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ArticlePaediatric drugs2026

Repeated-Dose High-Dose Ivermectin Pharmacokinetics and Safety in Children with Acute Dengue.

Keswadee Lapphra, Dumrong Mairiang, Joel Tarning, Dararat Prayongkul, Chunya Puttikhunt, Adisak Songjaeng, Tanapan Prommool, Nattaya Tangthawornchaikul, Kulkanya Chokephaibulkit, Panisadee Avirutnan

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Article in Paediatric drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03432442 (Pharmacokinetics and Pharmacodynamics of Ivermectin in Pediatric Dengue Patients), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
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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.

NCT03432442 phase2completednot on this map

Pharmacokinetics and Pharmacodynamics of Ivermectin in Pediatric Dengue Patients

TypeinterventionalSponsorMahidol UniversityRan2018 to 2020Enrolled24ConditionsDengue Hemorrhagic FeverArmsIvermectin
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Keswadee Lapphra *Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Dumrong Mairiang *Molecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Khlong Luang, Pathum Thani, Thailand.
Joel TarningMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Dararat PrayongkulSiriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, 12th Floor Adulyadejvikrom Building, Siriraj Hospital, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Chunya PuttikhuntMolecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Khlong Luang, Pathum Thani, Thailand.
Adisak SongjaengSiriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, 12th Floor Adulyadejvikrom Building, Siriraj Hospital, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Tanapan PrommoolMolecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Khlong Luang, Pathum Thani, Thailand.
Nattaya TangthawornchaikulMolecular Biology of Dengue and Flaviviruses Research Team, Medical Molecular Biotechnology Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Khlong Luang, Pathum Thani, Thailand.
Kulkanya ChokephaibulkitDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Panisadee AvirutnanSiriraj Center of Research Excellence in Dengue and Emerging Pathogens, Faculty of Medicine Siriraj Hospital, Mahidol University, 12th Floor Adulyadejvikrom Building, Siriraj Hospital, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand. panisadee.avi@mahidol.ac.th.ORCID http://orcid.org/0000-0003-0053-3045

Funding

Faculty of Medicine Siriraj Hospital, Mahidol University R016136003Faculty of Medicine Siriraj Hospital, Mahidol University R016634008Faculty of Medicine Siriraj Hospital, Mahidol University R016637004Faculty of Medicine Siriraj Hospital, Mahidol University Research Excellence Development (RED) programHealth Systems Research Institute No. 61-068
6 · The paper itself

Abstract

BACKGROUND AND

objectiveIvermectin has shown anti-dengue virus activity in experimental systems, and an adult dengue trial found faster clearance of circulating non-structural protein 1 (NS1) without improvement in viremia or clinical outcomes. Pediatric pharmacokinetic and safety data for repeated high-dose regimens remain limited. We characterized repeated-dose ivermectin pharmacokinetics and safety in children with acute uncomplicated dengue weighing ≥15 kg.

methodsIn this prospective, open-label, sequential dose-escalation study, children aged 1-15 years who presented within 72 h of fever onset and met the protocol laboratory-confirmation criteria for dengue received ivermectin 400 or 600 μg/kg once daily for 3 days. Noncompartmental analyses estimated exposure and peak concentrations from intensive plasma sampling. Exploratory analyses examined associations between exposure and viremia and NS1 trajectories during the first 48 h after dose 1; the study was not designed or powered to evaluate antiviral efficacy.

resultsAll 24 children completed follow-up and experienced at least one adverse event; most events were consistent with acute dengue. Six participants (25%) experienced serious adverse events consisting of grade 4 neutropenia; all participants were clinically well, required no neutropenia-specific treatment, and showed improvement at the next available assessment or follow-up. No serious adverse event was assessed as related to ivermectin. One asymptomatic grade 1 QTc-prolongation adverse event was recorded and required no intervention. Exposure increased with dose: median 0-48-h area under the concentration-time curve (AUC

conclusionsIn children weighing ≥15 kg with acute uncomplicated dengue, ivermectin exposure increased with administered dose, while dose-normalized AUC TRIAL REGISTRY: ClinicalTrials.gov: NCT03432442; first posted February 14, 2018.

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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.