Background

Plasmodium vivax is a frequent cause of recurring malaria in endemic areas as in its latent stage it resides in liver, and is responsible for relapse.

Treatment with 8 aminoquinoline Primaquine is given for 14 days, however studies have shown dismal results with adherence to therapy. A new long acting 8 aminoquinoline, Tafenoquine was introduced that showed efficacy and safety almost similar to Primaquine in a single dose regimen, hence giving hopes for improved compliance and help in eradicating malaria.

Methods

We searched for randomized controlled trials (RCTs) that compared the efficacy of Tafenoquine with Primaquine or placebo. Our primary outcome was the recurrence of Plasmodium vivax parasitemia at 6 months and our safety outcomes included total number of adverse events as well as serious adverse events. We performed pooled data analysis by the random effects model and I2 was used to assess heterogeneity.

Results

4 RCTs were included. Our pooled analysis showed that the number of episodes of recurrence at 6 months between Tafenoquine and Primaquine (RR = 1.08, 95% CI = 0.74–1.59), and between Tafenoquine and placebo (RR = 0.17, 95%CI = 0.03–1.11) was statistically insignificant. Comparison of serious adverse events did not show any significant risk associated with the use of Tafenoquine as compared to Primaquine when analyzed till day 29, which was the time period considered to show most probable drug associated events.

Conclusion

Tafenoquine as a single dose is an effective alternative to Primaquine for prevention of recurrence of P vivax malaria, with a reasonable safety profile.

中文翻译：

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用于预防间日疟原虫疟疾患者复发的单剂量他非诺喹——一项更新的荟萃分析。

背景

间日疟原虫是疟疾流行地区复发的常见原因，因为它潜伏在肝脏中，是复发的原因。

使用 8 氨基喹啉伯氨喹治疗 14 天，但研究显示坚持治疗的结果令人沮丧。推出了一种新的长效 8 氨基喹啉，他非诺喹在单剂量方案中显示出与伯氨喹几乎相似的功效和安全性，因此希望提高依从性并帮助根除疟疾。

方法

我们检索了比较他非诺喹与伯氨喹或安慰剂疗效的随机对照试验 (RCT)。我们的主要结果是 6 个月时间日疟原虫寄生虫血症的复发，我们的安全性结果包括不良事件和严重不良事件的总数。我们通过随机效应模型进行了汇总数据分析，并使用 I2 来评估异质性。

结果

包括 4 个 RCT。我们的汇总分析显示，他非诺喹和伯氨喹之间（RR = 1.08，95% CI = 0.74–1.59）以及他非诺喹和安慰剂（RR = 0.17，95%CI = 0.03–1.11）之间的 6 个月复发次数在统计上不显着。与伯氨喹相比，严重不良事件的比较未显示任何与使用他非诺喹相关的显着风险，直到第 29 天为止，这是被认为显示最可能的药物相关事件的时间段。

结论

单剂量他非诺喹是伯氨喹预防间日疟复发的有效替代品，具有合理的安全性。