Highlighting the need for harmonisation of g6pd reporting following the introduction of new antimalarials

Abstract

The recent introduction of new antimalarial drugs (e.g., tafenoquine)1 comes with a recommendation to ascertain G6PD deficiency in order to avoid drug induced haemolysis. A recent review of RCPAQAP G6PD survey results revealed a degree of variation in the interpretation of assay results in the range of 2.0–9.0 U/g Hb. Aim: To assess the current status of G6PD testing and reporting with a view to providing additional information to laboratories and clinicians when assessing patients prior to prescribing antimalarial drugs. Method: An online survey was forwarded to laboratories participating in the 2019 RCPAQAP Haematology G6PD program seeking further information about their testing, interpretation and reporting of G6PD results. 76 of the 144 participating labs (53%) responded. Results: The key findings were: • A wide variation in reference intervals being reported (lower limit of normal ranging from 4.6 to 11 U/g Hb). • 69% of respondents did not normally refer G6PD results for haematologist review. • 93% of respondents do not specify a cut-off level of G6PD and/or interpretive comment below which it is not advisable to administer antimalarial drugs. Conclusion: The key findings highlight the need to harmonise the reporting and interpretation of G6PD, particularly in light of new antimalarial treatments. Reference 1.Tse EG, Korsik M, Todd MH. The past, present and future of anti-malarial medicines. Malar J 2019; 18: 93.