Pyronaridine: a new 'old' drug on the verge of entering the antimalarial armamentarium

Abstract

Pyronaridine-artesunate is a promising new artemisinin-based combination therapy for the treatment of uncomplicated falciparum malaria and the first systematically evaluated artemisinin-based combination therapy for vivax malaria. The 3-day regimen proved to be highly efficacious in clinical trials in Africa and Asia and is currently under review by the EMA. Price et al. report data of an in vitro drug-susceptibility study evaluating the activity of pyronaridine against Plasmodium vivax and Plasmodium falciparum field isolates from Papua, Indonesia. The authors demonstrate high in vitro activity of pyronaridine at low nanomolar concentrations that is only paralleled by the artemisinin class of antimalarials. Besides exciting methodological insights into the new field of in vitro drug-susceptibility testing for P. vivax, these data are encouraging evidence for the future implementation of pyronaridine in combination therapy for the fight against malaria.