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The current 3-day artemether-lumefantrine regimen has been associated with high treatment failure rates in pregnant women. Although ACTs are recommended for treating\n                      <jats:italic>Plasmodium vivax<\/jats:italic>\n                      malaria, no clinical trials in pregnancy have been reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Pregnant women with uncomplicated malaria on the Thailand-Myanmar border participated in an open-label randomized controlled trial comparing dihydroartemisinin-piperaquine (DP), artesunate-mefloquine (ASMQ) and a 4-day artemether-lumefantrine regimen (AL\n                      <jats:sup>+<\/jats:sup>\n                      ). The primary endpoint for\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      infections was the PCR-corrected cure rate and for\n                      <jats:italic>P. vivax<\/jats:italic>\n                      infections was recurrent parasitaemia, before delivery or day 63, whichever was longer, assessed by Kaplan-Meier estimate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between February 2010 and August 2016, 511 pregnant women with malaria (353\n                      <jats:italic>P. vivax<\/jats:italic>\n                      , 142\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      , 15 co-infections, 1\n                      <jats:italic>Plasmodium malariae<\/jats:italic>\n                      ) were randomized to either DP (\n                      <jats:italic>n<\/jats:italic>\n                      =170), ASMQ (\n                      <jats:italic>n<\/jats:italic>\n                      =169) or AL\n                      <jats:sup>+<\/jats:sup>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      =172) treatments. Successful malaria elimination efforts in the region resulted in premature termination of the trial. The majority of women had recurrent malaria (mainly\n                      <jats:italic>P. vivax<\/jats:italic>\n                      relapses, which are not prevented by these treatments). Recurrence-free proportions (95% confidence interval [95% CI]) for vivax malaria were 20.6% (5.1\u201343.4)\u00a0for DP (\n                      <jats:italic>n<\/jats:italic>\n                      =125), 46.0% (30.9\u201360.0)\u00a0for ASMQ (\n                      <jats:italic>n<\/jats:italic>\n                      =117) and 28.7% (10.0\u201350.8) for\u00a0AL\n                      <jats:sup>+<\/jats:sup>\n                      \u00a0(\n                      <jats:italic>n<\/jats:italic>\n                      =126). DP and ASMQ provided longer recurrence-free intervals. PCR-corrected cure rates (95% CI) for falciparum malaria were 93.7% (81.6\u201397.9)\u00a0for DP (\n                      <jats:italic>n<\/jats:italic>\n                      =49), 79.6% (66.1\u201388.1)\u00a0for AMSQ (\n                      <jats:italic>n<\/jats:italic>\n                      =55) and 87.5% (74.3\u201394.2) for\u00a0AL\n                      <jats:sup>+<\/jats:sup>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      =50). Overall 65% (85\/130) of\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      \u00a0infections had\n                      <jats:italic>Pfkelch13<\/jats:italic>\n                      propeller mutations which increased over time and recrudescence occurred almost exclusively in them; risk ratio 9.42 (95% CI 1.30\u201368.29). Among the women with falciparum malaria, 24.0%\u00a0(95% CI 16.8\u201333.6) had\n                      <jats:italic>P. vivax<\/jats:italic>\n                      parasitaemia within 4 months. Nausea, vomiting, dizziness and sleep disturbance were more frequent with ASMQ. Miscarriage, small-for-gestational-age and preterm birth did not differ significantly among the treatment groups, including first trimester exposures (\n                      <jats:italic>n<\/jats:italic>\n                      =46).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      DP was well tolerated and safe, and was the only drug providing satisfactory efficacy for\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      -infected pregnant woman in this area of widespread artemisinin resistance. Vivax malaria recurrences are very common and warrant chloroquine prophylaxis after antimalarial treatment in this area.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01054248\">NCT01054248<\/jats:ext-link>\n                      , registered on 22 January 2010.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12916-021-02002-8","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T21:02:46Z","timestamp":1623272566000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["A randomized controlled trial of dihydroartemisinin-piperaquine, artesunate-mefloquine and extended artemether-lumefantrine treatments for malaria in pregnancy on the Thailand-Myanmar border"],"prefix":"10.1186","volume":"19","author":[{"given":"Makoto","family":"Saito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena I.","family":"Carrara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ellen","family":"Gilder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung Myat","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nay Win","family":"Tun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mupawjay","family":"Pimanpanarak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacher","family":"Viladpai-nguen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moo Kho","family":"Paw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warat","family":"Haohankhunnatham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamonchanok","family":"Konghahong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung Pyae","family":"Phyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Turner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue J.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jureeporn","family":"Duanguppama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallika","family":"Imwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germana","family":"Bancone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Proux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratap","family":"Singhasivanon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Nosten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-3257","authenticated-orcid":false,"given":"Rose","family":"McGready","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"issue":"4","key":"2002_CR1","doi-asserted-by":"publisher","first-page":"e107","DOI":"10.1016\/S1473-3099(18)30066-5","volume":"18","author":"SJ Rogerson","year":"2018","unstructured":"Rogerson SJ, Desai M, Mayor A, Sicuri E, Taylor SM, van Eijk AM. 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