Lumefantrine plasma concentrations in uncontrolled conditions among patients treated with artemether-lumefantrine for uncomplicated plasmodium falciparum malaria in Mwanza, Tanzania.
Adult
Antimalarials
/ therapeutic use
Artemether
/ therapeutic use
Artemether, Lumefantrine Drug Combination
/ therapeutic use
Artemisinins
/ therapeutic use
Child
Drug Combinations
Ethanolamines
/ therapeutic use
Female
Fluorenes
/ therapeutic use
Humans
Lumefantrine
/ therapeutic use
Malaria
/ drug therapy
Malaria, Falciparum
/ drug therapy
Male
Plasmodium falciparum
Tanzania
Treatment Outcome
Lumefantrine
day 3 concentration
day 7 concentration
treatment outcomes and Tanzania
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
04
05
2022
revised:
19
08
2022
accepted:
22
08
2022
pubmed:
6
9
2022
medline:
5
10
2022
entrez:
5
9
2022
Statut:
ppublish
Résumé
Therapeutic efficacy of artemether-lumefantrine is highly dependent on adequate systemic exposure to the partner drug lumefantrine particularly day 7 lumefantrine plasma concentration. There has been contradicting findings on the role of the cut-off values in predicting treatment outcomes among malaria patients in malaria endemic regions. This study assesses the day 3 and 7 lumefantrine plasma concentrations including related determinant factors and their influence on treatment outcomes among treated Tanzanian children and adults in uncontrolled conditions (real life condition). Data was nested from an efficacy study employing the WHO protocol, 2015 for monitoring antimalarial drug efficacy. Lumefantrine plasma concentration was measured by high performance liquid chromatography with ultraviolet (HPLC-UV). Lumefantrine plasma concentrations below 175ng/ml and 200ng/ml on day 3 and 7 did not affect adequate clinical and parasitological response (ACPR) and recurrence of infection (p = 0.428 and 0.239 respectively). Age and baseline parasitemia were not associated to day 3 median lumefantrine plasma concentrations (p = 0.08 and 0.31 respectively) and day 7 lumefantrine plasma concentrations (p = 0.07 and 0.41 respectively). However, the day 3 and day 7 lumefantrine plasma concentrations were significantly higher in males compared to females (p = 0.03 and 0.042 respectively). Lumefantrine plasma concentrations below cut-off points (175ng/ml and 200ng/ml) on day 3 and 7 did not influence treatment outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Therapeutic efficacy of artemether-lumefantrine is highly dependent on adequate systemic exposure to the partner drug lumefantrine particularly day 7 lumefantrine plasma concentration. There has been contradicting findings on the role of the cut-off values in predicting treatment outcomes among malaria patients in malaria endemic regions. This study assesses the day 3 and 7 lumefantrine plasma concentrations including related determinant factors and their influence on treatment outcomes among treated Tanzanian children and adults in uncontrolled conditions (real life condition).
METHODS
METHODS
Data was nested from an efficacy study employing the WHO protocol, 2015 for monitoring antimalarial drug efficacy. Lumefantrine plasma concentration was measured by high performance liquid chromatography with ultraviolet (HPLC-UV).
RESULTS
RESULTS
Lumefantrine plasma concentrations below 175ng/ml and 200ng/ml on day 3 and 7 did not affect adequate clinical and parasitological response (ACPR) and recurrence of infection (p = 0.428 and 0.239 respectively). Age and baseline parasitemia were not associated to day 3 median lumefantrine plasma concentrations (p = 0.08 and 0.31 respectively) and day 7 lumefantrine plasma concentrations (p = 0.07 and 0.41 respectively). However, the day 3 and day 7 lumefantrine plasma concentrations were significantly higher in males compared to females (p = 0.03 and 0.042 respectively).
CONCLUSION
CONCLUSIONS
Lumefantrine plasma concentrations below cut-off points (175ng/ml and 200ng/ml) on day 3 and 7 did not influence treatment outcomes.
Identifiants
pubmed: 36064162
pii: S1201-9712(22)00490-8
doi: 10.1016/j.ijid.2022.08.020
pii:
doi:
Substances chimiques
Antimalarials
0
Artemether, Lumefantrine Drug Combination
0
Artemisinins
0
Drug Combinations
0
Ethanolamines
0
Fluorenes
0
Artemether
C7D6T3H22J
Lumefantrine
F38R0JR742
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
192-199Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. All authors declare no competing interests