Evidence map›Paper›PMID 27107287›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016

Efficacy of Artesunate-mefloquine for Chloroquine-resistant Plasmodium vivax Malaria in Malaysia: An Open-label, Randomized, Controlled Trial.

Matthew J Grigg, Timothy William, Jayaram Menon, Bridget E Barber, Christopher S Wilkes, Giri S Rajahram, Michael D Edstein, Sarah Auburn, Ric N Price, Tsin W Yeo and 1 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01708876 (Artesunate-mefloquine vs Chloroquine in Patients With Acute Uncomplicated P. Knowlesi and P. Vivax Malaria), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
7.0field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01708876 phase3completednot on this map

Artesunate-mefloquine vs Chloroquine in Patients With Acute Uncomplicated P. Knowlesi and P. Vivax Malaria: a Randomized Open Label Trial in Sabah, Malaysia

TypeinterventionalSponsorMenzies School of Health ResearchRan2012 to 2014Enrolled250ConditionsUncomplicated Plasmodium Knowlesi MalariaArmsArtesunate-mefloquine, Chloroquine, Primaquine
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. The Vivax Surveyor: Online mapping database for Plasmodium vivax clinical trials.International journal for parasitology. Drugs and drug resistance · 2017
    Pooled it
  4. Trial
  5. Artemether-Lumefantrine Versus Chloroquine for the Treatment of Uncomplicated Plasmodium knowlesi Malaria: An Open-Label Randomized Controlled Trial CAN KNOW.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018
    Trial
  6. Article
  7. Article
  8. Article
  9. Longitudinal changes in iron homeostasis in human experimental and clinical malaria.medRxiv : the preprint server for health sciences · 2023
    Article
  10. No Association between the Plasmodium vivaxAntimicrobial agents and chemotherapy · 2023
    Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Review
  18. Liver Function Test Abnormalities in Experimental and ClinicalThe American journal of tropical medicine and hygiene · 2020
    Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 4 countries.

Matthew J GriggGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Timothy WilliamInfectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu.
Jayaram MenonClinical Research Centre, Queen Elizabeth Hospital.
Bridget E BarberGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Christopher S WilkesGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Giri S RajahramInfectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu.
Michael D EdsteinDepartment of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Queensland.
Sarah AuburnGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Ric N PriceGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Tsin W YeoGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Nicholas M AnsteyGlobal and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia.
Charles Darwin University · AUMenzies School of Health Research · AUArmed Forces Institute of Pathology · PKSouth Molton Medical Centre · GB

Funding

Wellcome Trust 091625
6 · The paper itself

Abstract

backgroundChloroquine (CQ)-resistant Plasmodium vivax is increasingly reported throughout southeast Asia. The efficacy of CQ and alternative artemisinin combination therapies (ACTs) for vivax malaria in Malaysia is unknown.

methodsA randomized, controlled trial of CQ vs artesunate-mefloquine (AS-MQ) for uncomplicated vivax malaria was conducted in 3 district hospitals in Sabah, Malaysia. Primaquine was administered on day 28. The primary outcome was the cumulative risk of treatment failure by day 28 by Kaplan-Meier analysis.

resultsFrom 2012 to 2014, 103 adults and children were enrolled. Treatment failure by day 28 was 61.1% (95% confidence interval [CI], 46.8-75.6) after CQ and 0% (95% CI, 0-.08) following AS-MQ (P < .001), of which 8.2% (95% CI, 2.5-9.6) were early treatment failures. All patients with treatment failure had therapeutic plasma CQ concentrations at day 7. Compared with CQ, AS-MQ was associated with faster parasite clearance (normalized clearance slope, 0.311 vs 0.127; P < .001) and fever clearance (mean, 19.0 vs 37.7 hours; P =001) and with lower risk of anemia at day 28 (odds ratio = 3.7; 95% CI, 1.5-9.3; P =005). Gametocytes were present at day 28 in 23.8% (10/42) of patients following CQ vs none with AS-MQ (P < .001). AS-MQ resulted in lower bed occupancy: 4037 vs 6510 days/1000 patients (incidence rate ratio 0.62; 95% CI, .60-.65; P < .001). One patient developed severe anemia not regarded as related to their AS-MQ treatment.

conclusionsHigh-grade CQ-resistant P. vivax is prevalent in eastern Malaysia. AS-MQ is an efficacious ACT for all malaria species. Wider CQ-efficacy surveillance is needed in vivax-endemic regions with earlier replacement with ACT when treatment failure is detected.Clinical Trials Registration NCT01708876.

Indexed as

Drug ResistanceMalaria, VivaxPlasmodium vivaxAdolescentAdultAgedAntimalarialsArtemisininsArtesunateChildChild, PreschoolChloroquineFemaleHumansInfantMaleAntimalarialsArtemisininsArtesunateChloroquineMefloquineartesunate-mefloquinechloroquinemalariaPlasmodium vivaxrandomized, controlled trial

Identifiers

PMID27107287
PMCPMC4872287
OpenAlexW2340320453

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.