Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy

© 2016 Springer International Publishing Switzerland. Naphthoquine is a 4-aminoquinoline antimalarial drug first synthesised in China in 1986 but which was not developed for clinical use until the late 1990s. Early in vitro parasite sensitivity and in vivo efficacy data, together with a long termina...

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Main Authors: Moore, Brioni, Laman, M., Salman, S., Batty, Kevin, Page-Sharp, Madhu, Hombhanje, F., Manning, L., Davis, T.M.E.
Format: Journal Article
Language:English
Published: ADIS INT LTD 2016
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1036951
http://hdl.handle.net/20.500.11937/88943
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author Moore, Brioni
Laman, M.
Salman, S.
Batty, Kevin
Page-Sharp, Madhu
Hombhanje, F.
Manning, L.
Davis, T.M.E.
author_facet Moore, Brioni
Laman, M.
Salman, S.
Batty, Kevin
Page-Sharp, Madhu
Hombhanje, F.
Manning, L.
Davis, T.M.E.
author_sort Moore, Brioni
building Curtin Institutional Repository
collection Online Access
description © 2016 Springer International Publishing Switzerland. Naphthoquine is a 4-aminoquinoline antimalarial drug first synthesised in China in 1986 but which was not developed for clinical use until the late 1990s. Early in vitro parasite sensitivity and in vivo efficacy data, together with a long terminal elimination half-life (up to 23 days), suggested that it could be used as monapy for uncomplicated falciparum and vivax malaria, but is now marketed as a single-dose, fixed co-formulation with artemisinin in a milligram per kilogram ratio of 1:2.5. This form of artemisinin combination therapy (ACT) has also shown high cure rates, especially in two randomised trials in which, consistent with World Health Organization recommendations for all ACTs, it was administered daily for 3 days rather than as single dose for Plasmodium falciparum and P. vivax infections (28-day adequate clinical and parasitological response ≥98.4 %). Although detailed safety monitoring has been performed in a minority of subjects, >4000 healthy volunteers and patients with malaria have been exposed to naphthoquine without any documented significant toxicity. As with other 4-aminoquinolines, naphthoquine is associated with prolongation of the electrocardiographic QT interval but not with cardiac or neurological events. It has been administered to children as young as 4 months of age but, due to a lack of pharmacokinetic, efficacy and toxicity data in young infants and in pregnant/lactating women, it should not be used in these vulnerable patient groups.With the emergence of parasite resistance to other ACTs, naphthoquine partnered with a potent artemisinin derivative may prove a viable alternative treatment for uncomplicated malaria.
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spelling curtin-20.500.11937-889432022-08-05T06:37:09Z Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy Moore, Brioni Laman, M. Salman, S. Batty, Kevin Page-Sharp, Madhu Hombhanje, F. Manning, L. Davis, T.M.E. Science & Technology Life Sciences & Biomedicine Pharmacology & Pharmacy Toxicology UNCOMPLICATED FALCIPARUM-MALARIA PAPUA-NEW-GUINEA IN-VITRO ACTIVITIES PLASMODIUM-FALCIPARUM ANTIMALARIAL-DRUGS DIHYDROARTEMISININ-PIPERAQUINE ARTEMETHER-LUMEFANTRINE SCHISTOSOMA-MANSONI PEDIATRIC MALARIA PHOSPHATE © 2016 Springer International Publishing Switzerland. Naphthoquine is a 4-aminoquinoline antimalarial drug first synthesised in China in 1986 but which was not developed for clinical use until the late 1990s. Early in vitro parasite sensitivity and in vivo efficacy data, together with a long terminal elimination half-life (up to 23 days), suggested that it could be used as monapy for uncomplicated falciparum and vivax malaria, but is now marketed as a single-dose, fixed co-formulation with artemisinin in a milligram per kilogram ratio of 1:2.5. This form of artemisinin combination therapy (ACT) has also shown high cure rates, especially in two randomised trials in which, consistent with World Health Organization recommendations for all ACTs, it was administered daily for 3 days rather than as single dose for Plasmodium falciparum and P. vivax infections (28-day adequate clinical and parasitological response ≥98.4 %). Although detailed safety monitoring has been performed in a minority of subjects, >4000 healthy volunteers and patients with malaria have been exposed to naphthoquine without any documented significant toxicity. As with other 4-aminoquinolines, naphthoquine is associated with prolongation of the electrocardiographic QT interval but not with cardiac or neurological events. It has been administered to children as young as 4 months of age but, due to a lack of pharmacokinetic, efficacy and toxicity data in young infants and in pregnant/lactating women, it should not be used in these vulnerable patient groups.With the emergence of parasite resistance to other ACTs, naphthoquine partnered with a potent artemisinin derivative may prove a viable alternative treatment for uncomplicated malaria. 2016 Journal Article http://hdl.handle.net/20.500.11937/88943 10.1007/s40265-016-0572-5 English http://purl.org/au-research/grants/nhmrc/1036951 http://purl.org/au-research/grants/nhmrc/1058260 ADIS INT LTD restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Pharmacology & Pharmacy
Toxicology
UNCOMPLICATED FALCIPARUM-MALARIA
PAPUA-NEW-GUINEA
IN-VITRO ACTIVITIES
PLASMODIUM-FALCIPARUM
ANTIMALARIAL-DRUGS
DIHYDROARTEMISININ-PIPERAQUINE
ARTEMETHER-LUMEFANTRINE
SCHISTOSOMA-MANSONI
PEDIATRIC MALARIA
PHOSPHATE
Moore, Brioni
Laman, M.
Salman, S.
Batty, Kevin
Page-Sharp, Madhu
Hombhanje, F.
Manning, L.
Davis, T.M.E.
Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title_full Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title_fullStr Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title_full_unstemmed Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title_short Naphthoquine: An Emerging Candidate for Artemisinin Combination Therapy
title_sort naphthoquine: an emerging candidate for artemisinin combination therapy
topic Science & Technology
Life Sciences & Biomedicine
Pharmacology & Pharmacy
Toxicology
UNCOMPLICATED FALCIPARUM-MALARIA
PAPUA-NEW-GUINEA
IN-VITRO ACTIVITIES
PLASMODIUM-FALCIPARUM
ANTIMALARIAL-DRUGS
DIHYDROARTEMISININ-PIPERAQUINE
ARTEMETHER-LUMEFANTRINE
SCHISTOSOMA-MANSONI
PEDIATRIC MALARIA
PHOSPHATE
url http://purl.org/au-research/grants/nhmrc/1036951
http://purl.org/au-research/grants/nhmrc/1036951
http://hdl.handle.net/20.500.11937/88943