ArticleBritish journal of clinical pharmacology2012
Artesunate/dihydroartemisinin pharmacokinetics in acute falciparum malaria in pregnancy: absorption, bioavailability, disposition and disease effects.
Article in British journal of clinical pharmacology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 5 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.
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Who cites it
42 citing papers in PubMed, 5 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Efficacy and tolerability of artemisinin-based and quinine-based treatments for uncomplicated falciparum malaria in pregnancy: a systematic review and individual patient data meta-analysis.The Lancet. Infectious diseases · 2020Pooled it
- Methodology of assessment and reporting of safety in anti-malarial treatment efficacy studies of uncomplicated falciparum malaria in pregnancy: a systematic literature review.Malaria journal · 2017Pooled it
- Systematic literature review and meta-analysis of the efficacy of artemisinin-based and quinine-based treatments for uncomplicated falciparum malaria in pregnancy: methodological challenges.Malaria journal · 2017Pooled it
- Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review.PLoS medicine · 2016Pooled it
- The influence of pregnancy on the pharmacokinetic properties of artemisinin combination therapy (ACT): a systematic review.Malaria journal · 2016Pooled it
- Population pharmacokinetic and pharmacodynamic properties of artesunate in patients with artemisinin sensitive and resistant infections in Southern Myanmar.Malaria journal · 2018Trial
- Artemether-Lumefantrine Pharmacokinetics and Clinical Response Are Minimally Altered in Pregnant Ugandan Women Treated for Uncomplicated Falciparum Malaria.Antimicrobial agents and chemotherapy · 2015Trial
- Opposite malaria and pregnancy effect on oral bioavailability of artesunate - a population pharmacokinetic evaluation.British journal of clinical pharmacology · 2015Trial
- Safe and efficacious artemisinin-based combination treatments for African pregnant women with malaria: a multicentre randomized control trial.Reproductive health · 2015Trial
- Pharmacokinetics of co-formulated mefloquine and artesunate in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum infection in Burkina Faso.The Journal of antimicrobial chemotherapy · 2014Trial
- Effect of high-dose or split-dose artesunate on parasite clearance in artemisinin-resistant falciparum malaria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2013Trial
- Concomitant efavirenz reduces pharmacokinetic exposure to the antimalarial drug artemether-lumefantrine in healthy volunteers.Journal of acquired immune deficiency syndromes (1999) · 2012Trial
- Nano-hydrogel-based delivery system for dihydroartemisinin to enhance cuproptosis and synergize with anti-PD-1 therapy in triple-negative breast cancer.Journal of nanobiotechnology · 2026Article
- Cohort Profile: the SMRU Refugee and Migrant Pregnancy Study in Western Thailand and Eastern Myanmar.Wellcome open research · 2026Article
- Artesunate: A Review of Its Potential Therapeutic Effects and Mechanisms in Digestive Diseases.Pharmaceutics · 2025Review
- Endoperoxide-enhanced self-assembled ROS producer as intracellular prodrugs for tumor chemotherapy and chemodynamic therapy.Exploration (Beijing, China) · 2024Article
- An artesunate pharmacometric model to explain therapeutic responses in falciparum malaria.The Journal of antimicrobial chemotherapy · 2023Article
- Physiologic Changes During Pregnancy and Impact on Small-Molecule Drugs, Biologic (Monoclonal Antibody) Disposition, and Response.Journal of clinical pharmacology · 2023Review
- Anti-CMV therapy, what next? A systematic review.Frontiers in microbiology · 2023Review
- Co-delivery of dihydroartemisinin and pyropheophorbide-iron elicits ferroptosis to potentiate cancer immunotherapy.Biomaterials · 2022Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
aimTo determine if reported lower plasma concentrations of artemisinin derivatives for malaria in pregnancy result from reduced oral bioavailability, expanded volume of distribution or increased clearance.
methodsIn a sequentially assigned crossover treatment study, pregnant women with uncomplicated falciparum malaria received i.v. artesunate (i.v. ARS) (4mgkg(-1) ) on the first day and oral ARS (4mgkg(-1) ) on the second, or, oral on the first and i.v. on the second, in both groups followed by oral ARS (4mgkg(-1) day(-1) ) for 5 days. Plasma concentrations of ARS and dihyroartemisinin (DHA) were measured by liquid chromatography-mass-spectrometry on days 0, 1, 2 and 6. Controls were the same women restudied when healthy (3 months post partum).
resultsI.v. ARS administration resulted in similar ARS and DHA pharmacokinetics in pregnant women with malaria (n= 20) and in controls (n= 14). Oral administration resulted in higher total drug exposure in pregnancy [AUC (95% CI) in (ngml(-1) h)/(mgkg(-1) )] of 55.1 (30.1, 100.0) vs. 26.5 (12.2, 54.3) for ARS, P= 0.002 and 673 (386, 1130) vs. 523 (351, 724) for DHA, P= 0.007. The corresponding median absolute oral bioavailability (F%) was 21.7 (12.6, 75.1) vs. 9.9 (6.0, 36.81) for ARS (P= 0.046) and 77.0 (42.2, 129) vs. 72.7 (42.0, 87.7) for DHA, P= 0.033. Total DHA exposure was lower at day 6 in pregnant women with malaria (P < 0.001) compared with day 0 or 1, but not in the controls (P= 0.084).
conclusionsThis study demonstrates the effects of malaria on oral ARS drug disposition are greater than those of pregnancy. This probably results from a disease related reduction in first pass metabolism. The data are reassuring regarding current dosing recommendations.
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Registered trials
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