A Cochrane review [Abstract] 1 included 10 studies and for efficacy analysis 5 RCT:s with a total of 5711 subjects. Pyronaridine-artesunate is efficacious against uncomplicated P. falciparum malaria, achieving a PCR-adjusted treatment failure rate of less than 5% at days 28 and 42. When compared with other marketed artemisinin-based combination therapies (ACTs) (artemether-lumefantrine, artesunate-amodiaquine, mefloquine plus artesunate) it may be at least as good as others. Raised alanine aminotransferase (ALT) greater than five times the upper limit of normal (> 5 x ULN) is more frequent with pyronaridine-artesunate compared to other antimalarials.
The possibility of liver toxicity should be taken into account when considering use of pyronaridine-artesunate in patients with known or suspected pre-existing liver dysfunction, and when co-administering with other medications which may cause liver dysfunction. However, no severe drug-induced liver injury cases have been reported.
Abstract and full text in Cochrane database http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006404.pub3/full (licence for full text required)
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