Tracking antimalarial resistance and treatment of malaria using Triple ACTs

Anti-malaria drug resistance is spreading throughout Southeast Asia and we need to find new treatments. Our researchers at MORU use a combination of artemisinin and two partner drugs instead of one. If confirmed safe and tolerable, triple artemisinin combination therapies might be a good option to treat multi-drug resistant malaria, as well as slow down the emergence and spread of anti-malarial resistance.

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Dr Rob van der Pluijm is the project coordinator of the second iteration of the TRAC project, known as TRAC II.

TRAC II aims to map resistance to antimalarials and assess the tolerability, safety and efficacy of two new triple artemisinin combination treatments (TACTs): Dihydroartemisinin-Piperaquine combined with Mefloquine and Artemether-Lumefantrine combined with Amodiaquine. The triple combinations will hopefully restore efficacy in areas where ACTs are currently starting to fail dramatically, whereas TACTs also aim to prolong the longevity of the artemisinins and partner drugs in areas where ACTs still work.

In addition, from July 2017 TRAC II assesses the safety tolerability and safety of another Triple ACT (arterolane-piperaquine combined with mefloquine in collaboration with the Kenya Medical Research Institute (KEMRI). A team from the London School of Hygiene and Tropical Medicine (LSHTM) is currently assessing the feasibility and efficacy of community led malaria elimination efforts.

Finally, the entomological (i.e. mosquito) factors in the spread of artemisinin resistance will be studied.

The UK’s Department For International Development (DFID) is the funder of the TRAC II trial.