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NOT Open Access | The pharmacokinetic properties of the antimalarial combination therapy artemether-lumefantrine in normal weight, overweight and obese healthy male adults

December 4, 2021 - 20:40 -- NOT Open Access
Sugiarto SR, Page-Sharp M, Drinkwater JJ, Davis WA, Salman S, Davis TME
Int J Antimicrob Agents. 2021 Nov 21:106482

The component drugs in the widely-used antimalarial artemisinin combination therapy artemether-lumefantrine are lipophilic, with the possibility that recommended fixed doses in adults may lead to sub-therapeutic concentrations and consequent treatment failure in overweight/obese individuals with malaria. The aim of this study was to investigate the pharmacokinetic properties of artemether, lumefantrine and their active metabolites dihydroartemisinin and desbutyl-lumefantrine in 16 normal-weight, overweight or obese healthy male volunteers (body mass index [BMI] categories ≤25 kg/m², >25 to ≤30 kg/m², and >30 kg/m², respectively; absolute range 19.3 to 37.2 kg/m²).

Not Open Access | Fatal case of delayed-onset haemolytic anaemia after oral artemether-lumefantrine

November 27, 2021 - 14:02 -- NOT Open Access
Gustafsson L, James S, Zhang Y, Thozhuthumparambil KP
BMJ Case Rep. 2021 Nov 19;14(11):e245718

Artemisinin derivatives are used globally in the management of falciparum malaria. Postartemisinin delayed haemolysis (PADH) is a recognised adverse event contributing to severe anaemia. To the best of our knowledge, we report the first recorded fatal case of PADH. A 60-year-old woman presented with two episodes of collapse at home and feeling generally unwell.

Efficacy of artesunate-amodiaquine and artemether-lumefantrine for uncomplicated Plasmodium falciparum malaria in Madagascar, 2018

November 20, 2021 - 14:11 -- Open Access
Catherine M. Dentinger, Tovonahary Angelo Rakotomanga, C. Arsène Ratsimbasoa, et al.
Malaria Journal 2021 20:432, 3 November 2021

Since 2005, artemisinin-based combination therapy (ACT) has been recommended to treat uncomplicated falciparum malaria in Madagascar. Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the first- and second-line treatments, respectively. A therapeutic efficacy study was conducted to assess ACT efficacy and molecular markers of anti-malarial resistance.

Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Co-administered Ruxolitinib and Artemether-Lumefantrine in Healthy Adults

November 3, 2021 - 20:27 -- Open Access
Chughlay MF, Barnes KI, Chalon S, et al.
Antimicrob Agents Chemother. 2021 Oct 25:AAC0158421

Despite repeated malaria infection, individuals living in malaria endemic areas remain vulnerable to re-infection. The Janus kinase (JAK1/2) inhibitor ruxolitinib could potentially disrupt the parasite-induced dysfunctional immune response when administered with anti-malarial therapy. This randomized, single-blind, placebo-controlled, single center phase 1 trial investigated the safety, tolerability, pharmacokinetic and pharmacodynamic profile of ruxolitinib and the approved antimalarial artemether-lumefantrine in combination.

Novel transdermal bioadhesive surfactant-based system for release and solubility improvement of antimalarial drugs Artemether-Lumefantrine

September 23, 2021 - 08:35 -- Open Access
Volpe-Zanutto F, Fonseca-Santos B, Foglio MA, et al.
Biomed Mater. 2021 Sep 20

Artemether (ART) and lumefantrine (LUM) are the gold standard antimalarial drugs used for the treatment of malaria in children and pregnant women. Typically, ART and LUM are delivered orally in the form of a combined tablet, however, the appropriateness of this route of administration for these drugs is questionable due to the poor absorption and therefore bioavailability observed unless administered alongside lipid-rich foods.Transdermal drug delivery in the form of a patch-type system has been identified as a viable alternative to the conventional tablet-based therapy.

Efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria among children in Africa: a systematic review and meta-analysis of randomized control trials

August 18, 2021 - 16:18 -- Open Access
Dawit Getachew Assefa, Gizachew Yismaw and Eyasu Makonnen
Malaria Journal 2021 20:340, 12 August 2021

Emergence of Plasmodium falciparum resistance to artemisinin and its derivatives poses a threat to the global effort to control malaria. The emergence of anti-malarial resistance has become a great public health challenge and continues to be a leading threat to ongoing malaria control efforts. The aim of this review was to synthesize available evidence on the efficacy of dihydroartemisinin-piperaquine (DHA-PQ) compared to artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria among children in Africa.

An assessment of the knowledge, practices and resources during the delivery of malaria health care services among private health care practitioners: a cross section study in the Mid-Western Region of Uganda

August 17, 2021 - 15:31 -- Open Access
Wanzira H, Tumwine D, Bukoma P, Musiime A, Biculu J, Ediamu T, Gudoi S, Tibenderana JK, Mulebeke R, Nantanda R, Achan J
BMC Health Serv Res. 2021 Aug 10;21(1):788

Approximately 50 % of the population in Uganda seeks health care from private facilities but there is limited data on the quality of care for malaria in these facilities. This study aimed to document the knowledge, practices and resources during the delivery of malaria care services, among private health practitioners in the Mid-Western region of Uganda, an area of moderate malaria transmission.

Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia

July 13, 2021 - 14:50 -- Open Access
Maude RJ, Tripura R, Sovannaroth S, et al.
BMJ Open. 2021 Jul 7;11(7):e045900

In the Greater Mekong Subregion, adults are at highest risk for malaria. The most relevant disease vectors bite during daytime and outdoors which makes forest work a high-risk activity for malaria. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria.

High prevalence of P. falciparum K13 mutations in Rwanda is associated with slow parasite clearance after treatment with artemether-lumefantrine

July 6, 2021 - 13:43 -- Open Access
Straimer J, Gandhi P, Renner KC, Schmitt EK
J Infect Dis. 2021 Jul 3:jiab352

In Southeast Asia, mutations in the Plasmodium falciparum k13 gene have led to delayed parasite clearance and treatment failures in malaria patients receiving artemisinin combination therapies. Until recently, relevant k13 mutations had been mostly absent from Africa.

Therapeutic efficacy of artesunate-amodiaquine and artemether-lumefantrine and polymorphism in Plasmodium falciparum kelch13-propeller gene in Equatorial Guinea

June 23, 2021 - 14:06 -- Open Access
Matilde Riloha Rivas, Marian Warsame, Pascal Ringwald, et al.
Malaria Journal 2021 20:275, 22 June 2021

Artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) are the currently recommended first- and second-line therapies for uncomplicated Plasmodium falciparum infections in Equatorial Guinea. This study was designed to evaluate the efficacy of these artemisinin-based combinations and detect mutations in P. falciparum kelch13-propeller domain gene (Pfkelch13).


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