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Tafenoquine plus chloroquine for the treatment and relapse prevention of Plasmodium vivax malaria (DETECTIVE): a multicentre, double-blind, randomised, phase 2b dose-selection study
- Source :
- The Lancet. 383:1049-1058
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- BACKGROUND: Clinical effectiveness of previous regimens to treat Plasmodium vivax infection have been hampered by compliance. We aimed to assess the dose-response, safety, and tolerability of single-dose tafenoquine plus 3-day chloroquine for P vivax malaria radical cure. METHODS: In this double-blind, randomised, dose-ranging phase 2b study, men and women (aged >/=16 years) with microscopically confirmed P vivax monoinfection (parasite density >100 to 7500 per muL blood). The primary efficacy endpoint was relapse-free efficacy at 6 months from initial dose (ie, clearance of initial infection without subsequent microscopically confirmed infection), analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT01376167. FINDINGS: Between Sept 19, 2011, and March 25, 2013, 329 patients were randomly assigned to a treatment group (chloroquine plus tafenoquine 50 mg [n=55], 100 mg [n=57], 300 mg [n=57], 600 mg [n=56]; or to chloroquine plus primaquine [n=50]; or chloroquine alone [n=54]). Relapse-free efficacy at 6 months was 57.7% (95% CI 43-70) with tafenoquine 50 mg, 54.1% (40-66) with tafenoquine 100 mg, 89.2% (77-95) with tafenoquine 300 mg, 91.9% (80-97) with tafenoquine 600 mg, 77.3% (63-87) with primaquine, and 37.5% (23-52) with chloroquine alone. Tafenoquine 300 mg and 600 mg had better efficacy than chloroquine alone (treatment differences 51.7% [95% CI 35-69], p
- Subjects :
- Male
Primaquine
Tafenoquine
Plasmodium vivax
Pharmacology
Gastroenterology
Primaquine/therapeutic use
chemistry.chemical_compound
Chloroquine
Peru
Secondary Prevention
biology
General Medicine
Middle Aged
Thailand
Treatment Outcome
Tolerability
Aminoquinolines
Drug Therapy, Combination
Female
Brazil
medicine.drug
Adult
medicine.medical_specialty
Adolescent
India
Malaria, Vivax/drug therapy/prevention & control
Article
Antimalarials
Young Adult
Pharmacotherapy
Double-Blind Method
Internal medicine
Malaria, Vivax
medicine
Humans
Aged
Intention-to-treat analysis
Dose-Response Relationship, Drug
business.industry
medicine.disease
biology.organism_classification
purl.org/pe-repo/ocde/ford#3.02.00 [https]
chemistry
Chloroquine/therapeutic use
Antimalarials/administration & dosage
Aminoquinolines/administration & dosage
business
Malaria
Subjects
Details
- ISSN :
- 01406736
- Volume :
- 383
- Database :
- OpenAIRE
- Journal :
- The Lancet
- Accession number :
- edsair.doi.dedup.....737ac52617f16fc95a1af00ee39f52e1
- Full Text :
- https://doi.org/10.1016/s0140-6736(13)62568-4