Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
The Effect of Regularly Dosed Acetaminophen vs No Acetaminophen on Renal Function in Plasmodium knowlesi Malaria (PACKNOW): A Randomized, Controlled Trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03056391 (Effect of Paracetamol on Renal Function in Plasmodium Knowlesi Malaria), which is not on this map. Cited by 17 papers, 1 of them a synthesis 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.
Effect of Paracetamol on Renal Function in Plasmodium Knowlesi Malaria: A Randomised Controlled Clinical Trial
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Clinical characteristics and outcome of malaria-associated acute kidney injury in adult patients: a systematic review and meta analysis.Malaria journal · 2026Pooled it
- Trial
- Development of a Disease-Specific Virtual Malaria Population for Physiologically-Based Pharmacokinetic Modeling.CPT: pharmacometrics & systems pharmacology · 2026Article
- Preparation, characterization and pre-clinical evaluation of artemether-lumefantrine-paracetamol (AL-P) loaded nanocarriers in the treatment of malaria.Malaria journal · 2026Article
- Population Pharmacokinetics and Pharmacodynamics of Paracetamol in Malaysian Patients With Plasmodium knowlesi Malaria.CPT: pharmacometrics & systems pharmacology · 2026Article
- Preventing pediatric acute kidney injury: is it even possible?Pediatric nephrology (Berlin, Germany) · 2026Review
- Integrative genomics ofbioRxiv : the preprint server for biology · 2026Article
- Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis.Research square · 2025Article
- Paracetamol: the potential therapeutic pathways defining its clinical use.Inflammopharmacology · 2025Review
- Article
- Infections and Acute Kidney Injury: A Global Perspective.Seminars in nephrology · 2023Review
- Acetaminophen as Renoprotective Treatment in a Patient With Severe Malaria.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- The kidney-brain pathogenic axis in severe falciparum malaria.Trends in parasitology · 2023Review
- Quantification of parasite clearance in Plasmodium knowlesi infections.Malaria journal · 2023Article
- Primaquine-induced Severe Hemolysis in the Absence of Concomitant Malaria: Effects on G6PD Activity and Renal Function.The American journal of tropical medicine and hygiene · 2023Article
- Optimizing Plasmodium vivax serological surveillance within a coendemic epidemiological landscape.Trends in parasitology · 2022Article
- Plasmodium vivax malaria serological exposure markers: Assessing the degree and implications of cross-reactivity with P. knowlesi.Cell reports. Medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 8 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcetaminophen inhibits cell-free hemoglobin-induced lipid peroxidation and improves renal function in severe falciparum malaria but has not been evaluated in other infections with prominent hemolysis, including Plasmodium knowlesi malaria.
methodsPACKNOW was an open-label, randomized, controlled trial of acetaminophen (500 mg or 1000 mg every 6 hours for 72 hours) vs no acetaminophen in Malaysian patients aged ≥5 years with knowlesi malaria of any severity. The primary end point was change in creatinine at 72 hours. Secondary end points included longitudinal changes in creatinine in patients with severe malaria or acute kidney injury (AKI), stratified by hemolysis.
resultsDuring 2016-2018, 396 patients (aged 12-96 years) were randomized to acetaminophen (n = 199) or no acetaminophen (n = 197). Overall, creatinine fell by a mean (standard deviation) 14.9% (18.1) in the acetaminophen arm vs 14.6% (16.0) in the control arm (P = .81). In severe disease, creatinine fell by 31.0% (26.5) in the acetaminophen arm vs 20.4% (21.5) in the control arm (P = .12), and in those with hemolysis by 35.8% (26.7) and 19% (16.6), respectively (P = .07). No difference was seen overall in patients with AKI; however, in those with AKI and hemolysis, creatinine fell by 34.5% (20.7) in the acetaminophen arm vs 25.9% (15.8) in the control arm (P = .041). Mixed-effects modeling demonstrated a benefit of acetaminophen at 72 hours (P = .041) and 1 week (P = .002) in patients with severe malaria and with AKI and hemolysis (P = .027 and P = .002, respectively).
conclusionsAcetaminophen did not improve creatinine among the entire cohort but may improve renal function in patients with severe knowlesi malaria and in those with AKI and hemolysis. CLINICAL TRIALS REGISTRATION: NCT03056391.
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