Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
Effect of high-dose or split-dose artesunate on parasite clearance in artemisinin-resistant falciparum malaria.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Pooled it
- Baseline data of parasite clearance in patients with falciparum malaria treated with an artemisinin derivative: an individual patient data meta-analysis.Malaria journal · 2015Pooled it
- Safety and efficacy of the choline analogue SAR97276 for malaria treatment: results of two phase 2, open-label, multicenter trials in African patients.Malaria journal · 2017Trial
- Opposite malaria and pregnancy effect on oral bioavailability of artesunate - a population pharmacokinetic evaluation.British journal of clinical pharmacology · 2015Trial
- Ligand decorated nanostructure carrier systems for targeted delivery of antimalarials.Discover nano · 2026Review
- Repurposing artesunate in acute myeloid leukemia: a pharmacokinetic rationale derived from antimalarial data.Cancer chemotherapy and pharmacology · 2026Article
- Health system challenges and facilitators associated with adaptive cycling deployment of multiple first-line treatment for uncomplicated malaria: a pilot study in a malaria-endemic region of Kenya.Malaria journal · 2025Article
- Artesunate Inhibits Neointimal Hyperplasia by Promoting IRF4 Associated Macrophage Polarization.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- An artesunate pharmacometric model to explain therapeutic responses in falciparum malaria.The Journal of antimicrobial chemotherapy · 2023Article
- Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data.BMC medicine · 2022Article
- Artemisinin resistance and malaria elimination: Where are we now?Frontiers in pharmacology · 2022Review
- Plasmodium falciparum resistance to ACTs: Emergence, mechanisms, and outlook.International journal for parasitology. Drugs and drug resistance · 2021Article
- Efficient Treatment of Experimental Cerebral Malaria by an Artemisone-SMEDDS System: Impact of Application Route and Dosing Frequency.Antimicrobial agents and chemotherapy · 2021Article
- Poor-quality antimalarials further health inequities in Uganda.Health policy and planning · 2019Article
- Review
- Modeling the Economic Impact of Substandard and Falsified Antimalarials in the Democratic Republic of the Congo.The American journal of tropical medicine and hygiene · 2019Article
- Development of an agent-based model to assess the impact of substandard and falsified anti-malarials: Uganda case study.Malaria journal · 2019Article
- Artemisinin resistance phenotypes and K13 inheritance in aProceedings of the National Academy of Sciences of the United States of America · 2018Article
- High-level artemisinin-resistance with quinine co-resistance emerges in P. falciparum malaria under in vivo artesunate pressure.BMC medicine · 2018Article
- Population Pharmacokinetic and Pharmacodynamic Modeling of Artemisinin Resistance in Southeast Asia.The AAPS journal · 2017Article
Corrections and comments
- Commented on by
Authors and funding
21 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundThe emergence of Plasmodium falciparum resistance to artemisinins on the Cambodian and Myanmar-Thai borders poses severe threats to malaria control. We investigated whether increasing or splitting the dose of the short-half-life drug artesunate improves parasite clearance in falciparum malaria in the 2 regions.
methodsIn Pailin, western Cambodia (from 2008 to 2010), and Wang Pha, northwestern Thailand (2009-2010), patients with uncomplicated falciparum malaria were randomized to oral artesunate 6 mg/kg/d as a once-daily or twice-daily dose for 7 days, or artesunate 8 mg/kg/d as a once-daily or twice-daily dose for 3 days, followed by mefloquine. Parasite clearance and recrudescence for up to 63 days of follow-up were assessed.
resultsA total of 159 patients were enrolled. Overall median (interquartile range [IQR]) parasitemia half-life (half-life) was 6.03 (4.89-7.28) hours in Pailin versus 3.42 (2.20-4.85) hours in Wang Pha (P = .0001). Splitting or increasing the artesunate dose did not shorten half-life in either site. Pharmacokinetic profiles of artesunate and dihydroartemisinin were similar between sites and did not correlate with half-life. Recrudescent infections occurred in 4 of 79 patients in Pailin and 5 of 80 in Wang Pha and was not different between treatment arms (P = .68).
conclusionsIncreasing the artesunate treatment dose up to 8 mg/kg/d or splitting the dose does not improve parasite clearance in either artemisinin resistant or more sensitive infections with P. falciparum. Clinical Trials Registration. ISRCTN15351875.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.