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Krintafel is an 8-aminoquinoline derivative with activity against all stages of the P.vivax lifecycle, including hypnozoites. Plasmodium parasite is a complex organism with a lifecycle spanning both humans and mosquitoes. After an infected mosquito bite, the P. vivax parasite infects the blood and causes an acute malaria episode.
It also has the ability to lie dormant in the liver-hypnozoite from where it periodically reactivates to cause relapses of P. vivax malaria. A single P. vivax infection can give rise to multiple episodes of malaria, in the absence of a new mosquito bite. These relapses can occur weeks, months or even years after the initial infection.
The dormant liver forms of the parasite cannot be readily treated with most anti-malarial treatments active against the blood-stage parasite. The 8-aminoquinoline, primaquine, is currently the only medicine that targets the dormant liver stage to prevent relapse. It must be taken for 14 days to be effective, a regimen that is associated with poor compliance.
The use of a medicine that targets the dormant liver forms of the parasite, co-administered with currently available anti-malarials such as chloroquine or artemisinin-based combination therapies (ACTs) is known as radical cure.
The clinical features of P. vivax malaria include fever, chills, vomiting, malaise, headache and muscle pain, and in some cases, can lead to severe malaria and be fatal. Common adverse reactions observed for Krintafel in clinical trials were dizziness, nausea, vomiting, headache, and decreased hemoglobin.