Evidence map›Paper›PMID 27613271›Full record

ReviewFEMS microbiology reviews2017

The clinical impact of artemisinin resistance in Southeast Asia and the potential for future spread.

Charles J Woodrow, Nicholas J White

Registry-linked trialAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in FEMS microbiology reviews, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05203744 (Safety, Tolerability and Pharmacokinetics of Tafenoquine After Weekly and Escalating Monthly Doses of Tafenoquine in Healthy Vietnamese Volunteers), which is not on this map. Cited by 117 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

NCT05203744 phase4unknown statusnot on this mapstarted 2022, after this paper: background citation

Safety, Tolerability and Pharmacokinetics of Tafenoquine After Weekly and Escalating Monthly Doses of Tafenoquine in Healthy Vietnamese Volunteers

TypeinterventionalSponsorNaval Medical Research CenterRan2022 to 2022Enrolled200ConditionsProphylaxisArmsTafenoquine prophylaxis
3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Artemisinin Therapy for Malaria in Hemoglobinopathies: A Systematic Review.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018
    Pooled it
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  12. Efficacy of Artemether-Lumefantrine for UncomplicatedThe American journal of tropical medicine and hygiene · 2018
    Trial
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  15. Review
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57 more citing papers are in PubMed but not listed here.

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

2 authors.

Charles J WoodrowMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6, Rajvithi Road, Bangkok 10400, Thailand.
Nicholas J WhiteMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6, Rajvithi Road, Bangkok 10400, Thailand nickw@tropmedres.ac.

Funding

Wellcome Trust
6 · The paper itself

Abstract

Artemisinins are the most rapidly acting of currently available antimalarial drugs. Artesunate has become the treatment of choice for severe malaria, and artemisinin-based combination therapies (ACTs) are the foundation of modern falciparum malaria treatment globally. Their safety and tolerability profile is excellent. Unfortunately, Plasmodium falciparum infections with mutations in the 'K13' gene, with reduced ring-stage susceptibility to artemisinins, and slow parasite clearance in patients treated with ACTs, are now widespread in Southeast Asia. We review clinical efficacy data from the region (2000-2015) that provides strong evidence that the loss of first-line ACTs in western Cambodia, first artesunate-mefloquine and then DHA-piperaquine, can be attributed primarily to K13 mutated parasites. The ring-stage activity of artemisinins is therefore critical for the sustained efficacy of ACTs; once it is lost, rapid selection of partner drug resistance and ACT failure are inevitable consequences. Consensus methods for monitoring artemisinin resistance are now available. Despite increased investment in regional control activities, ACTs are failing across an expanding area of the Greater Mekong subregion. Although multiple K13 mutations have arisen independently, successful multidrug-resistant parasite genotypes are taking over and threaten to spread to India and Africa. Stronger containment efforts and new approaches to sustaining long-term efficacy of antimalarial regimens are needed to prevent a global malaria emergency.

Indexed as

Plasmodium falciparumAntimalarialsArtemisininsAsia, SoutheasternDrug ResistanceForecastingHumansMalaria, FalciparumMutationAntimalarialsArtemisininsACTartemisininkelchmalariaresistancesoutheast Asia

Identifiers

PMID27613271
PMCPMC5424521

What OpenQuestion holds

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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.