+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Randomized trial of 3-dose regimens of tafenoquine (WR238605) versus low-dose primaquine for preventing Plasmodium vivax malaria relapse



Randomized trial of 3-dose regimens of tafenoquine (WR238605) versus low-dose primaquine for preventing Plasmodium vivax malaria relapse



Clinical Infectious Diseases 39(8): 1095-1103



Tafenoquine is an 8-aminoquinoline developed as a more effective replacement for primaquine. In a previous dose-ranging study in Thailand, 3 tafenoquine regimens with total doses ranging from 500 mg to 3000 mg prevented relapse of Plasmodium vivax malaria in most patients when administered 2 days after receipt of a blood schizonticidal dose of chloroquine. To improve convenience and to begin comparison of tafenoquine with primaquine, 80 patients with P. vivax infection were randomized to receive 1 of the following 5 treatments 1 day after receiving a blood schizonticidal dose of chloroquine: (A) tafenoquine, 300 mg per day for 7 days (n=18); (B) tafenoquine, 600 mg per day for 3 days (n=19); (C) tafenoquine, 600 mg as a single dose (n=18); (D) no further treatment (n=13); or (E) primaquine base, 15 mg per day for 14 days (n=12). The minimum duration of protocol follow-up was 8 weeks, with additional follow-up to 24 weeks. Forty-six of 55 tafenoquine recipients, 10 of 13 recipients of chloroquine only, and 12 of 12 recipients of chloroquine plus primaquine completed at least 8 weeks of follow-up (or had relapse). There was 1 relapse among recipients of chloroquine plus tafenoquine, 8 among recipients of chloroquine only, and 3 among recipients of chloroquine plus primaquine. The rate of protective efficacy (determined on the basis of reduction in incidence density) for all recipients of chloroquine plus tafenoquine, compared with recipients of chloroquine plus primaquine, was 92.6% (95% confidence interval, 7.3%-99.9%; P=.042, by Fisher's exact test). Tafenoquine doses as low as a single 600-mg dose may be useful for prevention of relapse of P. vivax malaria in Thailand.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 004292144

Download citation: RISBibTeXText

PMID: 15486831

DOI: 10.1086/424508


Related references

High-dose primaquine regimens against relapse of Plasmodium vivax malaria. American Journal of Tropical Medicine and Hygiene 78(5): 736-740, 2008

Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria. New England Journal of Medicine 380(19): 1875, 2019

Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria. New England Journal of Medicine 380(3): 229-241, 2019

Randomized Dose-Ranging Study of the Safety and Efficacy of Wr 238605 (Tafenoquine) in the Prevention of Relapse of Plasmodium vivax Malaria in Thailand. The Journal of Infectious Diseases 180(4): 1282-1287, 1999

Randomized dose-ranging study of the safety and efficacy of WR 238605 (Tafenoquine) in the prevention of relapse of Plasmodium vivax malaria in Thailand. Journal of Infectious Diseases 180(4): 1282-1287, 1999

The efficacy and tolerability of three different regimens of tafenoquine versus primaquine for post-exposure prophylaxis of Plasmodium vivax malaria in the Southwest Pacific. Transactions of the Royal Society of Tropical Medicine and Hygiene 102(11): 1095-1101, 2008

Single-Dose Tafenoquine to Prevent Relapse of Plasmodium vivax Malaria. New England Journal of Medicine 380(3): 215-228, 2019

Comparative ophthalmic assessment of patients receiving tafenoquine or chloroquine/primaquine in a randomized clinical trial for Plasmodium vivax malaria radical cure. International Ophthalmology 39(8): 1767-1782, 2019

Comparison of tafenoquine (WR238605) and primaquine in the post-exposure (terminal) prophylaxis of vivax malaria in Australian Defence Force personnel. Transactions of the Royal Society of Tropical Medicine and Hygiene 96(6): 683-684, 2003

Tafenoquine for preventing relapse in people with Plasmodium vivax malaria. Cochrane Database of Systematic Reviews 2015(4): Cd010458, 2015

Relapse of imported Plasmodium vivax malaria is related to primaquine dose: a retrospective study. Malaria Journal 11: 214, 2012

Tafenoquine plus chloroquine for the treatment and relapse prevention of Plasmodium vivax malaria (DETECTIVE): a multicentre, double-blind, randomised, phase 2b dose-selection study. Lancet 383(9922): 1049-1058, 2014

Effectiveness of combined chloroquine and primaquine treatment in 14 days versus intermittent single dose regimen, in an open, non-randomized, clinical trial, to eliminate Plasmodium vivax in southern Mexico. Malaria Journal 14: 426, 2015

Primaquine for preventing relapse in people with Plasmodium vivax malaria treated with chloroquine. Cochrane Database of Systematic Reviews 2013(10): Cd004389, 2013

Pharmacokinetic properties of single-dose primaquine in Papua New Guinean children: feasibility of abbreviated high-dose regimens for radical cure of vivax malaria. Antimicrobial Agents and ChemoTherapy 58(1): 432-439, 2014