Eurartesim is a combination of the bisquinolone, piperaquine, and dihydroartemisinin, the active metabolite of all artemisinin derivatives. The mechanism of action of piperaquine is unknown, but it is likely to act in a similar way to chloroquine, which prevents haem detoxification within the malaria parasite. Dihydroartemisinin has an endoperoxide bridge that is thought to be essential for its function, causing free-radical damage to parasite membranes.1
The efficacy of the piperaquine/dihydroartemisinin combination for the treatment of uncomplicated P. falciparum malaria was assessed in two randomised, open-label trials. The first study (n=1089) compared the combination with artesunate/mefloquine in adults and children in Asia,2 whereas the second study (n=1524) compared it with artemether/lumefantrine in children in Africa.3
Intention-to-treat analysis showed that 87.9% of patients treated with piperaquine/dihydroartemisinin were cured at day 63 in the Asian study, and 90.4% were cured at day 28 in the African study.
In both studies, the piperaquine/dihydroartemisinin combination was non-inferior to the comparator treatment, and had a similar safety profile.2,3 However, QT prolongation was observed more frequently and to a larger extent in patients receiving piperaquine/dihydroartemisinin than among those given the comparator treatments.1
- Eurartesim Summary of Product Characteristics, October 2011.
- Valecha N et al. PLoS ONE 2010; 5: e11880.
- Bassat Q et al. PLoS ONE 2009; 4: e7871.