Tafenoquine plus chloroquine for the treatment and relapse prevention of Plasmodium vivax malaria (DETECTIVE): a multicentre, double-blind, randomised, phase 2b dose-selection study

@article{LlanosCuentas2014TafenoquinePC,
  title={Tafenoquine plus chloroquine for the treatment and relapse prevention of Plasmodium vivax malaria (DETECTIVE): a multicentre, double-blind, randomised, phase 2b dose-selection study},
  author={Alejandro Llanos-Cuentas and Marcus Vg Lacerda and Ronnatrai Rueangweerayut and Srivicha Krudsood and Sandeep K. Gupta and Sanjay Kumar Kochar and Preetam Arthur and Nuttagarn Chuenchom and J{\"o}rg J. M{\"o}hrle and Stephan Duparc and Cletus Onwuzurike Ugwuegbulam and J P Kleim and Nick Carter and Justin A. Green and Lynda Kellam},
  journal={The Lancet},
  year={2014},
  volume={383},
  pages={1049-1058}
}
BACKGROUND Clinical effectiveness of previous regimens to treat Plasmodium vivax infection have been hampered by compliance. [...] Key MethodMETHODS 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 <100,000 per μL blood) were enrolled from community health centres and hospitals across seven sites in Brazil, Peru, India, and Thailand.Expand
Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria
TLDR
Among patients with normal G6PD enzyme activity, the decline in hemoglobin level with tafenoquine did not differ significantly from that with primaquine, and tafinoquine showed efficacy for the radical cure of P. vivax malaria, although tafanoquine was not shown to be noninferior to Primaquine. Expand
Single-Dose Tafenoquine to Prevent Relapse of Plasmodium vivax Malaria
TLDR
Single‐dose tafenoquine resulted in a significantly lower risk of P. vivax recurrence than placebo in patients with phenotypically normal G6PD activity, which resolved without intervention. Expand
Chloroquine–Primaquine versus Chloroquine Alone to Treat Vivax Malaria in Afghanistan: An Open Randomized Superiority Trial
TLDR
Protection against recurrence of P. vivax recurrence was greater in the first 6 months of follow-up than later, and implementation will require deployment of point-of-care phenotypic tests for G6PD deficiency. Expand
Clinical utility of tafenoquine in the prevention of relapse of Plasmodium vivax malaria: a review on the mode of action and emerging trial data
TLDR
Tafenoquine is an 8-aminoquinoline with activity against all human life cycle stages of Plasmodium vivax, including dormant liver stages – so called hypnozoites, and the latest hypothesis on the mode of action is elucidated. Expand
Single dose tafenoquine for preventing relapse in people with plasmodium vivax malaria-an updated meta-analysis.
TLDR
Tafenoquine as a single dose is an effective alternative to Primaquine for prevention of recurrence of P vivax malaria, with a reasonable safety profile. Expand
Efficacy of Chloroquine and Primaquine for the Treatment of Uncomplicated Plasmodium vivax Malaria in Cruzeiro do Sul, Brazil.
TLDR
Chloroquine and primaquine remain efficacious to treat acute uncomplicated P. vivax infection, but moderate recurrence rates were observed within 24 weeks of follow-up. Expand
Blood schizonticidal activity and safety of tafenoquine when administered as chemoprophylaxis to healthy, non-immune participants followed by blood stage Plasmodium falciparum challenge: A randomized, double-blinded, placebo-controlled Phase 1b study.
TLDR
Tafenoquine chemoprophylaxis is safe and effective in preventing malaria in healthy non-immune participants challenged with blood stage P. falciparum. Expand
Tolerability and safety of weekly primaquine against relapse of Plasmodium vivax in Cambodians with glucose-6-phosphate dehydrogenase deficiency
TLDR
Vivax-infected G6PDd Cambodian patients demonstrated significant, mostly transient, falls in Hb and one received a blood transfusion, and the feasibility of implementing a package of G6 PDd testing and supervised primaquine should be explored. Expand
Tafenoquine for preventing relapse in people with Plasmodium vivax malaria
TLDR
The effects of tafenoquine 300 mg (single dose) on preventing P vivax relapse is assessed and it is uncertain if TQ can cause more serious adverse events compared to PQ, as well as the certainty of the evidence using the GRADE approach. Expand
Increased primaquine total dose prevents Plasmodium vivax relapses in patients with impaired CYP2D6 activity: report of three cases
TLDR
Lack of response to primaquine was associated with impaired CYP2D6 activity in three patients presenting multiple relapses followed in a non-endemic setting. Expand
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