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Even though several new targets (mostly viral infection) for drug repurposing of pyronaridine and artesunate have recently emerged in vitro and in vivo, inter-species pharmacokinetic (PK) data that can extend nonclinical efficacy to humans has not been reported over 30 years of usage. Since extrapolation of animal PK data to those of humans is essential to predict clinical outcomes for drug repurposing, this study aimed to investigate inter-species PK differences in three animal species (hamster, rat, and dog) and to support clinical translation of a fixed-dose combination of pyronaridine and artesunate. PK parameters (e.g., steady-state volume of distribution (V), clearance (CL), area under the concentration-time curve (AUC), mean residence time (MRT), etc.) of pyronaridine, artesunate, and dihydroartemisinin (an active metabolite of artesunate) were determined by non-compartmental analysis. In addition, one- or two-compartment PK modeling was performed to support inter-species scaling. The PK models appropriately described the blood concentrations of pyronaridine, artesunate, and dihydroartemisinin in all animal species, and the estimated PK parameters in three species were integrated for inter-species allometric scaling to predict human PKs. The simple allometric equation ( = × ) well explained the relationship between PK parameters and the actual body weight of animal species. The results from the study could be used as a basis for drug repurposing and support determining the effective dosage regimen for new indications based on in vitro/in vivo efficacy data and predicted human PKs in initial clinical trials.
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http://dx.doi.org/10.3390/ijms25136998 | DOI Listing |
PLoS Med
August 2025
Department of Medical Microbiology and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Interrupting human-to-mosquito transmission is important for malaria elimination strategies as it can reduce infection burden in communities and slow the spread of drug resistance. Antimalarial medications differ in their efficacy in clearing the transmission stages of Plasmodium falciparum (gametocytes) and in preventing mosquito infection. Here, we present a retrospective combined analysis of six trials conducted at the same study site with highly consistent methodologies that allows for a direct comparison of the gametocytocidal and transmission-blocking activities of 15 different antimalarial regimens or dosing schedules.
View Article and Find Full Text PDFJ Antimicrob Chemother
August 2025
Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia.
Objectives: We assessed the therapeutic efficacy of pyronaridine-artesunate (Pyramax®) for the treatment of uncomplicated Plasmodium falciparum malaria in Gia Lai province, Central Vietnam where parasites are partially resistant to artemisinins.
Methods: In an open-label, single-arm trial, Pyramax® was administered to 120 patients (adults and children) infected with P. falciparum residing in Gia Lai province from March 2022 to December 2023.
Malar J
April 2025
Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Background: In polyclonal human malaria infections, the roles of individual clones in human-to-mosquito transmission and their relative transmissibility remain poorly understood. In addition, mutations conferring drug resistance can result in a transmission advantage or disadvantage.
Methods: Amplicon sequencing of complexity of infection and drug resistance markers was used to analyse post-treatment stage-specific malaria parasite dynamics in human blood infections and in the midguts of mosquitoes that became infected after direct membrane feeding assays (DMFAs).
Paediatr Int Child Health
February 2025
Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Background: Congenital malaria, characterised by low parasitaemia in newborns' peripheral blood, is difficult to diagnose by conventional techniques. Owing to its high sensitivity, polymerase chain reaction (PCR) allows for effective detection of low-density plasmodium infections. This study determined the prevalence of congenital malaria by PCR in newborns of mothers living in a malaria-endemic area of Kinshasa, Democratic Republic of Congo (DRC).
View Article and Find Full Text PDFMalar J
February 2025
Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo.
Background: The declining effectiveness of Intermittent Preventive Treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) due to the emergence of Plasmodium falciparum resistance highlights the need for alternative malaria prevention strategies in pregnant women. A novel approach was proposed: screening with an ultra-sensitive rapid diagnostic test and treating positive with pyronaridine-artesunate (ISTp-uRDT-PA). This trial compared the impact of both strategies on maternal malaria and anaemia, abortion, intrauterine death, birth weight, preterm delivery.
View Article and Find Full Text PDF