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artemether-lumefantrine

Not Open Access | Artemether-Lumefantrine Efficacy for the Treatment of Uncomplicated Plasmodium falciparum Infection in Choco, Colombia after 8 Years as First-Line Treatment

March 3, 2020 - 12:27 -- NOT Open Access
Author(s): 
Olivera MJ, Guerra AP, Macedo de Oliveira A, et al.
Reference: 
Am J Trop Med Hyg. 2020 Feb 24

Artemether–lumefantrine (AL) is the first-line treatment for uncomplicated Plasmodium falciparum infection in Colombia. To assess AL efficacy for uncomplicated falciparum malaria in Quibdo, Choco, Colombia, we conducted a 28-day therapeutic efficacy study (TES) following the WHO guidelines. From July 2018 to February 2019, febrile patients aged 5–65 years with microscopy-confirmed P. falciparum mono-infection and asexual parasite density of 250–100,000 parasites/µL were enrolled and treated with a supervised 3-day course of AL.

The duration of chemoprophylaxis against malaria after treatment with artesunate-amodiaquine and artemether-lumefantrine and the effects of pfmdr1 86Y and pfcrt 76T: a meta-analysis of individual patient data

March 2, 2020 - 15:29 -- Open Access
Author(s): 
Bretscher MT, Dahal P, Okell LC, et al.
Reference: 
BMC Med. 2020 Feb 25; 18(1):47

The majority of Plasmodium falciparum malaria cases in Africa are treated with the artemisinin combination therapies artemether-lumefantrine (AL) and artesunate-amodiaquine (AS-AQ), with amodiaquine being also widely used as part of seasonal malaria chemoprevention programs combined with sulfadoxine-pyrimethamine. While artemisinin derivatives have a short half-life, lumefantrine and amodiaquine may give rise to differing durations of post-treatment prophylaxis, an important additional benefit to patients in higher transmission areas.

A Randomized Controlled Trial of Three- versus Five-Day Artemether-Lumefantrine Regimens for Treatment of Uncomplicated Plasmodium falciparum Malaria in Pregnancy in Africa

March 2, 2020 - 14:01 -- Open Access
Author(s): 
Onyamboko MA, Hoglund RM, Lee SJ, Kabedi C, Kayembe D, Badjanga BB, Turner GDH, Jackson NV, Tarning J, McGready R, Nosten F, White NJ, Day NPJ, Fanello C
Reference: 
Antimicrob Agents Chemother. 2020 Feb 21;64(3). pii: e01140-19

Artemether-lumefantrine antimalarial efficacy in pregnancy could be compromised by reduced drug exposure. Population-based simulations suggested that therapeutic efficacy would be improved if the treatment duration was increased. We assessed the efficacy, tolerability, and pharmacokinetics of an extended 5-day regimen of artemether-lumefantrine compared to the standard 3-day treatment in 48 pregnant women and 48 nonpregnant women with uncomplicated falciparum malaria in an open-label, randomized clinical trial. Babies were assessed at birth and 1, 3, 6, and 12 months.

Differential Impact of Nevirapine on Artemether-Lumefantrine Pharmacokinetics in Individuals Stratified by CYP2B6 c.516G>T Genotypes

February 24, 2020 - 13:42 -- Open Access
Author(s): 
Abdullahi ST, Soyinka JO, Olagunju A, Bolarinwa RA, Olarewaju OJ, Bakare-Odunola MT, Winterberg M, Tarning J, Owen A, Khoo S
Reference: 
Antimicrob Agents Chemother. 2020 Feb 21;64(3). pii: e00947-19

There is an increased recognition of the need to identify and quantify the impact of genetic polymorphisms on drug-drug interactions. This study investigated the pharmacogenetics of the pharmacokinetic drug-drug interaction between nevirapine and artemether-lumefantrine in HIV-positive and HIV-negative adult Nigerian subjects. Thirty each of HIV-infected patients on nevirapine-based antiretroviral therapy and HIV-negative volunteers without clinical malaria, but with predetermined CYP2B6 c.516GG and TT genotypes, were administered a complete treatment dose of 3 days of artemether-lumefantrine. Rich pharmacokinetic sampling prior to and following the last dose was conducted, and the plasma concentrations of artemether/dihydroartemisinin and lumefantrine/desbutyl-lumefantrine were quantified using tandem mass spectrometry.

