Evidence map›Paper›PMID 30999915›Full record

Trial reportMalaria journal2019

Population pharmacokinetics and pharmacodynamics of the artesunate-mefloquine fixed dose combination for the treatment of uncomplicated falciparum malaria in African children.

Monia Guidi, Thomas Mercier, Manel Aouri, Laurent A Decosterd, Chantal Csajka, Bernhards Ogutu, Gwénaëlle Carn, Jean-René Kiechel

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Malaria journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 13% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Rhein Inhibits NF-Applied bionics and biomechanics · 2022
    Article
  3. Article
  4. Variability in Human In Vitro Enzyme Kinetics.Methods in molecular biology (Clifton, N.J.) · 2021
    Article
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

8 authors at 5 institutions in 2 countries.

Monia GuidiSchool of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
Thomas MercierLaboratory and Service of Clinical Pharmacology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Manel AouriLaboratory and Service of Clinical Pharmacology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Laurent A DecosterdLaboratory and Service of Clinical Pharmacology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Chantal CsajkaSchool of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
Bernhards OgutuKenya Medical Research Institute, Kisumu, Kenya.
Gwénaëlle CarnDrugs for Neglected Diseases initiative, Geneva, Switzerland.
Jean-René KiechelDrugs for Neglected Diseases initiative, Geneva, Switzerland. jean-rene.kiechel@wanadoo.fr.
University of Lausanne · CHDrugs for Neglected Diseases Initiative · CHKenya Medical Research Institute · KEUniversity Hospital of Lausanne · CHUniversity of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe World Health Organization (WHO) recommends combinations of an artemisinin derivative plus an anti-malarial drug of longer half-life as treatment options for uncomplicated Plasmodium falciparum infections. In Africa, artesunate-mefloquine (ASMQ) is an infrequently used artemisinin-based combination therapy (ACT) because of perceived poor tolerance to mefloquine. However, the WHO has recommended reconsideration of the use of ASMQ in Africa. In this large clinical study, the pharmacokinetics (PK) of a fixed dose combination of ASMQ was investigated in an African paediatric population to support dosing recommendations used in Southeast Asia and South America.

methodsAmong the 472 paediatric patients aged 6-59 months from six African centres included in the large clinical trial, a subset of 50 Kenyan children underwent intensive sampling to develop AS, its metabolite dihydroartemisinin (DHA) and MQ PK models. The final MQ PK model was validated using sparse data collected in the remaining participants (NONMEM

resultsAS/DHA concentration-time profiles were best described using a one-compartment model for both compounds with irreversible AS conversion into DHA. AS/DHA PK were characterized by a significant degree of variability. Body weight affected DHA PK parameters. MQ PK was characterized by a two-compartment model and a large degree of variability. Allometric scaling of MQ clearances and volumes of distribution was used to depict the relationship between MQ PK and body weight. No association was found between the model predicted AUC and appearance of recrudescence.

conclusionsThe population pharmacokinetic models developed for both AS/DHA and MQ showed a large variability in drug exposure in the investigated African paediatric population. The largest contributor to this variability was body weight, which is accommodated for by the ASMQ fixed dose combination (FDC) dosing recommendation. Besides body weight considerations, there is no indication that the dosage should be modified in children with malaria compared to adults. Trial registration Pan African Clinical Trials Registry PACTR201202000278282 registration date 2011/02/16.

Indexed as

AntimalarialsArtesunateChild, PreschoolDose-Response Relationship, DrugDrug CombinationsFemaleHumansInfantKenyaMalaria, FalciparumMaleMefloquineProspective StudiesRecurrenceAntimalarialsArtesunateDrug CombinationsMefloquineArtesunateDihydroartemisininMefloquinePopulation pharmacokinetics

Identifiers

PMID30999915
PMCPMC6471806
OpenAlexW2945745288

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.