Artesunate/pyronaridine: Difference between revisions
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{{Short description|Combination medication for the treatment of malaria}} |
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'''Artesunate/pyronaridine''', sold under the brand name '''Pyramax''', is a [[fixed-dose combination]] medication for the treatment of [[malaria]].<ref name=WHO21st/><ref name=WHO2010/> It can be used for malaria of both the ''[[P. falciparum]]'' and ''[[P. vivax]]'' types.<ref name=WHO2010/> It combines [[artesunate]] and [[pyronaridine]].<ref name=WHO21st/> It is taken by mouth.<ref name=EMA2017>{{cite web|title=Pyramax 180 mg/60 mg Film-coated tablet|url=http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_for_use_outside_EU/2012/06/WC500129288.pdf|website=EMA|access-date=13 December 2017}}</ref> |
'''Artesunate/pyronaridine''', sold under the brand name '''Pyramax''', is a [[fixed-dose combination]] medication for the treatment of [[malaria]].<ref name=WHO21st/><ref name=WHO2010/> It can be used for malaria of both the ''[[P. falciparum]]'' and ''[[P. vivax]]'' types.<ref name=WHO2010/> It combines [[artesunate]] and [[pyronaridine]].<ref name=WHO21st/> It is taken by mouth.<ref name=EMA2017>{{cite web|title=Pyramax 180 mg/60 mg Film-coated tablet|url=http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_for_use_outside_EU/2012/06/WC500129288.pdf|website=EMA|access-date=13 December 2017|archive-date=14 December 2017|archive-url=https://web.archive.org/web/20171214014547/http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_for_use_outside_EU/2012/06/WC500129288.pdf|url-status=dead}}</ref> |
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Artesunate/pyronaridine is used for [[malaria]] of both the ''[[P. falciparum]]'' and ''[[P. vivax]]'' types.<ref name=WHO2010/> It is not recommended for severe disease.<ref name=EMA2017/> |
Artesunate/pyronaridine is used for [[malaria]] of both the ''[[P. falciparum]]'' and ''[[P. vivax]]'' types.<ref name=WHO2010/> It is not recommended for severe disease.<ref name=EMA2017/> |
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A 2019 review found that the combination compared well to [[artemether/lumefantrine]].<ref name= |
A 2019 review (updated in 2021) found that the combination compared well to [[artemether/lumefantrine]].<ref name=":0">{{cite journal | vauthors = Pryce J, Taylor M, Fox T, Hine P | title = Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | issue = 6 | pages = CD006404 | date = June 2022 | pmid = 35726133 | pmc = 9209011 | doi = 10.1002/14651858.CD006404.pub4 }}</ref> Benefits also appear similar to [[mefloquine]] together with [[artesunate]].<ref name=":0" /> It is not recommended for the prevention of malaria.<ref name=EMA2017/> |
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== Research for drug repurposing == |
== Research for drug repurposing == |
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It has also been studied as a potential anticancer drug,<ref>{{cite journal | vauthors = Villanueva PJ, Martinez A, Baca ST, DeJesus RE, Larragoity M, Contreras L, Gutierrez DA, Varela-Ramirez A, Aguilera RJ | display-authors = 6 | title = Pyronaridine exerts potent cytotoxicity on human breast and hematological cancer cells through induction of apoptosis | journal = PloS One | volume = 13 | issue = 11 | pages = e0206467 | date = 2018-11-05 | pmid = 30395606 | pmc = 6218039 | doi = 10.1371/journal.pone.0206467 | url = https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206467 }}</ref> treatment for Ebola<ref>{{cite journal | vauthors = Lane TR, Massey C, Comer JE, Anantpadma M, Freundlich JS, Davey RA, Madrid PB, Ekins S | display-authors = 6 | title = Repurposing the antimalarial pyronaridine tetraphosphate to protect against Ebola virus infection | journal = PLoS Neglected Tropical Diseases | volume = 13 | issue = 11 | pages = e0007890 | date = November 2019 | pmid = 31751347 | pmc = 6894882 | doi = 10.1371/journal.pntd.0007890 }}</ref> |
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There is some ''[[in vitro]]'' evidence that suggests artesunate/pyronaridine may be worthy of clinical trial study to determine whether it might have a role as a drug for COVID-19 treatment.<ref>{{cite journal | vauthors = Krishna S, Augustin Y, Wang J, Xu C, Staines HM, Platteeuw H, Kamarulzaman A, Sall A, Kremsner P | display-authors = 6 | title = Repurposing Antimalarials to Tackle the COVID-19 Pandemic | journal = Trends in Parasitology | volume = 37 | issue = 1 | pages = 8–11 | date = January 2021 | pmid = 33153922 | pmc = 7572038 | doi = 10.1016/j.pt.2020.10.003 }}</ref> |
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It was announced on 3 April 2020 that [[artesunate/pyronaridine]], the main components of a new ACT antimalarial drug sold under the brand name Pyramax, showed an inhibitory effect on SARS-CoV-2 Pyramax showed a virus titer inhibition rate of '''99%''' or more after 24 hours in vitro tests using [[Hela cells]]. , while [[cytotoxicity]] was also reduced.<ref>{{Cite web|date=2020-04-03|title='피라맥스' 약물 재창출?…코로나19 치료제 타진|url=http://www.doctorsnews.co.kr/news/articleView.html?idxno=134131|access-date=2021-02-27|website=의협신문|language=ko}}</ref> |
