Last Updated: 28/05/2025

Triple drug combination screening

Objectives

This project aimed to identify parasite genotypes with decreased susceptibility to specific triple artemisinin-based combination therapy (TACTs) as well as potential TACTs that display antagonism in a genotype dependent manner.

Principal Investigators / Focal Persons

Alexey V. Zakharov

Rationale and Abstract

The first line treatments for uncomplicated Plasmodium falciparum malaria are artemisinin-based combination therapies (ACT), consisting of an artemisinin derivative combined with a longer acting partner drug. However, the spread of P. falciparum isolates with decreased susceptibility to artemisinin and partner drugs presents a significant challenge to current malaria control efforts. To stem the spread of drug resistant parasites, novel chemotherapeutic strategies are being evaluated, including the implementation of triple artemisinin-based combination therapy (TACT). Currently, there is limited knowledge on the pharmacodynamics and pharmacogenetic interactions of proposed TACT drug combinations. As a means to evaluate these interactions, NCGC scientists have established an in vitro high-throughput assays measuring the drug dose-response to three distinct agents. Sixteen different TACT combinations were screened against fifteen parasite lines from Cambodia, with a focus on parasites with differential susceptibilities to piperaquine and artemisinins. Analysis revealed drug-drug interactions unique to specific genetic backgrounds. The assay and analysis platform can be further leveraged to inform drug policy decisions and evaluate next-generation TACTs.

Date

Jan 2019 — Jan 2022

Total Project Funding

$427,431

Project Site

United States

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