Evidence map›Paper›PMID 35220555›Full record

ArticleInfection2022

Artesunate monotherapy versus artesunate plus quinine combination therapy for treatment of imported severe malaria: a TropNet retrospective cohort study.

Annarita Botta, Agnese Comelli, Iacopo Vellere, Flavia Chechi, Leila Bianchi, Gardini Giulia, Lina Rachele Tomasoni, Michele Spinicci, Luisa Galli, Francesco Castelli and 2 more

Open access · hybridAbstract read
In one paragraph

Article in Infection, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.4field-weighted citation impact, top 20% 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

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. 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

12 authors at 4 institutions in 1 country.

Annarita BottaDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Agnese ComelliUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Iacopo VellereDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Flavia ChechiSchool of Human Health Sciences, Degree of Medicine and Surgery, University of Florence, Florence, Italy.
Leila BianchiDivision of Pediatric Infectious Disease, Anna Meyer Children's University Hospital, Florence, Italy.
Gardini GiuliaUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Lina Rachele TomasoniUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Michele SpinicciDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Luisa GalliDivision of Pediatric Infectious Disease, Anna Meyer Children's University Hospital, Florence, Italy.
Francesco CastelliUniversity Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, Italy.
Alessandro BartoloniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Lorenzo ZammarchiDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy. lorenzo.zammarchi@unifi.it.ORCID http://orcid.org/0000-0003-0892-8404
University of Brescia · ITAzienda Ospedaliero-Universitaria Careggi · ITUniversity of Florence · ITMeyer Children's Hospital · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe addition of intravenous quinine (IVQ) to intravenous artesunate (IVA) has been recently suggested by World Health Organization  in areas where artemisinin resistance is highly prevalent. Since IVA is not yet widely available as "Good Manufacturing Practices" product, for several years combination treatment with IVA and IVQ was used in some Italian centers to mitigate the legal risks in using an unlicensed drug.

methodsA retrospective cohort study was designed to compare IVA + IVQ and IVA treatment for imported severe malaria. We collected data from three Italian centers. Adult and pediatric cohorts were analyzed separately.

resultsForty-nine patients treated with IVA and 44 with IVA + IVQ were enrolled, 45 were adults and 48 children. All acquired malaria in Sub-Saharan Africa. In the adult cohort, median of fever clearance time (FCT) was similar in both groups (48 h vs 48 h, p = 0.19) but number of patients who reached apyrexia within 48 h (FCT48) was higher in IVA group (20/24, 83.3% vs 8/17, 47%, p = 0.002). The parasite clearance time (PCT) measure did not differ (median 48 h vs 48 h, p = 0.669). In the pediatric cohort, FCT did not differ in the two groups (median 30 vs 48 h, p = 0.50) while PCT was longer in IVA + IVQ group (median 72 vs 48 h, p = 0.002). Adverse events (AEs) in adults were more common in the combination treatment group (6/19, 31.58% vs 2/26, 7.69%, p = 0.055).

conclusionIVA + IVQ treatment did not show better outcome with respect to IVA monotherapy. AEs were more frequent in the IVA + IVQ group compared to the monotherapy. Further studies are necessary to investigate whether IVA + IVQ could be an efficient strategy to treat severe malaria cases in areas at high risk of artemisinin resistance.

Indexed as

AntimalarialsArtemisininsMalariaMalaria, FalciparumAdultArtesunateChildDrug Therapy, CombinationFeverHumansQuinineRetrospective StudiesAntimalarialsArtemisininsArtesunateQuinineArtemisinin resistanceArtesunateItalyMalariaQuinine

Identifiers

PMID35220555
PMCPMC9338132
OpenAlexW4214520467

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.