SynthesisClinical pharmacokinetics2021
Influence of Malnutrition on the Pharmacokinetics of Drugs Used in the Treatment of Poverty-Related Diseases: A Systematic Review.
Synthesis in Clinical pharmacokinetics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers, 2 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
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- The Efficacy of Pharmacological Treatment of Depression in Anorexia Nervosa and Underweight Patients: A Systematic Review.European eating disorders review : the journal of the Eating Disorders Association · 2026Pooled it
- Does acute malnutrition in young children increase the risk of treatment failure following artemisinin-based combination therapy? A WWARN individual patient data meta-analysis.The Lancet. Global health · 2024Pooled it
- Azithromycin in severe malaria bacterial co-infection in African children (TABS-PKPD): a phase II randomised controlled trial.BMC medicine · 2024Trial
- Anthropometric Exclusions in Pediatric Clinical Trials: Implications for Medication Dosing in Malnourished Children.Journal of clinical pharmacology · 2026Article
- Prognostic Impact of Combined Nutritional and Cognitive Status on Long-Term Outcome in Acute Decompensated Heart Failure.Nutrients · 2026Article
- Adopting a Comprehensive Approach to Improve Nutritional Status among Critically Ill Children in Low-Resource Settings: A Narrative Review.International journal of preventive medicine · 2026Review
- Article
- The value of an ecological approach to address micronutrient malnutrition.The American journal of clinical nutrition · 2025Article
- Malnutrition and Its Effect on Drug Pharmacokinetics: A Clinical Perspective.Clinical pharmacokinetics · 2025Review
- The Long-Term Efficacy of Cephalosporin in Elderly Hip Fracture Patients: A Comprehensive Analysis.Journal of clinical medicine · 2025Article
- Exploring the Pharmacokinetic Profile of Antiretroviral Efavirenz in Low Protein Malnourished Condition in Wistar Rats.European journal of drug metabolism and pharmacokinetics · 2025Article
- Evaluation of Social and Clinical Factors Associated with Adverse Drug Reactions Among Children with Drug-Resistant Tuberculosis in Pakistan.Tropical medicine and infectious disease · 2025Article
- Investigator-Initiated Clinical Pharmacokinetic Studies in Resource-Limited Settings: Minimal Requirements and Practical Guidance.Journal of clinical pharmacology · 2025Review
- Nutritional Deficiencies and Management in Tuberculosis: Pharmacotherapeutic and Clinical Implications.Nutrients · 2025Review
- [Evaluation Of Dosage Errors During Mass Treatment Campaigns Targeting Lymphatic Filariasis And Onchocerciasis In The Health Districts Of Bougouni And Kolondièba, Mali].Le Mali medical · 2025Article
- Minimal Physiologically-Based Pharmacokinetic Modeling of Atenolol and Metoprolol Absorption in Malnourished Rats.European journal of drug metabolism and pharmacokinetics · 2025Article
- Nutritional Factors and Food and Nutrition Insecurity in Patients with Tuberculosis.Nutrients · 2025Article
- Article
- 3D-Printed Tablets of Nifurtimox: In Vitro and In Vivo Anti-Pharmaceutics · 2025Article
- Pharmacogenetics in Tuberculosis-HIV Coinfected Populations: A Systematic Review of Genetic Variants Influencing Antiretroviral and Anti-Tuberculosis Drug Response.Journal of multidisciplinary healthcare · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatients affected by poverty-related infectious diseases (PRDs) are disproportionally affected by malnutrition. To optimize treatment of patients affected by PRDs, we aimed to assess the influence of malnutrition associated with PRDs on drug pharmacokinetics, by way of a systematic review.
methodsA systematic review was performed on the effects of malnourishment on the pharmacokinetics of drugs to treat PRDs, including HIV, tuberculosis, malaria, and neglected tropical diseases.
resultsIn 21/29 PRD drugs included in this review, pharmacokinetics were affected by malnutrition. Effects were heterogeneous, but trends were observed for specific classes of drugs and different types and degrees of malnutrition. Bioavailability of lumefantrine, sulfadoxine, pyrimethamine, lopinavir, and efavirenz was decreased in severely malnourished patients, but increased for the P-glycoprotein substrates abacavir, saquinavir, nevirapine, and ivermectin. Distribution volume was decreased for the lipophilic drugs isoniazid, chloroquine, and nevirapine, and the α1-acid glycoprotein-bound drugs quinine, rifabutin, and saquinavir. Distribution volume was increased for the hydrophilic drug streptomycin and the albumin-bound drugs rifampicin, lopinavir, and efavirenz. Drug elimination was decreased for isoniazid, chloroquine, quinine, zidovudine, saquinavir, and streptomycin, but increased for the albumin-bound drugs quinine, chloroquine, rifampicin, lopinavir, efavirenz, and ethambutol. Clinically relevant effects were mainly observed in severely malnourished and kwashiorkor patients.
conclusionsMalnutrition-related effects on pharmacokinetics potentially affect treatment response, particularly for severe malnutrition or kwashiorkor. However, pharmacokinetic knowledge is lacking for specific populations, especially patients with neglected tropical diseases and severe malnutrition. To optimize treatment in these neglected subpopulations, adequate pharmacokinetic studies are needed, including severely malnourished or kwashiorkor patients.
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