Trauma Organ Protection Using Artesunate (TOP-ART) 

The final study can be found here

Trial registration number: ISRCTN15731357

Artesunate is a drug that has been in use for many years as the treatment of choice for severe malaria. It has very few adverse effects and can even be used safely by patients with kidney failure or liver dysfunction.  

Using experimental (rat) models of severe bleeding, we have discovered that the intravenous injection of small doses of Artesunate (1 to 4.8 mg/kg) upon resuscitation reduces organ failure after trauma haemorrhage. The drug appears to enhance the protection of organs by reducing the body’s excessive inflammatory response to injury and blood loss, and by activating well-known cell-survival pathways. 

Having made this exciting discovery in the laboratory, C4TS now want to translate these findings to patients by conducting a Phase 2a clinical trial. 

The aim of this trial, ‘Trauma Organ Protection using ARTesunate’ (TOP-ART), was to compare safety and benefit of Artesunate administration in addition to standard treatment in severely-injured bleeding trauma patients.

Study Design

TOP-ART was conducted as a single centre study at the Royal London Hospital Major Trauma Centre.  105 adult trauma patients were recruited who were randomised to receive either:

  • Low dose intravenous Artesunate (35 patients)
  • High dose intravenous Artesunate (35 patients)
  • Placebo (35 patients)

The trial enrolled eligible patients over a 24-month period and determine patient outcomes in-hospital for up to 28 days and mortality at 90 days. The trial ran from 2017. 

A therapeutic agent that reduces the incidence and severity of multiple organ failure could have a major global impact on trauma patient outcomes and their requirements for healthcare utilisation.

Key Documents

The key documents supporting the trial can be downloaded from the links below:

Study protocol

Consent form

Patient information sheet

Trial Status

Phase 1, which used a treatment does of 2.4mg/kg (the WHO recommended level for artesunate's current indication) was completed on 20 June 2018. Phase 2 has commenced, and patients are now being treated at a higher dose (4.8mg/kg), which pre-clinical studies suggested could be more efficacious. Patient recruitment is on track.


The Principal Investigator was: Professor Chris Thiemermann



Artesunate: ancient healer

Artesunate is a semi-synthetic derivative of the plant Artemisinin annua, also known as Sweet Wormwood.  The plant is found commonly in China where it has been used in Chinese herbal medicine for over 2000 years.

Share this page