Spotlight on Artemisinin Combination Therapies & Parasite Clearance Rates

The Literature Review Resource is a library of published clinical efficacy studies and an overview of key publication trends since 1960. The ACT Literature Review Database takes a closer look at all published results for clinical trials of artemisinin combination therapy (ACT) or artemisinin monotherapy treatments for uncomplicated falciparum malaria.

One of the simplest measures of artemisinin resistance looks at the levels of delayed parasite clearance in the first few days following treatment. The ACT Literature Review Database assesses the utility of applying a different marker of artemisinin resistance using a threshold of 10% of patients who remained with detectable parasitaemia on Day 3 following treatment, as currently recommended by the WHO.

The database includes all published results between January 2000 - December 2011, amounting to 65,078 patients enrolled into 213 clinical trials with 413 treatment arms (26 with an artemisinin derivative alone and 387 with a combination with a partner drug).

You can view the highlights of the study including the most frequent treatment regimens, sample size per treatment arm and variations in trial methodologies. A full analysis is available in the recent publication by Das D, Price R, Bethell D et al. entitled ‘Early parasitological response following artemisinin-containing regimens: a critical review of the literature’ available in Malaria Journal 2013 reference 12:125 doi:10.1186/1475-2875-12-125. 

This metanalysis highlights the multiple factors influencing the efficacy of a surveillance system based on Day 3 parasite prevalence rates. It has also helped launch an individual patient level analysis in which we pooled results from 213 studies to assess clinical treatment efficacy and to better understand the factors influencing parasite clearance rates for the most significant ACTs.

View a summary of the key findings, graphs and trial location maps that you are welcome to use and share.

These data will be updated regularly, please send us your feedback if you are aware of other published studies that we can include. Email wwarn@wwarn.org