NOT Open Access | Plasmodium falciparum malaria recrudescence after treatment with artemether-lumefantrine

February 14, 2020 - 16:57 -- NOT Open Access
Author(s): 
Bourque DL, Chen LH
Reference: 
Journal of Travel Medicine, Volume 27, Issue 1, January 2020, taz082

Müller et al.1 recently described the expansion of artemisinin resistance in Southeast Asia, particularly Plasmodium falciparum kelch13 (pfk13) mutations, and its implications for the non-immune traveller.

Usefulness of day 7 lumefantrine plasma concentration as a predictor of malaria treatment outcome in under-fives children treated with artemether-lumefantrine in Tanzania

February 14, 2020 - 16:51 -- Open Access
Author(s): 
Manase Kilonzi, Omary Minzi, Ritah Mutagonda, Vito Baraka, Philip Sasi, Eleni Aklillu and Appolinary Kamuhabwa
Reference: 
Malaria Journal 2020 19:66, 11 February 2020

Day 7 plasma lumefantrine concentration is suggested as a predictor for malaria treatment outcomes and a cut-off of ≥ 200 ng/ml is associated with day 28 cure rate in the general population. However, day 7 lumefantrine plasma concentration can be affected by age, the extent of fever, baseline parasitaemia, and bodyweight. Therefore, this study assessed the usefulness of day 7 lumefantrine plasma concentration as a predictor of malaria treatment outcome in under-fives children treated with generic or innovator drug-containing artemether-lumefantrine (ALu) in Tanzania.

NOT Open Access | Artemether-lumefantrine and Dihydroartemisinin-Piperaquine Retain High Efficacy for Treatment of Uncomplicated Plasmodium falciparum Malaria in Myanmar

December 23, 2019 - 14:33 -- NOT Open Access
Author(s): 
Han KT, Lin K, Nyunt MM, et al.
Reference: 
Am J Trop Med Hyg. 2019 Dec 12

The emergence of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014–2015, we assessed the therapeutic efficacies of artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DP) for the treatment of uncomplicated P. falciparum at three study sites in Rakhine, Shan, and Kachin states in Myanmar.

Gametocyte clearance in children, from western Kenya, with uncomplicated Plasmodium falciparum malaria after artemether-lumefantrine or dihydroartemisinin-piperaquine treatment

December 10, 2019 - 08:22 -- Open Access
Author(s): 
Omondi P, Burugu M, Matoke-Muhia D, Too E, Nambati EA, Chege W, Musyoka KB, Thiongo K, Otinga M, Muregi F, Kimani F.
Reference: 
Malar J. 2019 Dec 4; 18(1):398

The efficacy and safety of artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DP) against asexual parasites population has been documented. However, the effect of these anti-malarials on sexual parasites is still less clear. Gametocyte clearance following treatment is essential for malaria control and elimination efforts; therefore, the study sought to determine trends in gametocyte clearance after AL or DP treatment in children from a malaria-endemic site in Kenya.

The efficacy of dihydroartemisinin-piperaquine and artemether-lumefantrine with and without primaquine on Plasmodium vivax recurrence: A systematic review and individual patient data meta-analysis

October 15, 2019 - 15:36 -- Open Access
Author(s): 
Robert J. Commons, Julie A. Simpson, Ric N. Price, et al.
Reference: 
PLoS Med 16(10): e1002928

Artemisinin-based combination therapy (ACT) is recommended for uncomplicated Plasmodium vivax malaria in areas of emerging chloroquine resistance. We undertook a systematic review and individual patient data meta-analysis to compare the efficacies of dihydroartemisinin-piperaquine (DP) and artemether-lumefantrine (AL) with or without primaquine (PQ) on the risk of recurrent P. vivax.

Medical Condition: 

Clinical illness and outcomes in Nigerian children with late-appearing anaemia after artemisinin-based combination treatments of uncomplicated falciparum malaria

June 8, 2016 - 15:59 -- Open Access
Author(s): 
Sowunmi A, Akano K, Ayede A, Ntadom G, Aderoyeje T, Adewoye E, Fatunmbi B
Reference: 
BMC Infectious Diseases 2016, 16:240 (1 June 2016)

This was an open label study with the main objectives of evaluating the clinical features, the risk factors for, the temporal changes in haematocrit and the outcomes of a LAA in malarious children treated with artesunate-amodiaquine (AA), artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DHP). 

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