falciparum in Viet Nam (2017-2018).
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Prevalence of Plasmodium falciparum plasmepsin2/3 gene duplication in Africa and Asia: a systematic review and meta-analysis.Malaria journal · 2025Pooled it
- Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria.The Cochrane database of systematic reviews · 2022Pooled it
- Therapeutic efficacy of pyronaridine-artesunate (Pyramax) in treatingAntimicrobial agents and chemotherapy · 2024Trial
- Efficacy, Safety and Tolerability of Pyronaridine-artesunate in Asymptomatic Malaria-infected Individuals: a Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Pyronaridine-Artesunate (Pyramax) for Treatment of Artemisinin- and Piperaquine-Resistant Plasmodium falciparum in the Central Highlands of Vietnam.Antimicrobial agents and chemotherapy · 2021Trial
- Article
- The emergence of artemisinin partial resistance in Africa: how do we respond?The Lancet. Infectious diseases · 2024Review
- Emergence, transmission dynamics and mechanisms of artemisinin partial resistance in malaria parasites in Africa.Nature reviews. Microbiology · 2024Review
- Unrevealing the therapeutic potential of artesunate against emerging zoonoticFrontiers in veterinary science · 2024Article
- Genetic surveillance shows spread of ACT resistance during period of malaria decline in Vietnam (2018-2020).Frontiers in genetics · 2024Article
- Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam.Malaria journal · 2023Review
- Therapeutic efficacy of pyronaridine-artesunate (PyramaxMalaria journal · 2023Article
- In vitro activity of rhinacanthin analogues against drug resistant Plasmodium falciparum isolates from Northeast Thailand.Malaria journal · 2023Article
- Article
- Mosquitoes and Mosquito-Borne Diseases in Vietnam.Insects · 2022Review
- Clinical and In Vitro Resistance of Plasmodium falciparum to Artesunate-Amodiaquine in Cambodia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Progress and challenges of integrated drug efficacy surveillance for uncomplicated malaria in Thailand.Malaria journal · 2021Article
- Pyronaridine-artesunate real-world safety, tolerability, and effectiveness in malaria patients in 5 African countries: A single-arm, open-label, cohort event monitoring study.PLoS medicine · 2021Observational
- Multidrug-Resistant Plasmodium falciparum Parasites in the Central Highlands of Vietnam Jeopardize Malaria Control and Elimination Strategies.Antimicrobial agents and chemotherapy · 2021Article
- Liver Function Test Abnormalities in Experimental and ClinicalThe American journal of tropical medicine and hygiene · 2020Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundMultidrug-resistant Plasmodium falciparum undermines the efficacy of currently deployed antimalarial therapies in southern Viet Nam.
methodsBetween May 2017 and December 2018, this prospective, open-label, single-arm, observational clinical trial, conducted in Binh Phuoc, Dak Nong, Gia Lai, Khanh Hoa, and Ninh Thuan provinces, evaluated the safety and efficacy of oral pyronaridine-artesunate once daily for 3 consecutive days in adults and children with microscopically confirmed P. falciparum malaria. Patients were treated as inpatients for Days 0-3, with follow-up visits on Days 7, 14, 21, 28, 35, and 42. The primary outcome was the proportion of polymerase chain reaction (PCR)-adjusted adequate clinical and parasitological response (ACPR) at Day 42.
resultsThe cumulative incidence of PCR-adjusted ACPR at Day 42 was 96.1% (95% confidence interval [CI] 91.4-98.2; Kaplan-Meier). In the per-protocol analysis, the proportion of patients with Day 42 PCR-adjusted ACPR was 96.1% (147/153; 95% CI 91.7-98.5). The proportion of patients with parasitemia at Day 3 was 24.0% (40/167; 95% CI 17.7-31.2). The prevalences of the Kelch13 (C580Y) mutation were: in Binh Phuoc, 97.7% (43/44); in Dak Nong, 96.2% (25/26); in Gia Lai, 57.8% (37/64); in Khanh Hoa, 66.6% (6/9); and in Ninh Thuan, 3.6% (1/28). The majority of artemisinin-resistant isolates also had increased plasmepsin2 copy number (75.9%; 85/112). There was 1 isolate (Binh Phuoc) that had Kelch13 (C580Y) plus increased plasmepsin2 and Pfmdr1 copy numbers. Asymptomatic transient increases in alanine transaminase and aspartate transaminase were observed at Day 7, resolving by Day 28.
conclusionsPyronaridine-artesunate can be used to diversify antimalarial therapy in areas of artemisinin-resistant P. falciparum in Viet Nam. CLINICAL TRIALS REGISTRATION: ACTRN12618001274268.
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