Glucose-6-phosphate dehydrogenase deficiency and antimalarial drug development

• Main Authors: Ernest Beutler, Stephan Duparc, Ogobara Doumbo, Kanjaksha Ghosh, Marcus Vinicius Guimaraes De Lacerda, Didier Lapierre, Sornchai Looareesuwan, Zulfiqarali Premji, Tom Vulliamy, Christopher Whitty
• Other Authors: Scripps Research Institute
• Format: Review
• Published: 2018
• Subjects: Immunology and Microbiology; Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/24511
• Institution: Mahidol University

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is relatively common in populations exposed to malaria. This deficiency appears to provide some protection from this infection, but it can also cause hemolysis after administration of some antimalarial drugs, especially primaquine. The risk of drug-induced G6PD deficiency-related hemolysis depends on a number of factors including the G6PD variant, the drug and drug dosage schedule, patient status, and disease factors. Although a great deal is known about the molecular biology of G6PD, determining the potential for drug-induced hemolysis in the clinical setting is still challenging. This report discusses the potential strategies for assessing drug-induced G6PD deficiency-related hemolytic risk preclinically and in early clinical trials. Additionally, the issues important for conducting larger clinical trials in populations in which G6PD deficiency is prevalent are examined, with a particular focus on antimalarial drug development. Copyright © 2007 by The American Society of Tropical Medicine and Hygiene.