World Journal of
Pharmaceutical and Life Sciences

EFFECT OF A POLY-PILL OF METFORMIN, ARTESUNATE AND ESOMEPRAZOLE LOW-DOSE (MEALD) COMBINATION IN PREVENTION OF MALARIA AND SELECTED METABOLIC SYNDROME CRITERIA

Dr. S. E. Oriaifo*

ABSTRACT

Malaria-induced attenuation of the insulin signalling pathway may be important in the aetiology of T2DM, while T2DM has been linked with increased malaria risk. AMPK activators, of which metformin, artesunate and esomeprazole are examples, down-regulate malaria-induced inhibition of AMPK, upregulate host immunity and may inhibit the spread of drug resistance in malaria. They also attenuate all stages of malaria parasite life-cycle. The long clinical duration of action of esomeprazole and the accumulation of metformin in erythrocytes may acquit them satisfactorily as combinatorial agents with artesunate which has a short duration of action. In the present report, the effect of the combination of metformin (500 mg daily with no interruption), esomeprazole (10 mg daily; intermittent) and artesunate (12.5 mg daily; intermittent) low-dose (MEALD) combination was compared to that of metformin alone in the attenuation of selected metabolic syndrome criteria in adult men. Also, the differential effects of the drug combination and metformin alone on parasite clearance and fever recrudescence were compared in adults. Results show that the MEALD combination was more significantly effective (P < 0.05) in reducing glucose levels and other selected metabolic syndrome criteria and in effecting parasite clearance and preventing parasite recrudescence over 18- month period than the metformin alone. Present report highlights that the MEALD combination deserves further study in a larger sample size. This would define its role in addressing both malaria drug resistance and the diabetes-malaria connection.

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