COVID-19 prevention and treatment: a critical analysis of chloroquine and hydroxychloroquine clinical pharmacology
20 June 2020
Paper by NJ White et al, PLoS Medicine, in press. Using available pharmacokinetic information from healthy volunteers, the treatment of malaria, the chronic treatment of rheumatological conditions and the toxicokinetics of chloroquine in self-poisoning, the authors predict exposures and safety margins in the high dose chloroquine and hydroxychloroquine COVID-19 prevention and treatment regimens currently under evaluation. These regimens are predicted to have reasonable safety margins. Large, well conducted randomised clinical trials with appropriate monitoring are required to determine if chloroquine and hydroxychloroquine have preventive or treatment efficacy in COVID-19 and acceptable safety. Current recommendations for their use outside of clinical trials are not justified at this time.
10 April 2020
Global health experts have united in a call for governments and international organisations around the world to plan strategically for the coordinated production, equitable distribution and surveillance of COVID-19 medical products to ensure access to quality-assured medications for everyone.
11 March 2020
Adding a third anti-malaria drug to current artemisinin-combination therapies (ACTs) provides effective treatment against multidrug-resistant falciparum malaria in Southeast Asia, say Oxford researchers in a study in The Lancet. Using TACTs should extend current malaria drugs so drug-resistant malaria doesn't kill millions more and derail hopes of controlling and eliminating malaria.
Global study highlights the extent and impact of drug-resistant enteric fever and the urgent need for new approaches
23 December 2019
A new study conducted by Christiane Dolecek and colleagues analysed data on antimicrobial resistance of the bacteria Salmonella Typhi and Salmonella Paratyphi, from around the globe, spanning the time from 1990 to 2018. The study highlights the impact of drug resistance and the urgent need for interventions.
7 November 2019
Noting that substandard and falsified medical products (including medicines, vaccines, biologics, and diagnostics) represent a significant and growing threat to human health, The Lancet Global Health published 'The Global access to quality-assured medical products: the Oxford Statement and call to action'.
New research supports co-administration of primaquine with artemisinin-based combination therapies for P. vivax malaria
8 October 2019
An individual patient data meta-analysis of 2,017 patients from 19 studies has found a high risk of recurrence following treatment of P. vivax malaria with artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) unless they are co-administered with primaquine. The research supports recommendations that these artemisinin-based combination therapies (ACT) should be combined with primaquine.
24 July 2019
MORU researchers have found that severe malnutrition is associated with lower exposure to the antimalarial drug lumefantrine in children treated with artemether-lumefantrine, the most common treatment for uncomplicated falciparum malaria. The study, which is the first to specifically address this, calls urgently for further research into optimised dosing regimens for undernourished children.
Rapidly spreading multidrug-resistant parasites render frontline malaria drug ineffective in southeast Asia
23 July 2019
A rapidly evolving multi-drug resistant lineage of P. falciparum malaria parasites continues to spread in South East Asia, leading to alarmingly high treatment failure rates in Cambodia, Thailand and Vietnam for DHA-piperaquine, one of the world’s most important anti-malaria drugs.
19 July 2019
A large clinical trial in Africa and Asia has shown that a 7 day course of high dose primaquine, a drug used to treat P. vivax malaria, is well tolerated and just as effective as the current standard 14 day regimen, according to a study published this week in The Lancet. These findings have important implications for the treatment and elimination of vivax malaria in the Asia Pacific.
2 July 2019
New research by Makoto Saito and colleagues at SMRU found that a longer follow-up is required to assess antimalarial drug efficacy in pregnant women. This was found across all drugs assessed in low malaria transmission settings. The report’s authors have called for guidelines specifically for pregnant women and further investigation of optimal follow-up periods in high malaria transmission settings.
26 February 2019
On 12 Feb 2019, Professor Arjen Dondorp published a new book: Sepsis Management in Resource-limited Settings. The result of a 3-year project led by MORU and the European Society of Intensive Care Medicine (ESICM), the book was written by critical care physicians from around the globe.
9 November 2018
A systematic review analyses the results of 177 trials conducted between 1982 and 2016, including 18,436 patients who underwent electrocardiographic evaluation during malaria clinical trials. Nick White and colleagues found that serious cardiovascular side effects, which include sudden cardiac death, are very rare in the treatment of malaria with quinoline antimalarials. The work emphasises the importance of continued pharmacovigilance with the increasing use of quinoline antimalarials in mass treatment strategies such as intermittent preventative treatment and mass drug administration.
7 November 2018
The manufacture and distribution of medicines is a global industry, tainted by fake and substandard products. Not only might these drugs not work as expected, but some are even contributing to antimicrobial resistance. So, what’s in your medicine cabinet? This is an article on Mosaic, a Wellcome publication
7 November 2018
Every person has the right to expect that when they use a medical product, whether medicine, vaccine or diagnostic kit, it works. But too often, that is not the case. Substandard medical products result from errors, negligence or poor practice in manufacturing, transportation and/or storage. In contrast, falsified products result from criminal fraud. Both innovative and generic products are affected.
4 September 2018
A team of researchers led by Yoel Lubell at MORU and IDDO used data from the USA and Thailand to link the consumption of antibiotics with the direct and indirect costs of treating patients for five drug-resistant bacterial infections.
13 June 2018
Current recommended treatment regimens for the most widely used medicine for uncomplicated Plasmodium falciparum malaria may be sub-optimal for small children and pregnant women according to a study led by Professor Joel Tarning.
8 June 2018
One of the world’s most widely used anti-malarial drugs is safe to use, say researchers, after a thorough review and analysis of nearly 200,000 malaria patients who’d taken the drug dihydroartemisinin-piperaquine (DHA-PPQ). There is such a low risk of sudden unexpected death from DHA-PPQ, one of the world’s most effective medicines to treat malaria, that there is no need to limit its current use.
