This review summarises trials evaluating the effects of
dihydroartemisinin-piperaquine (DHA-P) compared to other
artemisinin-based combination therapies recommended by the World Health
Organization. After searching for relevant trials up to July 2013, we
included 27 randomized controlled trials, enrolling 16,382 adults and
children and conducted between 2002 and 2010.
<b>What is uncomplicated malaria and how might
dihydroartemisinin-piperaquine work </b>
Uncomplicated malaria is the mild form of malaria which usually causes a
fever, with or without headache, tiredness, muscle pains, abdominal
pains, nausea, and vomiting. If left untreated, uncomplicated malaria
can develop into severe malaria with kidney failure, breathing
difficulties, fitting, unconsciousness, and eventually death.
DHA-P is one of five artemisinin-based combination therapies the World
Health Organization currently recommends to treat malaria. These
combinations contain an artemisinin component (such as
dihydroartemisinin) which works very quickly to clear the malaria
parasite from the person's blood, and a longer acting drug (such as
piperaquine) which clears the remaining parasites from the blood and may
prevent new infections with malaria for several weeks.
What the research says
DHA-P versus artemether lumefantrine
In studies of people living in Africa, both DHA-P and artemether-lumefantrine are very effective at treating malaria (high quality evidence). However, DHA-P cures slightly more patients than artemether-lumefantrine, and it also prevents further malaria infections for longer after treatment (high quality evidence). DHA-P and artemether-lumefantrine probably have similar side effects (moderate quality evidence). DHA-P versus artesunate plus mefloquine
In studies of people living in Asia, DHA-P is as effective as artesunate
plus mefloquine at treating malaria (moderate quality evidence).
Artesunate plus mefloquine probably causes more nausea, vomiting,
dizziness, sleeplessness, and palpitations than DHA-P (moderate quality
Overall, in some people, DHA-P has been seen to cause short term changes
in electrocardiographs tracing the conduction of the heart rhythm (low
quality evidence), but these small changes on the electrocardiograph
resolved within one week without serious consequences.
Zani, B.; Donegan, S.; Olliaro, P.L.; Sinclair, D. Dihydroartemisinin-piperaquine for treating uncomplicatedPlasmodium falciparummalaria. Cochrane Database of Systematic Reviews (2014) (Issue 1) Art. No.: CD010927. [DOI: 10.1002/14651858.CD010927]
Dihydroartemisinin-piperaquine for treating uncomplicated Plasmodium falciparum malaria