Trial reportAntimicrobial agents and chemotherapy2004
Comparative pharmacokinetics of intramuscular artesunate and artemether in patients with severe falciparum malaria.
Trial report in Antimicrobial agents and chemotherapy, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Artemether for severe malaria.The Cochrane database of systematic reviews · 2019Pooled it
- Artemether for severe malaria.The Cochrane database of systematic reviews · 2014Pooled it
- Artesunate versus quinine for treating severe malaria.The Cochrane database of systematic reviews · 2012Pooled it
- Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial.Lancet (London, England) · 2010Trial
- Randomized controlled trial of artesunate or artemether in Vietnamese adults with severe falciparum malaria.Malaria journal · 2010Trial
- The pharmacokinetics of intravenous artesunate in adults with severe falciparum malaria.European journal of clinical pharmacology · 2006Trial
- Artesunate suppositories versus intramuscular artemether for treatment of severe malaria in children in Papua New Guinea.Antimicrobial agents and chemotherapy · 2006Trial
- Artemether bioavailability after oral or intramuscular administration in uncomplicated falciparum malaria.Antimicrobial agents and chemotherapy · 2003Trial
- Improved protocols using sodium artesunate for the treatment of experimental cerebral malaria.Antimicrobial agents and chemotherapy · 2026Article
- Phase I study on the pharmacokinetics of intravaginal, self-administered artesunate vaginal pessaries among women in Kenya.PloS one · 2025Article
- Artemisinin-resistant malaria.Clinical microbiology reviews · 2024Review
- Inter-Species Pharmacokinetic Modeling and Scaling for Drug Repurposing of Pyronaridine and Artesunate.International journal of molecular sciences · 2024Article
- Article
- Dimeric Artesunate Glycerophosphocholine Conjugate Nano-Assemblies as Slow-Release Antimalarials to Overcome Kelch 13 Mutant Artemisinin Resistance.Antimicrobial agents and chemotherapy · 2022Article
- Usher syndrome IIIA: a review of the disorder and preclinical research advances in therapeutic approaches.Human genetics · 2022Review
- Advances and roadblocks in the treatment of malaria.British journal of clinical pharmacology · 2022Review
- Artemisinin Binds and Inhibits the Activity ofPathogens (Basel, Switzerland) · 2021Article
- Comparative effects of artemether and in combination with diminazene aceturate in the treatment of experimentalJournal of parasitic diseases : official organ of the Indian Society for Parasitology · 2021Article
- Parenteral artemisinins are associated with reduced mortality and neurologic deficits and improved long-term behavioral outcomes in children with severe malaria.BMC medicine · 2021Observational
- Bioactive Compounds, Pharmacological Actions, and Pharmacokinetics of Wormwood (Antibiotics (Basel, Switzerland) · 2020Review
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
The first-dose pharmacokinetic properties of intramuscular (i.m.) artesunate (ARTS; 2.4 mg/kg immediately [stat], followed by 1.2 mg/kg i.m. daily) and artemether (ARM; 3.2 mg/kg i.m. stat, followed by 1.6 mg/kg i.m. daily) were compared in Vietnamese adults with severe falciparum malaria. A total of 19 patients were studied; 9 received ARTS, and 10 received ARM. ARTS was absorbed very rapidly; concentrations in plasma peaked between 1,362 and 8,388 nmol/liter (median, 5,710 nmol/liter) within 20 min of injection and then declined with a median (range) half-life (t(1/2)) of 30 (3 to 67) min. ARTS was hydrolyzed rapidly and completely to the biologically active metabolite dihydroartemisinin (DHA). Peak DHA concentrations in plasma ranged between 1,718 and 7,080 nmol/liter (median, 3,060 nmol/liter) and declined with a t(1/2) of 52 (26 to 69) min. In contrast, ARM was slowly and erratically absorbed. The absorption profile appeared biphasic. Maximum ARM concentrations in plasma ranged between 67 nmol/liter (a value close to the 50% inhibitory concentration for some Plasmodium falciparum isolates) and 1,631 nmol/liter (median, 574 nmol/liter) and occurred at a median (range) of 10 (1.5 to 24) h. There was relatively little conversion to DHA. After i.m. injection in cases of severe malaria, absorption of the water-soluble ARTS is rapid and extensive, whereas the oil-based ARM is slowly and erratically absorbed, with relatively little conversion to the more active DHA. On the basis of this pharmacological study, parenteral ARTS is preferable to ARM as an initial antimalarial therapy, particularly in the most seriously ill patients. These findings should be formally assessed by a randomized clinical trial.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.