Abstract

Malaria is one of the most important parasitic diseases of man. The development of drug resistance in malaria parasites is an inevitable consequence of their widespread and often unregulated use. There is an urgent need for new and effective drugs. Pyronaridine is a known antimalarial drug that has received renewed interest as a partner drug in artemisinin-based combination therapy. To study its pharmacokinetic properties, particularly in field settings, it is necessary to develop and validate a robust, highly sensitive and accurate bioanalytical method for drug measurements in biological samples. We have developed a sensitive quantification method that covers a wide range of clinically relevant concentrations (1.5ng/mL to 882ng/mL) using a relatively low volume sample of 100μL of whole blood. Total run time is 5min and precision is within ±15% at all concentration levels. Pyronaridine was extracted on a weak cation exchange solid-phase column (SPE) and separated on a HALO RP amide fused-core column using a gradient mobile phase of acetonitrile–ammonium formate and acetonitrile-methanol. Detection was performed using electrospray ionization and tandem mass spectrometry (positive ion mode with selected reaction monitoring). The developed method is suitable for implementation in high-throughput routine drug analysis, and was used to quantify pyronaridine accurately for up to 42days after a single oral dose in a drug-drug interaction study in healthy volunteers.

Highlights

  • Malaria is one of the most important infectious diseases in the world, resulting in an estimated 214 million cases and 438,000 deaths in 2015 [1]

  • Pyronaridine is a synthetic antimalarial drug, developed in the 1970s, which has been used as a mono-therapy in China

  • In the drugdrug interaction study in healthy volunteers [5], fluoride-oxalate was used as an anticoagulant for all drugs in the study and this anticoagulant was selected for the validation of pyronaridine

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Summary

Introduction

Malaria is one of the most important infectious diseases in the world, resulting in an estimated 214 million cases and 438,000 deaths in 2015 [1]. Artemisinin-based combination therapy (ACT) is the World Health Organization recommended first-line treatment against P. falciparum malaria [2]. The fastacting artemisinin component kills the majority of parasites during the first days of treatment As, this class of drug has a short biological half-life [3,4], it is necessary to combine it with a longacting partner drug to eliminate residual parasites and ensure cure. Pyronaridine is a synthetic antimalarial drug, developed in the 1970s, which has been used as a mono-therapy in China. It has a long biological half-life (13–17 days) and is suitable to use in ACTs [5,6,7]. The fixed-dose combination of artesunate and pyronaridine is a newly developed and deployed ACT, which has shown excellent efficacy against both P. falciparum and P. vivax malaria [8]

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