The Effect of Dosing Regimens on the Antimalarial Efficacy of Dihydroartemisinin-Piperaquine: A Pooled Analysis of Individual Patient Data
| Autor: | Bart Janssens, Corine Karema, Chris Drakeley, Philip J. Rosenthal, Adoke Yeka, Raquel González, Timothy M. E. Davis, Ambrose O. Talisuna, Aung Pyae Phyo, Charles J. Woodrow, Henk D. F. H. Schallig, Emmanuel Arinaitwe, Elizabeth A. Ashley, Mamadou S. Ba, Frank Smithuis, Karen I. Barnes, Grant Dorsey, Patrick Sawa, Paul N. Newton, Halidou Tinto, Steffen Borrmann, François Nosten, Seif Shekalaghe, Simon I. Hay, Carol Hopkins Sibley, Neena Valecha, Jeff Smith, Thuy Nguyen, Caterina I. Fanello, Clarissa Moreira, Jane Achan, Oumar Gaye, Michel Van Herp, William Yavo, Anyirékun Fabrice Somé, Arjen M. Dondorp, Carolyn Nabasumba, Moussa Koné, Teun Bousema, Peter W. Gething, Kasia Stepniewska, P. Sasithon, Jean-Bosco Ouédraogo, Petra F. Mens, Bertrand Lell, Mbaye Pene, Quique Bassat, Philippe J Guerin, Sabah A. Omar, Joel Tarning, Mayfong Mayxay, Issaka Zongo, Ivo Mueller, Louis K. Penali, Harin Karunajeewa, Moses R. Kamya, Tran Tinh Hien, Umberto D'Alessandro, Patrice Piola, Albert Same-Ekobo, Jean Louis Ndiaye, Clara Menéndez, Michèle van Vugt, Babacar Faye, Christian Nsanzabana, Ghulam Rahim Awab, Ishag Adam, Roger Tine, Prabin Dahal, Michael Nambozi, Emiliana Tjitra, Ric N. Price, Kevin Marsh, Martin M Meremikwu, Nicholas J. White, Jennifer A. Flegg |
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| Přispěvatelé: | Garner, Paul |
| Rok vydání: | 2016 |
| Předmět: |
Falciparum
Male medicine.medical_specialty WorldWide Antimalarial Resistance Network (WWARN) DP Study Group Genotype medicine.medical_treatment 030231 tropical medicine Dihydroartemisinin Pharmacology Medical and Health Sciences Efficacy 03 medical and health sciences Antimalarials 0302 clinical medicine Dihydroartemisinin/piperaquine Drug Therapy Risk Factors Internal medicine Piperaquine General & Internal Medicine Medicine Humans 030212 general & internal medicine Dosing Risk factor Survival rate business.industry Evaluation of treatments and therapeutic interventions General Medicine Sulfadoxine/pyrimethamine Artemisinins 3. Good health Malaria Infectious Diseases 6.1 Pharmaceuticals Combination Quinolines Female business medicine.drug |
| Zdroj: | Scopus-Elsevier PLoS medicine, vol 10, iss 12 PLoS Medicine, Vol 10, Iss 12, p e1001564; discussion e1001564 (2013) |
| ISSN: | 1549-1676 |
| DOI: | 10.1371/journal.pmed.1001564 |
| Popis: | Background:Dihydroartemisinin-piperaquine (DP) is increasingly recommended for antimalarial treatment in many endemic countries; however, concerns have been raised over its potential under dosing in young children. We investigated the influence of different dosing schedules on DP's clinical efficacy.Methods and Findings:A systematic search of the literature was conducted to identify all studies published between 1960 and February 2013, in which patients were enrolled and treated with DP. Principal investigators were approached and invited to share individual patient data with the WorldWide Antimalarial Resistance Network (WWARN). Data were pooled using a standardised methodology. Univariable and multivariable risk factors for parasite recrudescence were identified using a Cox's regression model with shared frailty across the study sites. Twenty-four published and two unpublished studies (n = 7,072 patients) were included in the analysis. After correcting for reinfection by parasite genotyping, Kaplan-Meier survival estimates were 97.7% (95% CI 97.3%-98.1%) at day 42 and 97.2% (95% CI 96.7%-97.7%) at day 63. Overall 28.6% (979/3,429) of children aged 1 to 5 years received a total dose of piperaquine below 48 mg/kg (the lower limit recommended by WHO); this risk was 2.3-2.9-fold greater compared to that in the other age groups and was associated with reduced efficacy at day 63 (94.4% [95% CI 92.6%-96.2%], p |
| Databáze: | OpenAIRE |
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