25 May 2018
Primaquine can be used to prevent the transmission of falciparum malaria from human to mosquito. Bob Taylor and colleagues at the Mahidol Oxford Research Unit (MORU) have developed an age-based regimen for single low-dose primaquine to block the transmission of malaria in sub-Saharan Africa.
25 April 2018
The rapid elimination of potentially untreatable P. falciparum malaria in South-East Asia is possible, according to a ground-breaking new study published today in The Lancet. The study authors say that setting up community-based malaria clinics for early diagnosis, treatment and monitoring, combined with mass antimalarial drug administration (MDA) to everyone living in ‘hotspot’ areas.
10 April 2018
Giving paracetamol (acetaminophen) to patients ill with severe malaria made them less likely to develop potentially fatal kidney failure. Each year severe malaria causes close to half a million deaths globally. Acute kidney injury occurs in 40% of adults and at least 10% of children with severe malaria, killing an estimated 40% of these adults and 12-24% of the children. The study reported for the first time that giving regular doses of paracetamol protects the kidney in adult patients with severe falciparum malaria.
Labels showing antibiotics used to produce food a must to fight drug-resistant superbugs Labels showing antibiotics used to produce food a must to fight drug-resistant superbugs
31 January 2018
To fight the growing global threat of antibiotic-resistant bacteria, food labels around the world should include an ‘antibiotic footprint’ section that clearly shows the type and amount of antibiotics used to produce that food, say scientists in a study led by Associate Professor Direk Limmathurotsakul.
21 September 2017
A highly drug resistant malaria "superbug" from western Cambodia is now present in southern Vietnam, leading to alarming failure rates for dihydroartemisinin (DHA)-piperaquine — Vietnam’s national first-line malaria treatment, leading malaria scientists warn.
21 August 2017
Changing home designs and materials to make homes cooler and harder for mosquitoes to enter could reduce malaria transmission in sub-Saharan Africa, according to a new study in The Lancet Planetary Health.
19 July 2017
An existing malaria rapid diagnostic test (RDT) can be adapted to predict the delayed anaemia that can complicate severe malaria in patients treated with artemisinin-based antimalarial drugs
First-trimester artemisinin derivatives and quinine treatments and the risk of adverse pregnancy outcomes in Africa and Asia
19 June 2017
It has been maintained for decades that quinine is the safest drug for treatment of malaria in the first trimester of pregnancy. In the largest analysis of data from Thailand and Africa, artemisinins are reported to be at least as safe as quinine. This will simplify treatment protocols worldwide.
3 February 2017
A lineage of multidrug resistant P. falciparum malaria has widely spread and is now established in parts of Thailand, Laos and Cambodia, causing high treatment failure rates for the main falciparum malaria medicines, artemisinin combination therapies (ACTs)
Pharmacometric model enables revised dose regimen so all malaria patients can safely be treated with DP
18 January 2017
In the largest study of its kind, a team of researchers led by MORU and WWARN in Bangkok developed a pharmacokinetic model that enabled a revised dose regimen to safely treat all malaria patients including young children with dihydroartemisinin-piperaquine (DP), a widely used antimalarial and a first-line treatment against malaria recommended by the World Health Organization (WHO).
14 December 2016
Prof Paul Newton, Director of LOMWRU and Head of the Medicine Quality Group at the Infectious Diseases Data Observatory IDDO, explains the history of falsified medicines and highlights what needs to be done to avert a problem that threatens us all.
18 October 2016
Training local Karen and Burman women as skilled birth attendants in refugee settings resulted in no adverse perinatal outcomes and many positive outcomes such as a drop in stillbirths and infant deaths and more babies being born in clinics rather than at home, says a new study published in the scientific journal PLOS ONE.
14 September 2016
Multidrug-resistant bacterial infections cause more than 19,000 excess deaths a year in Thailand alone, according to a study published today in eLife Sciences Publications. In a first for Thailand, the study systematically examined microbiology laboratory and hospital databases from nine public hospitals in Northeast Thailand and compared them to Thailand’s national death registry to estimate that 19,122 deaths in Thailand in 2010 were excess deaths caused by multidrug-resistant bacterial infections.
28 June 2016
The rapid decline in effectiveness of a widely used anti-malaria drug treatment on the Thailand-Myanmar border is linked to the increasing prevalence of specific mutations in the malaria parasite itself, according to a paper published in The Clinical infectious Disease Journal.
14 March 2016
Dr Joel Tarning from MORU discusses his New England Journal of Medicine editorial on treating malaria in pregnancy, outlining new evidence on the effectiveness of artemisinin-combination therapies in pregnant women with malaria.
11 February 2016
Artemisinins, the most effective antimalarials available, should be endorsed in the first trimester of pregnancy to ensure optimal treatment of falciparum malaria in pregnant women, reports a paper published today in The Lancet Infectious Diseases.
12 January 2016
Melioidosis, a difficult to diagnose deadly bacterial disease, is likely to be present in many more countries than previously thought, reports a paper published online today in the journal Nature Microbiology. The study predicts that melioidosis is present in 79 countries, including 34 that have never reported the disease.
14 April 2015
An unconventional clinical trial design might have advantages over classical trials for testing treatments for Ebola virus disease (EVD), suggests a study published this week in PLOS Medicine. The work of an international team led by John Whitehead of Lancaster University, UK and Ben Cooper (Oxford University, UK, and Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand) provides much-needed data to inform a debate on the scientific and ethical justification for non-randomized EVD trials that has taken place in the editorial pages of a number of medical journals in past months.