Pyronaridine development at a standstill: No one prepared to foot the bill? A review of Chinese development and more recent studies

Pyronaridine, a Mannich base synthetic antimalarial, was developed and commercialized in China but is not available elsewhere. Currently, the drug is not widely used because of its high cost and failure to meet international standards. However, despite common chemical features, it has proved effective in chloroquine-resistant falciparum malaria and would represent a valid addition to the armamentarium of antimalarial drugs, since it has potential for replacing chloroquine and for use in treating drug-resistant falciparum malaria. Nonetheless, there is at present no commercial partner interested in the drug, and there has been little progress towards an improved formulation, reduced cost-of-goods or international registration. Pyronaridine should be protected against resistance by combining it with a fast-acting antimalarial, namely an artemisinin derivative.