Short-course primaquine for the radical cure of Plasmodium vivax malaria: A multicentre, randomized, placebo-controlled non-inferiority trial
The Lancet Sep 19, 2019
Taylor WRJ, Thriemer K, von Seidlein L, et al. - Via a randomized, double-blind, placebo-controlled, non-inferiority trial in eight healthcare clinics of 2,336 patients (aged ≥ 6 months) with normal glucose-6-phosphate dehydrogenase (G6PD) and presenting with uncomplicated vivax malaria, researchers evaluated the efficiency of a shorter course (7 days) of primaquine for radical cure of vivax malaria. The incidence rate of symptomatic recurrent Plasmodium vivax malaria was 0·18 and 0·16 recurrences per person-year, respectively, for 935 patients in the 7-day primaquine group and for 937 patients in the 14-day primaquine group with a variation of 0·02. For 464 patients in the placebo group, the incidence rate was 0·96 recurrences per person-year. Within 42 days of starting treatment, potentially drug-related serious adverse events were noted in nine of 935 patients in the 7-day group, one of 937 in the 14-day group and none of 464 in the control arm. Four of the serious adverse events were notable hemolysis. Therefore, 7-day primaquine was well endured and non-inferior to 14-day primaquine in individuals with normal G6PD. The short-course regimen might enhance adherence and hence the efficiency of primaquine for the radical cure of P vivax malaria.
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