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A preprint published in July 2020 reported that pyronaridine and artesunate exhibit antiviral activity against SARS-CoV-2 and influenza viruses using human lung epithelial ([[Calu-3]]) cells and [[Vero cell|Vero]] cells.<ref name=":0">{{Cite journal|last=Bae|first=Joon-Yong|last2=Lee|first2=Gee Eun|last3=Park|first3=Heedo|last4=Cho|first4=Juyoung|last5=Kim|first5=Yung-Eui|last6=Lee|first6=Joo-Yeon|last7=Ju|first7=Chung|last8=Kim|first8=Won-Ki|last9=Kim|first9=Jin Il|last10=Park|first10=Man-Seong|date=2020-07-28|title=Pyronaridine and artesunate are potential antiviral drugs against COVID-19 and influenza|url=https://www.biorxiv.org/content/10.1101/2020.07.28.225102v1|journal=bioRxiv|language=en|pages=2020.07.28.225102|doi=10.1101/2020.07.28.225102}}</ref> This in vitro experiment was very important in that the human lung cell [[Calu-3]] was used, '''the cells were first infected with SARS-COV-2 and then treated with drugs 1 hour later.''' |
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Also, this in vitro experiment is encouraging in that the combination of pyronaridine and artesunate showed '''100%''' inhibition in Vero cells. When each component was tested in [[Vero cell|Vero]] cells, the effect was less than that of HCQ, but when the two components were combined, it showed 100% inhibition and the effect lasted 48 hours. This shows that the two ingredients have a synergistic effect. |
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When tested in calu-3 cells with a single component of PYR and ART, the inhibition rate was 80-90%, especially the SI value of ART was very high, reaching 220. |
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The combination of pyronaridine and artesunate is being studied as a possible treatment for moderate to severe SARS-COV-2. <ref name=":1">{{Cite journal|last=Krishna|first=Sanjeev|last2=Augustin|first2=Yolanda|last3=Wang|first3=Jigang|last4=Xu|first4=Chengchao|last5=Staines|first5=Henry M.|last6=Platteeuw|first6=Hans|last7=Kamarulzaman|first7=Adeeba|last8=Sall|first8=Amadou|last9=Kremsner|first9=Peter|date=2021-01-01|title=Repurposing Antimalarials to Tackle the COVID-19 Pandemic|url=https://www.cell.com/trends/parasitology/abstract/S1471-4922(20)30288-9|journal=Trends in Parasitology|language=English|volume=37|issue=1|pages=8–11|doi=10.1016/j.pt.2020.10.003|issn=1471-4922|pmid=33153922}}</ref> The preprint<ref name=":0" /> published in July 2020 is cited as a reference paper for this paper.<ref name=":1" /> |
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It is currently in phase II clinical trial in [https://clinicaltrials.gov/ct2/show/NCT04475107 South Korea], [https://clinicaltrials.gov/ct2/show/NCT04532931 South Africa]and [https://clinicaltrials.gov/ct2/show/NCT04701606?cond=COVID&cntry=PH&draw=2&rank=2 Philippine.] phase III clinical trial in [https://clinicaltrials.gov/ct2/show/study/NCT04695197?term=Malcov&cond=COVID-19&draw=2&rank=1 Burkina Faso, Kenya]. The clinical trials in Burkina Faso, Kenya are led by CDC in the USA and The Liverpool School of Tropical Medicine in the UK. |
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== References == |
== References == |
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Latest revision as of 10:51, 24 October 2023
| Combination of | |
|---|---|
| Artesunate | Antimalarial |
| Pyronaridine | Antimalarial |
| Clinical data | |
| Trade names | Pyramax[1] |
| Other names | Artesunate/pyronaridine tetraphosphate[1] |
| Routes of administration | By mouth[2] |
| ATC code | |
| Identifiers | |
| CAS Number | |
Artesunate/pyronaridine, sold under the brand name Pyramax, is a fixed-dose combination medication for the treatment of malaria.[3][1] It can be used for malaria of both the P. falciparum and P. vivax types.[1] It combines artesunate and pyronaridine.[3] It is taken by mouth.[2]
The combination is generally well tolerated.[1] Side effects may include headache, vomiting, or cough.[1] Use in those with severe liver disease or kidney disease is not recommended.[2] Use is not generally recommended in early pregnancy.[2] However, there are no other options and if treatment may save the mother's life it may be used.[2] The two components work by different mechanisms.[2]
It is on the World Health Organization's List of Essential Medicines.[3]
Medical uses
[edit]Artesunate/pyronaridine is used for malaria of both the P. falciparum and P. vivax types.[1] It is not recommended for severe disease.[2]
A 2019 review (updated in 2021) found that the combination compared well to artemether/lumefantrine.[4] Benefits also appear similar to mefloquine together with artesunate.[4] It is not recommended for the prevention of malaria.[2]
Research for drug repurposing
[edit]There is some in vitro evidence that suggests artesunate/pyronaridine may be worthy of clinical trial study to determine whether it might have a role as a drug for COVID-19 treatment.[5]
References
[edit]- ^ a b c d e f g "Application for inclusion in the WHO Model List of essential medicines" (PDF). WHO. Nov 2010. Retrieved 29 June 2017.
- ^ a b c d e f g h "Pyramax 180 mg/60 mg Film-coated tablet" (PDF). EMA. Archived from the original (PDF) on 14 December 2017. Retrieved 13 December 2017.
- ^ a b c World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ a b Pryce J, Taylor M, Fox T, Hine P (June 2022). "Pyronaridine-artesunate for treating uncomplicated Plasmodium falciparum malaria". The Cochrane Database of Systematic Reviews. 2022 (6): CD006404. doi:10.1002/14651858.CD006404.pub4. PMC 9209011. PMID 35726133.
- ^ Krishna S, Augustin Y, Wang J, Xu C, Staines HM, Platteeuw H, et al. (January 2021). "Repurposing Antimalarials to Tackle the COVID-19 Pandemic". Trends in Parasitology. 37 (1): 8–11. doi:10.1016/j.pt.2020.10.003. PMC 7572038. PMID 33153922.
